Chiropractic offices are common. Chiropractic offices that talk openly about decompression — the traction table many of them own but few explain well — are not. Mark Anthony sat down with Dr. Chet Barton, DC, to ask a simple question: if chiropractic adjustments already exist, why do so many patients with disc and nerve pain need something else entirely?
Barton graduated from the University of Florida and has been a chiropractor for about 15 years, specializing in decompression therapy almost from the start. He runs a solo practice inside a personal training gym in Winter Park, a suburb of Orlando, without administrative staff — he handles intake, exam, and treatment himself, often spending one to two hours with a new patient before deciding on a course of care.
Key Takeaways
- Decompression is a form of spinal traction delivered by a computer-controlled table that gently pulls the spine in a wave-like pattern — it targets disc and facet joint problems in the cervical and lumbar spine, not the thoracic spine.
- It works partly by loading the spine in the axial plane, a direction of movement people rarely get anywhere else in daily life besides sleep — regular exercise and adjustments happen in the coronal, sagittal, and transverse planes instead.
- Muscle spasm is the main side effect, more common on older cable-and-pulley tables; Dr. Barton uses a sensor-based Hill DT table that automatically eases off if a patient moves, and treats spasms in-office with a vibration plate.
- He's openly skeptical of chiropractors marketing stem cells, exosomes, and light therapy for joint and back pain, and says shockwave ("softwave") devices are often sold well beyond their actual FDA-approved use.
- Roughly 66-70% of disc herniations resolve on their own; for the rest, his approach is a defined, evidence-based course — typically 6 to 12 sessions — rather than the 24-to-36-visit plans he says some clinics push.
What Spinal Decompression Actually Does to the Spine
Barton described decompression as traction "since the stone age" — what used to be called the rack — modernized with what he called sinusoidal wave movement, driven by computer algorithms. A patient is held in static traction while the table gently waxes and wanes, rather than pulling with constant force. It can be done in the cervical spine or the lumbar spine; the thoracic spine, he said, generally can't be decompressed the same way.
He pointed to two specific mechanisms. First, decompression improves what he called fluid discal shift — for a herniated or bulging disc, the table changes the mechanical environment enough that the body has a better chance of resorbing the disc material on its own. Second, for facet joint problems — facet hypomobility, hypertrophy, or "facet syndrome" — decompression gets those planar joints "gliding like they should" again.
"We move in the coronal, sagittal, and transverse planes just fine — daily movement, exercise, adjustments, all happen in those planes. Decompression adds that fourth plane of movement, which we don't get anywhere else, and it's phenomenal for you."
— Dr. Chet Barton, DCWho Needs It, What to Expect, and Why Spasms Happen
Barton said most people can benefit from decompression, but the clearest candidates are patients with back or neck pain, radicular pain running down a leg or arm, or chronic pain that waxes and wanes. Some patients use it proactively rather than reactively — he described a landscaper who comes in once a month purely for decompression, with no adjustment involved, as maintenance. It can also be scheduled the same day as an adjustment when a fuller care plan calls for it.
Muscle spasm is the main side effect, and Barton was candid that it used to be a bigger problem: older cable-and-pulley systems like the DRX9000 and older Chattanooga-style tables allowed for mechanical slop and human error, which increased the odds of a spasm afterward. He now uses a Hill DT table, built on actuators and sensors that automatically back off if a patient coughs, sneezes, or moves — reducing, though not eliminating, that risk. When spasms do occur, he addresses them in-office with a vibration plate, a neuromuscular re-education tool, along with light stretching and movement. Decompression isn't suitable for a spine that has been surgically or congenitally fused, or for patients with osteoporosis.
On dosage, Barton said the research supports roughly 6 to 12 sessions, and that historically decompression has gotten patients better "nine times out of ten" — a success rate he put at 80 to 90%. He was critical of clinics that sell 24-to-36-visit packages upfront, calling that approach "more of a money grab" than good practice, since no one can accurately predict where a given patient will be weeks out. He described a 78-year-old patient with arthritis and radicular pain down her left leg who did an initial 12 sessions without major improvement; rather than move to an MRI or an injection, she chose to continue, and her pain resolved by roughly the 15th or 16th visit, returned briefly, and was gone again by visit 18. In another case, a patient with a disc herniation from 15 years earlier — which Barton noted falls into the roughly 30-34% of cases that don't fully self-resolve — returned after a flare-up and was prescribed eight sessions.
Why He's Skeptical of Stem Cells, Light Therapy, and "Softwave"
Barton was direct about where he thinks the profession oversells. On light therapy, he said the evidence suggests it doesn't penetrate past the skin and, at best, reaches surface muscle — not the kind of joint rehab some clinics imply. On stem cells and exosomes, he noted there isn't a single FDA-approved exosome treatment for any condition, and that stem cells are approved primarily for wound care — burn victims and patients healing from procedures like mastectomies — not for injecting into a painful knee or back. Paying "five, six grand" for a stem cell injection without clear supporting research, he said, is often "buying hopes and dreams," with any improvement likely driven by placebo effect or by whatever other therapy the patient is also doing.
He drew a similar line around shockwave devices marketed as "softwave": the technology is FDA-approved specifically for second-degree burns, he said, but some clinics apply it broadly to plantar fasciitis, tennis elbow, and back pain without evidence that shockwave itself — rather than the rest of the care plan, or the fact that most back pain resolves within about two weeks regardless — is what's producing the improvement. He also cautioned against leaning on individual success stories, referencing well-known one-off chiropractic anecdotes, and said isolated cases don't establish that a treatment works broadly; what matters, in his view, is the cumulative direction of randomized controlled trials. By contrast, he pointed to chronic and acute low back pain, neck pain, and headaches as conditions where chiropractic manipulative therapy and decompression do have solid research behind them.
Movement, Sleep, and When Conservative Care Should Come First
For all his focus on decompression, Barton kept returning to what he called the four biggest levers in health: evidence-based therapeutic exercise, nutrition, sleep, and mental health — bigger, he said, than any passive treatment a clinic offers. He specifically cited the benefit of two non-consecutive resistance-training days a week as outsized compared to most modalities patients pay for. His view: when a patient isn't addressing those fundamentals, "you're stepping over dollars to pick up pennies."
He also touched on insurance and coverage: insurers typically cover chiropractic adjustments and will often authorize an initial block of 6 to 12 visits before requiring proof of ongoing medical necessity for more, which he said tracks with what the research actually supports. Barton said he isn't anti-surgery — there's "a time and place for meds, time and place for surgeries," in his words — but believes conservative options like decompression and adjustment deserve a real trial first when there are no red flags pointing to something more serious.
