Future of Spinal Decompression (Part 1)

Hey there, and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now. Hello, and welcome to the Practice Builders Podcast. My name is Dr. Vince Leone.

And I'm Dr. Kyle Pankinen. This is gonna be, I think, a really good topic that we're gonna talk about today. It's gonna be forward-looking, looking to the future of our favorite niche, which is spinal decompression. And Dr. Leone will give the title and we'll dig in.

Oh yeah, I'm excited about this one because, you know, if you know me, you know I love spinal decompression. So the title of this episode is The Future of Spinal Decompression. And this is part 1 because this is a big topic. And so we'll, we'll be revisiting this topic as we move along. And what's interesting, Dr. Kyle, is I've been working on our State of Spinal Decompression report that'll be coming out at the end of 2025. And we're gonna, at Specialized Practice, we're gonna start releasing this on a yearly basis at the end of each year, the State of Spinal Decompression. And we'll reflect back on the past year. We'll interview some of the decompression table manufacturers. We'll look at, you know, the marketing, the clinical. So it'll be a really great report. But For this episode, let's go ahead and dive in. And so I think we can talk about demand, some of the latest research, and we can talk about some of the advances in technology and adjunct therapies. So I think from a demand, just to dive in perspective, the latest research I've found in the United States, Is there's about 100 million people that suffer from back pain every single year, and about 8 to 10% of that is due to a chronic nature, typically a disc. So if you kind of rough that out, 10 million people every single year suffering from some type of bulging, herniated, or degenerative disc. And then on top of that, Dr. Kyle, you have 1.5 million spinal surgeries every single year. About 125,000 a month. So I think it's a positive thing from our perspective. In other words, there's plenty of these patients out there. It's kind of sad, right? Because you just intuitively know not all those people really need spinal surgery. But yeah, what are you seeing from the research side, from your perspective, on the demand side?

Funny you should ask that, Dr. Vince, because we have a brand new study out on spinal decompression where they really dig into this. And so that's one of the questions Dr. Leone and I get quite often as well. Is there a future in spinal decompression? Isn't the market getting saturated? Aren't, you know, there's more doctors doing decompression. I don't know if this niche will really work for me. And let me tell you folks, nothing could be further from— there's plenty of demand. Let me just read just 3 or 4 sentences from the latest spinal decompression study out. In the introduction, it says low back pain accounts for one of the highest incident medical conditions that contributes to disability, decreased activities of daily living, decreased quality of life, and inability to work in the United States and worldwide. In fact, of all diseases and injuries that contribute to disability-adjusted life years in the United States, low back pain ranks 3rd. It affects 70 to 85% of people during their lifetime. Here's the kicker, docs, with approximately 20% becoming chronic in the age 20 to 59 Your range. Low back pain has been the leading cause of disability for numerous decades. And it says finally, furthermore, many chronic musculoskeletal patients, especially with low back pain, do not respond to surgery and many develop dependence on opioids. So if you think about that, 20%. So it's— you'd mentioned 10%. It's actually the latest studies are up to 20% of these turn chronic.

Percent. Wow. Wow. And, you know, when you have a condition that is taking people out of work and reducing their ability to earn a living, and you're worried about someone, you know, having the desire to do it, I mean, good Lord, there is no bigger desire than your ability to provide, right? Your ability to earn a living. And that's not even talking about or considering The subsequent effects. So, not only not being able to earn a living, right, but being able to— or not being able to have the self-esteem that goes along with the confidence, that how that affects your relationships with your spouse, with your kids, with your friends. I mean, I know this myself just because, you know, in 2015, I had a zipline accident that resulted in a pretty significant disc and a compression fracture, and it It had a massive toll on my life. So, um, I think we can put to bed or to rest once and for all that there is more than enough demand for spinal decompression or non-surgical treatment of a disc. And it's just a matter of being able to, A, have the clinical acumen and the tools to actually heal somebody, and then being able to Reach them and let them know about who you are and what you do.

Yeah, never gonna run out of demand. It's a never-ending stream of patients. People already equate chiropractic with back pain, so you're— we're working right in our wheelhouse here. And if you have this technology with a good clinical protocol, a clinically excellent doctor, This is just a— it's a no-brainer that this is gonna be something that you can add to your clinic if you're not already doing it, or if you are doing it, to grow it even further. And we obviously think it's the way to go in clinical practice.

Oh yeah, 100%. So the demand is there, obviously. And we knew that, right? So we're just reiterating what we believed for years. Some of the research is catching up And that is painting an even clearer picture of the volume. From a technology standpoint, what do you think and what are you seeing in the marketplace? I know you have obviously quite a few lasers, you've invested in shockwave. What are your thoughts on, from a technical— technology standpoint, to help these doctors deliver even better results with these patients?

Yeah, I, I personally think as a chiropractor, having been in practice 25 years, this is the most exciting time I've ever seen to be a chiropractor.

Mm-hmm.

Because when I first got into practice, you had, you had your adjustment table, you had your little handheld ultrasound machine, and you had your, your interferential electrical stim machine. And maybe some doctors, if you're really cool, had a little intersegmental Traction table or something.

If you're really cool.

If you're really cool, that will— and now, now, wow, we have Class 4 deep tissue robotic laser therapy. Yeah, we have these, we have these world-class shockwave devices, and the technology of the decompression tables has also really advanced from the original one back in the late 1980s, the Vax-D, to now what we have today with tables that are controlled by computers and actuators and sensors and the ability to capture the spine in such a way that we can target specific disc levels and change angles on tables. It is, it's an exciting time to be a doc. And when you marry a good decompression table with good technology behind it and good training with some of this latest therapeutic equipment such as laser and/or shockwave, you got a win-win, you got a home run, and you're going to help a higher percentage of patients than you could ever before.

Yeah, and on top of that, um, you know, Laser, shockwave, like that's common knowledge and, and, you know, things that we talk about from a chiropractic standpoint. But if you talk to, say, a medical doctor or a physical therapist, I would venture to say less than 10% of those professions have these therapies in their clinics. They, they don't know what deep tissue robotic laser even is or versus what it does. Right? They don't know what spinal decompression does or how it serves these patients. They really don't on a widespread basis. Maybe some of the younger doctors, younger MDs, younger PTs. You got to remember, the way these doctors are trained, it's very different, very, very different than what we and how we are trained.

Right.

You know, is it better? Is it worse? I mean, I don't really want to say that. It's just different, right? It's just different. And chiropractors, by and large, are early adopters. So when you think of this opportunity and these advancing technologies to bring them into the clinic and get results when you would never be able to get the results— like, look, we, we love the adjustment. There's, there's no getting around the adjustment's amazing. Um, but we have got to evolve with the times. And patients are evolving and they are demanding, you know, they want to get better as fast as possible, right? And by and large, they typically want to avoid surgery, right? Who wants to go have surgery? I don't think anybody wants to have surgery, right? So I think from a technology standpoint, I totally agree. This is an extremely exciting time to be in practice, to have these tools that are readily available to us, that we can help conditions that we just never thought we could help before. I mean, it's, it's, it's wild. Hey there, it's Dr. Vince, and if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And if you know another doc who's ready to grow their practice, share this with them. It might be exactly what they need right now. Thank you in advance, and now back to the show.

Yeah, it is so great. It's— it— and you can quickly distinguish yourself from your competition By just embracing this modern technology. Even, even if, you know, you're a chiropractor and you're adding this technology, it's not like if you're in a city of 10 or 12 or 15 or 20 chiropractors, realistically there's probably only 1 or 2 others that have this technology.

Mm-hmm.

And so you're gonna differentiate yourself from the chiro down the road, definitely from the physical— local physical therapy department. And, but the demand for these high-end therapies, shockwave is kind of the new kid on the block. And we are starting to see patients come in, are asking, do you have shockwave therapy?

Really?

Yep. And so that there is that, and the technology and the research behind it is really exploding in the positive direction. And so that's a, that's a bandwagon, I think, doctors should jump on if they haven't already is to embrace that technology. Laser's been around a while. The technology keeps getting better with it, and laser is tremendous. I'm a big fan of laser. I have 6 lasers. But shockwave is the new shiny bright object, the new kid on the block, and, uh, it's a— it's something that's not a flash in the pan or a fad. It's, it's here to stay. Yeah, just like laser is.

Yeah, 100%. Um, and then just shifting then to the training, I feel like— and honestly, Doc, this is, this is why I started Specialized Practice— is because I felt that there was a real dearth in our industry for like comprehensive and, um, extensive training, right? Essentially continuing education. On spinal decompression and the disc. Now, are there— is there training out there for, you know, MRI and disc? Yeah, absolutely. But specific to decompression, I mean, there, there is not a ton of companies out there that literally specifically train you on being an expert in spinal decompression. And that's why I formed this company. That's why we've, um, have launched the Decompression Accelerator so that we can ramp up doctors very quickly into this niche and turn them into a true expert. That's why we started the summit 3 years ago, right? With— and the reason why the summit started was because there was a gap in the marketplace, right? There was the existing, you know, seminars on decompression were by and large just a lot of fluff and sales. That's why, why we started the summit, because we wanted a clinically focused seminar that was focused, you know, all in on, hey, how do you get the best results with your decompression table? And how do you differentiate yourself? How do you position yourself? How do you market yourself? That's why we started the summit, right? That's why it's been so successful. Now we've had 3 years. We just wrapped it up in September. Got the— already put the deposit on the hotel for next year, September 26th, 2026. It's going to be even better. We're going to actually elongate the, uh, the seminar to 2.5 days versus 1.5 days. And so, um, I think, you know, in my opinion, the good doctors, you know, they've been in practice for 20, 30 years. They don't want to offer a service that they don't feel confident that they can deliver the results, right? By and large, doctors are highly ethical, and they don't want to just take someone's money if they can't deliver the clinical outcome. So that's kind of what I'm really excited about is, you know, positioning Spinal Specialized Practice as the de facto leader in spinal decompression education so that we can have great doctors in our— in the United States that are delivering outstanding care.

Yes. And the Decompression Summit is delivering on that. In my opinion, it's the best training that is available in our profession for really honing your clinical skills, marketing, research. It all comes together in that summit to produce a beautiful thing. And that's why we get so many great reviews. Doctors say that if not— if it's not the best seminar they've ever been to, they say it's in the top 2 or 3 ever. And these are doctors that have been, like you said, In practice, 20 and 25 and 30 years. And so the other thing I would say about this is when you're choosing— if you're new to the world of decompression, you're thinking about getting a table— make sure you get it from a table manufacturer that also is going to provide you some degree of training. In other words, don't just get it from a company that's literally going to ship the table to you and say good luck.

Ah.

And, uh, because we have doctors in our group that we've worked with over the years that literally that was— that they didn't really get any training. And so the beautiful thing is though, now, hey, we have the summit, we have specialized practice, we have this— all this new research coming out, and we can get a doctor up to speed like with the Practice Accelerator literally in about 3 months and they are off to the races and growing a decompression practice. And it's a beautiful thing to see some of these doctors and how much progress they can make in such a short time.

Yeah, I mean, it's— there's no substitute for, for, you know, your network, right? When you're around, you know, experts that either are currently doing it like Dr. Kyle or have done it in the recent past, myself, and then you're with And among other doctors that are doing the exact same thing that you are, growing spinal decompression, sharing best practices, wins, what to avoid, challenges that they're facing and then overcoming, having, you know, clinical Q&As every single week, having business Q&As every single week. There's just no substitute. I mean, if you're wondering if you're stuck and you're wondering, well, why am I stuck? Well, if you're on an island, And trying to kind of figure it out on your own, that's probably why you're stuck, right? Because you're not tapping into, um, you know, the resources that are out there. Um, and Doc, there's still doctors out there that don't even know that the research supports 24 visits as the minimum viable dose. Talked to a doctor the other day. He's been offering decompression, by the way, very successful practice overall. Um, he's been offering decompression for years, 15 years. He didn't know that the research supported 24 visits. It's like, well, come on. I mean, if you're gonna be an expert and charge people money and, you know, position yourself as such, you gotta at least do the basics. You gotta know, because the table manufacturers don't really, I mean, some do and some don't, but, you know, that's not, they're not clinicians. I mean, they're table manufacturers, right? So while I totally agree that there are some that are better than others in terms of like the support that they provide and the clinical support that they provide. By and large, that's their job is to sell you a table. At the end of the day, their job is to sell you a table. They're not— their job is not to turn you into a spinal decompression expert. So that has to go on you. I always say, got to make 2 investments. First one, table. Second one, yourself. Ideally, you flip it. You invest in yourself. in the training, in the systems, in the enrollment, and get prepared. And then you get the table. That's how I've seen it work the best.

Yeah, and I would just add to that one brief thing. I literally just finished talking to a doctor about an hour ago, and that is a new client of Specialized Practice, and that's what he said. I've been doing decompression for a few years, but you know, I really don't know the— how this works. I, I need to know it In, in my head and have confidence that this really works and what the research shows. And, and I need to rub shoulders with other doctors that are doing this successfully so that I can gain confidence and really recommend this at a higher level to my patients. And, you know, that's where he's going to get— he's going to get in a group of doctors that are doing this and learning together and growing together. And the synergy of that is, uh, is a beautiful and tremendous thing. And, uh, so I'm excited for this doctor's future.

Yeah, and so the future is bright. I mean, I think that's the gist of this podcast, is the future with spinal decompression is very bright. Um, it's a phenomenal, um, additional lane of service that you can either add or grow within your practice. And, um, you know, I, I kind of almost feel like we're just getting started. You know, we had this big spike in the late '90s when the, you know, Axiom came out with the DRX-9000. And, you know, while it's a good table, they, you know, they got in trouble with some of their marketing efforts. And so I feel like it kind of— it spiked and it pulled back. But I feel like we're on the uptrend right now of, you know, implementation of this lane of service. And I think it's, uh, it's just a, you know, it's a really exciting time to be in practice.

Yeah. This is gonna grow, this is gonna mushroom. And one of the things we'll talk about in part 2 is the research component of this. As I follow it pretty closely, the research is really starting to ramp up, not only in the United States but other countries. And so we're— that's gonna fuel the growth of this. So we'll dig into that more next time. We'll whet your appetite.

I'm looking forward to it, Doc. Uh, okay, well, that's gonna wrap up this episode. The Future of Spinal Decompression, Part 1. Thanks for joining, and we'll see you all on the next episode. Hey, it's Dr. Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients, then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support. And it's all guaranteed. Spots are limited. Head to www.decompressionaccelerator.com to learn more.