Spinal Decompression Report Review - 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 am Dr. Kyle Pankinen. And we're back together. The team is back. We're gonna deliver a great podcast today, Lord willing. And we're really excited about this because this is gonna be a unique thing to our profession. What Dr. Leone has put together, I think, is a gift to our profession, and the work and talent behind it is really something. And so I'm gonna let him introduce What this is, but I think you're going to be excited about it.

Yeah, well, thank you very— thank you for the kind words, Dr. Kyle. Um, and today we are going to discuss the State of Spinal Decompression 2026. So this is a report I put together. If you're watching on YouTube, it's a little blurry, but I'm holding it up. Probably not great for radio, but the point being is this is our annual report. So it's actually 2025-2026, so we're looking at Benchmarks, insights, and predictions for the growth-minded chiropractor focused on spinal decompression. So in the introduction of it, basically what I talk about is, you know, in my opinion and experience, decompression up to this point has been frankly it's been a little loosey-goosey. In other words, some doctors are doing ten visits; some doctors are doing six at a time; some are doing twenty. 24. Some are adding lasers, some are not. Some are doing shockwaves, some are not. And so, the whole kind of goal at Specialized Practice is to professionalize decompression. If you think about, say, a knee surgeon and they're going to do an MCL, they're not turning to their buddy and say, hey, how do we do that again? Do we just do this or do we do this and that? It's like, no, no. They have a specific protocol that they follow every single time. Right? And the vast majority of your patients with a disc fall into the same categories, right? They're moderate to severe. They have a bulging, herniated, or degenerative disc. And so what we want to do again is kind of systemize and professionalize decompression so that we're using proven protocols. We're using market research and published research so that we can deliver consistent and really great clinical outcomes for our patients. And The State of Spinal Decompression Report was my version of that to give to the industry so that you understand and can see, well, where are we at now in terms of the maturity of this particular niche in our profession? And this is— I mean, traction's been around forever, right? Decompression's been around for quite some time too, but let's just call it 25 years, right?

Yeah. Right.

You know, some say, you know, somewhere some docs were using it in the mid-'90s. I think the DRX came out '05-ish, but let's just say we're somewhere around 25 years into this particular lane of service. And what we want to do here is share with you what the information, the research that I've found, and then obviously give you the opportunity to get ahold of this report if you are interested. Dr. Kyle, we're going to start with— so Chapter 1 is obviously Letter from Myself. Chapter 2 is the State of the Spinal Decompression Report. So what I found really interesting is if we look at year-over-year adoption of decompression in chiropractic practices, it's growing at 4% a year. And if you look at the trend, By 2031, um, you know, it's all going up right now. That's good news and bad news, I think, for doctors. What, what is your opinion on that, Dr. Kyle?

Well, it's good news in the sense that if you— there's plenty of people out there that need it. And it's good news because if you can adapt the— adopt this therapy into your clinic, it's going to sets you apart right now. But as more and more people adopt it, you may have a little competition. So then you have to think about what is going to differentiate you from your competition.

Mm-hmm.

And that's where it comes down to big time, correct, good protocol, clinical competency, world-class exam. A great supporting staff around you to implement this. Those are the clinics that will not just have a table, but they'll have a system in place and the training and the knowledge and the wherewithal to implement that. And that's going to help them to stand out from their competitor down the road who just simply has a table and, oh, we occasionally throw a person or two on that and do a few sessions. of decompression. And so there's plenty of people to go around as far as you're never going to run out of back and neck pain cases to do decompression. That's not the issue.

No.

So that should never scare you away from embracing this technology. But those doctors that really go all in on the implementation of this and really learn and become a master of it, those are the ones that are gonna Really do well.

I think that's an excellent point because what I think to summarize all that, it really comes down to mastery, right? Are you going to be a true expert in decompression? It's something that we've talked about this entire time we've been on this podcast and for years since I started the consulting company is like, we need true experts in disc and decompression versus someone just dabbling. And, you know, I talked to a doctor yesterday and, you know, had a fairly successful practice and has had a table for like a year. And he's like, yeah, you know, just, you know, put someone on once in a while. It's just like, you know, that table will gather dust. And so, you know, if you think like as you move forward in the future, as the adoption continues to grow— now, why is it growing? It's because patient demand. Right. And we'll get into that in a second. But as adoption continues to grow, your competition will become greater. Now, the best way to cut through the noise and beat competition is mastery, right? Because if someone, a patient walks in and they can see it's truly a decompression clinic and there's signage and there's systems and there's Training by the staff. You can see that the staff is knowledgeable about it. The examination, like Dr. Kyle said, is world-class. The presentations are clear and based on research versus they walk into a clinic that looks like every other clinic and they, you know, get kind of a perfunctory exam to be polite. And the, you know, the doctor says, well, you know, we'll start you out, you know, for 6 visits and we'll see how it goes. Yeah, that guy's gonna lose. There's no kind of no two ways about that. So that's what we don't want. That's what we don't want for everyone listening to this podcast. We want you to move into that mastery category. So patient demand, let's just talk briefly about that. So every single month, there's 125,000 spinal surgeries across the US. So that's 1.5 million a year. That's just people getting the surgeries, right? That's not all the people considering getting the surgeries. So, and by the way, I'm not trying to throw rocks at surgeons, right? Surgeons are excellent at what they do. They're obviously very well trained, but they're, you know, like healthcare, they have a success rate and a fail rate, and they're not there to fail, right? Most of these guys are like friggin' alpha males who are so driven, you would have no clue. These guys are crazy driven, right? So, they're not there to fail. They want to succeed when they work on patients, but the reality is they don't. And some people, a lot of people, they want a nonsurgical solution. So, that's where we come in, right? We're not trying to, like, again, it's not my opinion to throw shade on other healthcare providers. That's not the point. The point The point is that there is patient demand for a non-surgical solution, and chiropractic ain't it, guys. I'm sorry to tell you that, but it is not it for disc. Neither is PT, massage, drugs, injections, etc. It's decompression.

Yeah, America has more spine surgeries than any nation on the planet, and the only reason they find from studies is because we have more surgeons, not because we have more Spine conditions than necessarily other countries. And so people are really seeking non-surgical options. And statistics show a first-time surgery, depending on the study you read, has anywhere from a 10 to 46% failure rate. So that means probably it's somewhere in the middle. So 20-some to maybe close to 30% of these people, they're failing. And these statistics are out there. People can research and look these things up. And I, I can't tell you how many patients I've talked to. Oh yeah, I talked to my neighbor, he had back surgery, didn't work for him. Or I talked to my, my, my, my brother had spine surgery, it made him worse. And so people know these things. They, they talk to their friends, their family, their neighbors, and they hear these stories and they come in like, that's the last thing I want to do, doc, is have a back surgery because I know It doesn't work in a lot of cases. And so all this information is out there available to people if they just look it up or talk to people. And so they come in and they're like, Doc, whatever it takes, I want to avoid surgery if at all possible. What do you got for me? And so doctors that are embracing this technology— this is one of the best times right now to be a chiropractor because we have this technology and we can help The majority of these people, and the studies out shown 85 to up to 93% success rate in that range of these people, and most of these people we're treating would be potential surgical candidates if the decompression does not get them better. So how many people are we saving from surgery? It's a lot, I think.

Yeah, and again, when you talk about patient demand, I mean, every single year there's about 100 million people that suffer from back pain. So this is general back pain, right? This isn't disc conditions. This is just general back pain. Woke up wrong, did too much over the weekend, that type of thing, that type of back pain, your common neck and back pain patients. About 8 to 10% of that, so 8 to 10 million people per year, is due to a chronic issue, bulging herniated degenerative disc. Those are our patients, right? And so when you Now, this may make sense for you if you're doing marketing. You're like, well, why don't I get all my discs? Like, why don't I— I'm supposed to be running decompression ads. Why don't I get all disc patients? Well, because patients, they don't necessarily know, right? They don't know that they have a disc. They know they have back pain. So they see an ad for back pain or whatever. So they're going to respond. And the good news is, look, if they're— if you do a world-class exam, you're going to have the utmost confidence what the primary pain generator is, like Dr. Kyle teaches. And then you can then sift and sort. Hey, this is a chiro patient, this is a disc patient. We want to, we want to help all of them. Obviously, you know, we would like more decompression patients, but we don't want to discard chiropractic patients. I mean, that's the base of your practice, right? That's what you're there for. And if you have an associate, even better, right? You just fill him up. So, um, the, the numbers support growth, um, but again, through mastery. So. Now, this is interesting. Typical patient journey before finding decompression, um, usually medications, right? You're going to take some Advil, um, you know, maybe you get some muscle relaxers from your primary care physician. Um, again, if we're only treating, what, 8% of the population, Doc? Is that kind of what it is these days, something like 8 to 10%?

8 to 10, 8 to 11, right in that range.

Yeah, so where's the other 90% going? To their medical doctor, right? Or Amazon or ChatGPT. And they're just going to, you know, do the lowest barrier things first, which is Advil, Tylenol, right? That's your meds. That's a first. Then they go usually to physical therapy. Why? Because they go to their medical primary care physician, right? They go to their MD and the MD starts with meds. And/or they'll say, okay, go see your PT, and this, and then they send over the PT. That's why PTs have no problem with new patients, because they have 90% of all neck and back pain patients coming into them through their PCP, right? So PTs and chiros are different in that regard. They have no problem with new patients. Then chiropractic care. Finally, we get to chiropractic care, and then a surgical consult when Chiro fails, um, and sometimes the whole chiropractic thing is skipped, right? But then they have the surgical consult, and now they're in that awareness model that Dr. Kyle talked about where they're like, gosh, maybe I, maybe I don't want to do this, right? Um, and then they start looking for alternatives, non-surgical alternatives, and that's where we come in. So, um, we talked about pricing landscape, Doc. What In your experience talking with our doctors, what is the range on what doctors charge for care plans?

Yeah, so the lower-end ones are gonna be a little above $3,000 and the higher-end ones are gonna be $6,000 to $7,000. So you're probably, your average doc out there is probably $4,500 to $5,000, right in that range somewhere. And if you think about it, docs, do you need 25 new decompression patients every month to really make a sizable shift in your practice? New. If you had 3, if you had 5, if you had 10 cases a month, that's, say, $5,000 apiece on average. That's life-changing for doctors from a financial point of view. And these are people that you're also gonna be rewarded with not only financially, but you're gonna, you're gonna change their life in more times than not. Where their quality of life, their pain, their job performance, their activities of daily living, things are gonna improve. And you're gonna, in many ways, give that patient their quality of life back. But that's the general range that we're seeing out in the field. Smaller, more rural areas like I'm a little bit on the lower end of that. And then, you know, the bigger urban metropolitan areas are a little on the higher end of that. And then you got a lot of middle America that's, You know, right at that $4,000 or $5,000 range.

Yeah, and I, I'm not crazy about the, you know, $10,000 to $14,000 price points. I was talking to a client, he's in Burbank, California, and there's a doctor down the, um, uh, I don't know if it's down the street, but certainly within 10 minutes, and she's charging $12,000 to $14,000, um, for a decompression plan. I don't love that. Because I feel like it's pricing too many people out. Yeah, are they in a wealthy area? They are. I don't think that that really means that you necessarily should go that high. I do think your area does dictate what the price should be 'cause there's cost of living to factor in. In other words, if an average house in, In Southern California, it costs $1 million, and in Dr. Kyle's neighborhood, it's $500,000. Well, yeah, then that does make sense to increase the price point. But I do think going to $12K to $14K is a little outside of what I think is acceptable personally. I think for most doctors, $4K to $6K is a really fair price range. Our North Star is always on a budget of around $2,000 a month on ad spend, $2,500. We'd like to get 5 starts, you know, um, and 5 starts for, you know, at $4,000 to $5,000, that's $20,000, $25,000 a month. Hey, you can live on— you can live on that, right? And that's again not including any of your chiropractic or laser or anything else that you're doing. That's just the decompression.

Yeah, it's easy to— a lot of our— I just talked to a client of ours just an hour or two ago, and he looked at his February of last year, before he was a client, before he started decompression, and this February of this year, not even done with the month, we're at February 20th here, he's quadrupled his practice. And he just, and he just started. He was at $11,000-some a month last February, which is pretty low. He's at almost $40,000 to $50,000, and the month isn't even done yet. And almost all that has been Decompression. He's signing on 3, 4, 5 new decompression cases every week as of late. He's just on fire, this doctor is.

Yeah, and I know who you're talking about. He's, he's, he is on fire.

Yeah, he's talking to me about, you know, I gotta add more staff and I need help and I, I'm hooking up these people by myself and this is crazy. And all the whole point being, I mean, it's not like he's seeing It's not like he's had to increase his volume of chiropractic where he's, oh, I gotta add 100 extra patient visits a week. These are just— these are decompression cases. That's what— that's what the growth is. And this is— it's a cash-based thing.

Mm-hmm.

And, uh, that's the beauty of it. And even if he was only doing, you know, 1 new case a week and got 4 or 5 a month, that's still life-changing for a doctor if that's at $11,000 a month and now suddenly added $20,000 more a month. Uh, but this guy's doing, you know, almost $30,000, $40,000 more a month. So—

That's wild.

Wild is right.

Um, and, you know, some doctors will say, well, gosh, it's not covered by insurance. You do not want this covered by insurance. Um, the day that this becomes an insurance service is gonna be a bad time for decompression, in my opinion, because then they dictate what we can charge, right? So right now we can dictate what we charge. And as long as we provide the value, the patient will pay it. There's tons of insurance fatigue right now. People pay so much for insurance. They know it just, you know, it's overpromising and underdelivering right now, insurance is. So we all pay a lot for insurance. It never covers everything that we want. People understand that. You just— it's a messaging and it's a communication skill set to get past that. But it's not rocket science, right? Once you get it down, once your staff gets that down, they can talk to patients very easily about what is and what isn't covered. I still think all practices should take the good insurances. Usually there's always several good insurances, you know. Obviously, there's tons of bad ones, but I like to take, you know, the good insurances because then we can serve people through chiropractic that way. But also, you know, when patients call in, do you take insurance? Yeah, we do. You know, is this covered? Depends what the doctor recommends. You know, is decompression specifically covered? No, typically not. I mean, we'll always call your insurance, but typically it's not.

I have found that people, if you take insurance and you're offering them a decompression program, And you sometimes itemize out, okay, we're gonna do some chiropractic in your protocol. If there's even something in their protocol—

Exactly.

That their insurance covers a small part of it, they're much more apt to say yes to it than if the insurance covers none of it. And, uh, that we've just found a higher acceptance rate in our own practice with that. And so I agree, I don't think we want to completely I've seen doctors, I know 2 of them very well, that went all cash, and it takes a really exceptional, exceptional doctor with tremendous people skills and talents to consistently month after month after month produce on that. Where insurance, for the average everyday guy like me who's, I might be okay with people skills and stuff, but— To the energy that it takes to maintain that cash practice is tough. But if you have a nice blend of some insurance with all these different cash services that we teach, that's a winning formula.

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. I think I know who you're talking about on the, on the all-cash one. Um, and he is a big personality and he does very well, but he always talks about how it's an all-cash practice and how much harder it is. And so, and, and he is, in my opinion, the exception, not the norm when it comes to Running a cash practice and being successful at it, and even he still complains about. But hey, this this I'm all cash. I'm all cash. You know, like that's a you know some basically a caveat. It it's a it is more challenging. There's no doubt about it. It's going to be more challenging, and just because people have insurance and they want to use it, even if a little bit, even if it's just for their exam and x-rays. Right? That is helpful to patients to get over that hurdle, 'cause you're never gonna, you know, quote unquote, make any money on day 1. You know, it's all in actual care plans where you would actually generate significant revenue. So we wanna lower that barrier as much as possible, and so that people can just get in front of you, you can develop your expertise, develop rapport, and— And make a recommendation, right? Give them a chance to say yes. If they don't get in the door, they, they don't even have the opportunity to say yes. Yeah.

And that's the big key is get them in the door. Then you got at least a fighting chance if you're a provider for them. So couldn't agree more with that.

So the next chapter is Marketing Insights and Benchmarks. You know, I don't know if we want to go too deep on this because we've covered marketing quite a bit in the past. But, you know, essentially in this chapter, Um, the key, I guess, emphasis is you really want to have a diversity of your marketing. In other words, you don't want to have your decompression patients all coming from paid marketing or all coming from just Facebook. Um, one is the one, one of the most dangerous numbers in business, right? If you have one staff member or if you have one marketing channel. So if something happens to that one staff member or that one marketing channel, then the practice craters. So really what this talks about in this chapter is just diversifying, right? Let's create 2 to 3 to 4 internal marketing strategies— email marketing, physician referrals, uh, patient referral programs and systems, you know, uh, business outreach. I mean, there's, there's a million of them, right? There's tons, but those are some off the top of my head. And then you have your paid channels, right? Facebook, Meta, you got Instagram, obviously that goes hand in hand with Facebook. You have Google, you can do YouTube, you can do TikTok, you can do streaming. I think streaming is a really interesting option right now. You can do radio, you can do what Dr. Pankinen does. He basically does them all, right? And has added a podcast. So there's a million opportunities out there Uh, and if you're saying, but I don't like to market, okay, if you tell me that, then you're telling me I don't like money. That's what I hear when someone says, I don't like to market. It means like, hey, I just don't care enough to grow my practice. I'm sorry, that, that is the reality. If you didn't want to market at all, then you really should have been a medical doctor or a physical therapist because they don't have to market, right? Because there's so much overwhelming, just like general, um, you know, People just know about PT and they know to go to their medical doctor. We're chiropractors, right? We have a different— we just live in a different world. It is the reality. We need to get our message out there. So if you don't like marketing, just think, hey, how do I reach more people? How can I— I love what I do. I love decompression. I want to help more people. How do I do that? How do I reach more people? Use that as your guiding kind of light.

Yeah.

And then you'll start to see channels open up.

Yeah, I just, I think marketing is fun. And marketing is just, to me, it's just telling people over and over and over and over again what you have to offer them. And you wanna do it as many avenues and ways that you can get the message out there. And so talking directly to people through radio or podcasts is a great way to do it. There's like— Dr. Leone listed all those different ways that you can do. You just, you don't need to become a master of marketing, but you need to, like you said, you need to have 2 or 3 or 4 different avenues that are all like buckets that you're drawing a little bit from each month. And you might not have one bucket that's overly great, but you get a couple from that one and a couple from that one, and over a course of the month you've generated several Good quality patients. Like Dr. Leone said, I don't have— I have a little bit of market in all those things we've talked about. I don't have one that's just like, oh yeah, I can get rid of all these other ones and just focus on this one. It wouldn't be enough. But you add all that together month after month, year after year, hundreds of new patients every year. And it all— but it comes from diversity, and that's the big key. So. Don't be afraid of marketing. If you don't like it, just, just learn to embrace it, learn to love it. And if you start to do it more and more, eventually it'll just become second nature and you'll get good at it and you'll probably actually start liking it.

I've never met a doctor that's done $100,000 a month plus consistently that doesn't market heavily. Never. Not once. Not in my, you know, been in practices 2007. Never. So if you want to hit $100,000 a month and you're doing $50,000, $60,000, maybe $75,000 a month and it's through internal referrals, well, first of all, if you're hitting $75,000 a month from just referrals, amazing. You've done an excellent job and people really, really like you. Um, but if you want to go to $100K, uh, plus consistently, you have to do marketing. It just It just is what it is. Some doctors do marketing and don't even realize it, which is really funny, right? Um, I remember my dad told me this story. There was, you know, he used to go to Parker back in the '70s, and he credits Parker for building his career or saving his career. And there was this one doctor that was just booming. He was just crushing it. And so, you know how everyone goes to part— they go to seminars and, and there's a table there. Shoot, well, someone's going to get adjusted, right?

That's right.

So this doctor's adjusting another doctor, and he adjusts him, he's like— and he stands up and he finishes the adjustment, he's like, so is there anyone else that you know that, um, that I can help? And he's like, what? And he's like, oh, sorry, I thought you were a patient. That's all this guy did. Every single— every single patient, that's— he said that exact same thing every time they got off the table. And the guy got referrals up the wazoo. So it can be as simple as that. It's not going to build your decompression side Um, nearly as quickly as doing some paid marketing to complement it. Um, but that doctor was marketing, right? He was marketing. He was pushing referrals with every single patient. He just didn't realize he was doing it. Um, but anyways, regardless, regardless, that is the marketing component. Let's move on to our research component, which, um, you know, Dr. Kyle is so good with research and is always on top of that. By the way, in the marketing Um, chapter, one thing I think that will be helpful for a lot of doctors is kind of key benchmarks. Um, you know, cost per acquisition for a new patient start, what consult should cost you, etc., so that you kind of know as you run ads, okay, I'm within what's called KPI, key performance indicators. When you're running ads, you do want to make sure that you are tracking those things so that, you know, hey, because some doctor may May say, uh, like I tell doctors, they're like, I want 14 new patients. I'm like, okay, well, let me do the math. So on average, we're gonna pay about $500 for a new patient start. Do you have $7,000 in ad spend, and can you close at 50%? And he's like, what, $7,000? Yes, sir. Yes, you have got to pay to play. You can't spend $1,000 on Facebook and expect to get 10 new patients a month. That was, that was back in 2018, 2019. You could do that. Not anymore. Um, so you need to educate yourself about what is realistic when you do do paid marketing, right? Because if you're spending $500 to $700 per new patient start, that's actually okay. That's, that's industry norm right now in a, in a kind of mid-market, um, uh, type of city. Smaller, smaller markets like Dr. Pankinen's, it's better. Bigger markets— Dallas, LA, Miami— is more expensive. It's just, it is what it is because there's more competition. So educate yourself on, on what the, the KPIs are, what the realistic KPIs are, before you start dumping a bunch of money in, because you actually may be profitable. I was talking to one doctor and he was, uh, it was doing like, I don't know, $3,000 in Google, and he was getting, um, new patient starts for like $700, but he was going to turn it off. I'm like, why? Your care plan's $6,000. You're, you're printing money. Why would you turn that off? He's like, oh yeah, I never thought about it like that. So, you know, know your numbers. If you're going to run paid ads, if you're going to put money into the marketplace, know your numbers so that you know whether you are, you know, successful or not, and then whether you should hammer down and put more money in. Because if you're— say you're getting your CPA, your cost per acquisition, at say $400 or even $500 and your care plan's $5,000, Well, then you want to spend as much money as possible and see how many new patients you can get from that particular platform. So, but you don't— you won't know to do that unless you know your numbers. Um, okay, let's dive into the next chapter, which is research. And, um, you know, Dr. Pankinen came up with these phenomenal research that I doubt anybody has, has seen these. But, um, the one I really like is that first one, that large-scale 267 patients, Dr. Pankinen.

267 patients and the average patient, well, 90, I think it was 91 or 90.5% of the patients in the study.

90.5.

Saw significant improvement. And I believe the average pain reduction was 62 or something. Yep, you're exactly right.

Percent. Yep.

And hey, that's pretty good. I don't have those numbers in front of me.

That is pretty good. I'm impressed.

Anyway, yeah, that's one of the largest studies ever done on spinal decompression. It was a 20—

University of South Florida? Is that—

University of South Florida.

Yeah. Okay. USF.

And that— there's, there's, there's more research now coming out on spinal decompression the last 2 or 3 years. For whatever reason, it's accelerated. And sure, there's— I actually just put together a presentation coming up for our summit this fall, and I'm just kind of— all the studies that have come out just since September up until present, there's been several new ones in that time frame. So that's why one of the reasons it's exciting time to be in this, because, you know, in the early years of decompression we had a few studies, but now it's, it's Snowballing to a point where the evidence is getting overwhelming. That— and as we educate people on this, as we educate doctors on this, and we get more people doing decompression, it's only going to grow. And the cool thing about these studies is you got University of Southern Florida, there's this— there's a study from Pakistan, there's, there's been, uh—

Wasn't there one in Egypt?

There's one in Egypt that's come out recently. There's Korea, Japan, some of these other countries. So it's not just the United States. It's being conducted worldwide. And so I keep up every study, new one that comes out. I look at it, read it, and I put it in a file so I have it. And It's, uh, it's getting mildly challenging to keep up right now with all of it. So that's, that's a good problem. So it's exciting. Good research out there. Disc herniation reduction, pre- and post-MRIs, disc bulge reduction, increases of disc height, all of that is out there.

And I, I thought the one on the, um, amount of pull, right? Whereas heavy pull versus light pull. So this one, let's see. So high force versus low force decompression for sciatica. Lower force decompression, 10% of body weight, performed as well or better than high force. That's wild.

Isn't this wild?

Because you would think like, like that your, your natural inclination would be like, Well, no, we need to pull more, right? We need to, but not according to this.

Yeah, there's been 2 studies, 2 or 3 actually studies that have come out in the last decade or less that all show that similar trend that when they do lesser pulls, the patients do better. They did a cervical spine one recently. This was a lumbar one you're referencing. Cervical spine one where they did 5% of body weight, 10% of body weight, 15% of body weight. And 20%. They found at 20% of body weight for cervical that they actually started to produce iatrogenesis, meaning that the patients got neck pain, headaches, dizziness. They were causing problems. 5% didn't change them a lot, but 10 to 15% of body weight was the sweet spot. But 10% did just as well as the 15%.

Hmm.

So even in the cervical spine, You don't need— doesn't appear to be much more than about 10% of body weight to produce good results. That 10% and 50% body weight study was from the lumbar spine, showed that 10%, even the lumbar spine, can produce benefit, and in some cases just as well as 50%. Now, is 10% the optimal for lumbar? We don't necessarily know that. It might be 20% or 30%, but certainly you don't have to pull hard to get results is what the studies are showing.

Yeah, and, um, that's a great point. Uh, what I think is so interesting about this is, again, the more you know, like, as a— because again, from the beginning we're talking about mastery, right? So the more you know, the better that you can accommodate for your patient. In other words, say it's super acute. Well, yeah, you're going to go lighter. You're Even if they don't feel something, you're going to, you can, you can communicate why you're going lower. And even if they don't necessarily feel a strong pull, it's okay. The research supports that. And we're doing it low force because you're so acute. We may increase down the road, but it is still effective according to the research. I have it right here. It's not just you saying this, you pull it out. You have these papers available to you. Don't you think that that would position you as more of an expert to a patient?

Yeah.

So it's just in this type of situation, it's the more you know, the better. So again, that— and that's why I wrote the report, because I wanted to make this available to you. We have all the links to it in the, in the, um, the report itself. So you just click on it and then you will pull up the PubMed report or whatever, wherever it was listed. Um, so, uh, we were gonna go through the whole the whole report, Doc, but we're only halfway through. I mean, we haven't even got to breakout trends and table and adjunct therapy insights and practice spotlights and predictions and opportunities for 2026, the roadmap for 2026. So I think we're gonna have to do a part 2.

I think so, Doc. I think, I think we were talking off the show. I said, do you want to do this all in one or divide it up into chunks? Oh, we can get it all in one.

No, no, we talk too much. We're chiropractors. What are you going to do? Um, so go to, go to Decompression Decompressionreport.com. So decompressionreport.com, it's $49. It's a whopping $49. I know you guys can afford it. If you are serious about decompression, go get this report, educate yourself, get the information. I spent 3 months putting this together, um, and, uh, with the help of Dr. Pankinen. So please do that, um, and get this in your inbox so you can read it. It's, uh, it's a, it's a PDF, right? We're We're not doing the printed version. That was just too much work. So, just get the PDF version, put it on your iPad or whatever. You're probably not gonna be able to read it on your phone. So, it needs to be on a tablet or your desktop, but dig into this. And I think that you will really, really enjoy the information if you're serious about decompression. So, we're about halfway through the report. We'll do a part 2 then, Dr. Leone. Pänkinen and look at the second half of this report and dive into those topics at that time.

Oh, I'm excited. Can't wait to do it. And, uh, no, I mean, I was the first doctor to be able to, uh, see the finished product that was put together for this, and my first impression of it as I read through it was this is really thorough, really complete. Really well done. So I encourage any doctor that's either in decompression or thinking about getting into it, this is a must-have report. It's gonna move the needle for you in the right direction.

Yeah, so just go to decompressionreport.com and get your copy today. So that's gonna wrap up this podcast. This'll be part 1 of the State of Spinal Decompression Report. I want to thank everyone for tuning in today. Please remember to share this with a friend or colleague if you feel like it would benefit them. And, um, hey, if you think about it, give us a like and a subscribe. We would really appreciate it. So for Dr. Kyle Penkin, and I'm Dr. Vince Leone, this is the Practice Builders Podcast, 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.