IDD therapy for lumbar disc problems in Edinburgh
To my knowledge there is only one clinic providing IDD therapy for lumbar disc problems in Edinburgh. And yet IDD has been around for the best part of 20 years (20 in the USA, but over 10 years in the UK). Why is this? Does IDD actually work? As an Edinburgh osteopath, let me expand…
Why isn’t IDD therapy practised more widely?
1. It’s expensive. The most obvious people to offer IDD therapy are manual therapists – osteopaths, chiropractors and physios. But their clients aren’t used to paying the kind of fees we’re talking here. It’s a big commitment financially, and health insurers in the UK don’t cover it. There’s no point in having 1 or 2 sessions. I think the minimum is 6, but more commonly 10-20 sessions, which would easily amount to £600+. That’s still a lot less then surgery however.
2. It’s a large piece of equipment. I don’t have room for one in my practice – I’m sure many other practitioners are the same.
Does IDD for back pain / sciatica actually work?
As ever, the answer to this isn’t straight forward. I’m sure there are people who have benefited from IDD therapy. But what does the science say? On the IDD therapy evidence page for the main UK distributor, they showcase the scientific literature published in support of the device. They state “The manufacturers of SPINA machines and IDD Therapy put forward the treatment for independent testing and are transparent in the presentation and publication of data. ” As part of this transparency they cite a number of articles. I was looking for reviews, where researchers will collate data from a number of studies and report on the generalised findings across those studies.
However, none of the articles were reviews (I don’t think there’s enough research to warrant someone to undertake a review), and certainly none were “systematic reviews of placebo controlled trials” (the best kind of review). The best article I could find (in terms of quality of research) in so far as it mentioned “single blind, randomized controlled trial” in the title is linked to here*. It’s not very promising however, with there being no significant difference between IDD therapy and sham IDD therapy. However, both of the groups – in conjunction with a “standard graded activity program” – improved significantly during the study period.
IDD therapy from the horse’s mouth
Stephen Small, the distributor of IDD therapy machines in the UK also pointed out that “the patient groups were a narrow group who did not have any nerve pain. Nerve pain is one of the key areas IDD is used for so the study is very limited and it would be wrong to judge it on that one piece. There are other studies and articles, which show promise, although they are small and clearly there need to be more studies …”
Stephen also puts his money where his mouth is. He doesn’t just distribute machines in the UK. He is a co-owner of Spinex Disc Clinic in London which majors on the use of IDD therapy. I like him.
Would I try IDD therapy?
Yes. If I had intractable sciatic pain and I felt that it might be a useful addition to all the other strategies I can employ to speed up healing. And avoid aggravating my sciatica. Then, I would certainly consider it. I have recommended other patients try it in order to avoid surgery. However, neither of the two I recommended it to felt any benefit and one certainly felt considerable discomfort. But it would be hypocritical of me to criticize the lack of evidence in favour of IDD, while discounting IDD on the basis of 2 patients’ experiences. I’m open to IDD therapy in Edinburgh benefiting some people some of the time. But like most clinical interventions (including osteopathy) it won’t help all of the people all of the time. 🙁
*No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy. Eur Spine J. 2009 Dec;18(12):1843-50. doi: 10.1007/s00586-009-1044-3. Epub 2009 May 31.