Search "spinal decompression" and you'll get three completely different things dressed in the same words: a surgery, a motorised machine, and a $200 inversion table on a marketplace site. They are not interchangeable. Here's what each one actually does, and how to work out which conversation you're having.
The one thing they have in common
Between two vertebrae sits a disc, and either side of it, a gap the nerve root travels through. When a disc bulges or loses height, that gap narrows and the nerve gets crowded — which is why a problem in your lower back can be felt as pain down your leg. Every method below is trying to solve the same geometry problem: make more space.
Where they differ is how much control there is, who's supervising, and how targeted it is.
1. Inversion tables
You strap in by the ankles and tip upside down. Gravity pulls on the whole spine at once. It's cheap, it's available, and for some people it genuinely feels good in the moment.
The limitations are worth knowing. There is no targeting — the pull is applied to your entire spine regardless of which level is the problem, and the segment that's already too mobile gets stretched just as much as the one that's stuck. There's no supervision, no assessment, and no way to know whether you're helping or aggravating.
There's also a safety list. Being inverted raises intraocular and intracranial pressure, so it's generally not appropriate with high blood pressure, glaucoma, retinal problems, heart conditions, or during pregnancy. If you already own one, that's fine — but it's not a substitute for finding out what's actually wrong.
2. Motorised decompression tables
These are the branded machines — you'll see names like DRX9000 or Triton advertised. You're harnessed to a table and a motor applies a programmed cycle of pull and release to a region of the spine, usually over 20 to 30 minutes, across a set course of sessions.
The strength is consistency: the machine does exactly the same thing every time, and the protocol is repeatable. The trade-off is that a preset program can't respond to what your spine is doing on the day. It also tends to be sold as a fixed package of sessions, which is worth asking about before you commit.
We don't use one at Uprise, and we'd rather say so plainly than let a brand name do the selling.
3. Doctor-controlled flexion-distraction
This is what our decompression is. You lie face-down on a segmented table whose lower half drops, flexes and lengthens in slow cycles while the chiropractor keeps a hand contact directly on the vertebra being treated. Each cycle takes a few seconds; a session is several short sets.
Because the depth, angle and level are set by hand, they can change mid-session in response to what the tissue is doing. That's the part a motor can't do. There's no thrust, no twisting and nothing cracks, which is also why it suits acute flare-ups, older patients, and people who simply don't want to be adjusted in the traditional way.
It's not magic and it isn't right for everyone — but it is targeted, supervised, and adjustable, which is more than the other two non-surgical options can claim.
4. Surgical decompression
A discectomy or laminectomy physically removes the tissue crowding the nerve. It's a real operation with real recovery, and for the right person it's the right answer — particularly where there's progressive neurological loss, or severe nerve pain that hasn't responded to a genuine trial of conservative care.
Guidelines generally recommend trialling conservative care first for uncomplicated disc-related pain. That trial should be actively managed and measured, not "wait six weeks and see". If you'd like the longer version of that argument, we wrote it up in do I need surgery for a disc bulge?
So which one?
If you have red-flag signs — bladder or bowel changes, saddle numbness, progressive weakness, both legs involved — none of the above. That's a same-day medical assessment.
Otherwise, the useful order is: get assessed, find out which level and which nerve, trial targeted conservative care with someone measuring whether it's working, and keep surgery in reserve for if it isn't. Buying a table off the internet skips the only step that actually tells you what you're dealing with.
We're in Byford, inside Byford Medical Centre, open seven days including evenings and weekends. HICAPS on-site, no referral needed. Book online in under a minute and we'll start with the assessment.