VAX-D: Treating Back Pain Without Surgery

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Before a sudden onset of excruciating back pain left him barely able to stand, retired internist Ernie Reiner, MD, was busy volunteering at a health clinic in Tampa, Fla., and improving his golf and tennis game. After several tests showed a herniated disk and lumbar stenosis (narrowing of the spine in the lower back), he reluctantly scheduled shoulder pain,” Dyer tells WebMD. “The practitioner needs to be a good clinical observer.”

Can patients suffer injuries during VAX-D treatment? Current literature from the VAX-D manufacturer states that “not one single injury has been sustained by a patient.” A published report in a 2003 issue of Mayo Clinical Proceedings disputes that statement. The report describes a severe complication suffered by a patient during VAX-D treatment. The authors describe a “sudden, severe exacerbation of radicular pain” during a treatment session. Images of the subject’s lumbar region showed significant enlargement of the disk protrusion after VAX-D, requiring emergency surgery. To date, this is the only published report of an adverse effect caused by VAX-D.

How Effective Is It?

Does VAX-D really work? To date, anecdotes such as that reported by Reiner and others offer the most persuasive evidence in favor of VAX-D’s effectiveness. But what do studies tell us about VAX-D?

“There are some studies suggesting that VAX-D is effective. Most people would say they’re fairly flawed. The studies out there are not high quality,” says Daniel J. Mazanec, MD, a spine specialist with the Cleveland Clinic. Lack of controls and the use of “sham treatments” (or sciatica, making it hard to determine what improved the pain,” Mazanec tells WebMD.

Would he be willing to try it on his patients? “There need to be better studies before I would be comfortable believing that it’s an effective part of a treatment regimen,” Mazanec says.

Other clinicians who do incorporate VAX-D into their practice report favorable results.

Such is the case with Philippe Chemaly, DO, MPH, a physiatrist. He uses VAX-D on patients as part of a comprehensive treatment approach rather than a singular solution to back pain. “With VAX-D, there is no substitution for good physical therapy. Physical therapy teaches you techniques to do at home, which I think add to your long-term outcomes,” he tells WebMD.

Though he claims a high success rate with VAX-D — between 70% and 80% — he acknowledges that not all patients achieve optimal outcomes. “Younger patients do better. Typically they’re less obese, have less [spinal] degeneration going on, more abdominal strength and better flexibility,” he says.

Chemaly has halted VAX-D in patients who experience pain during the procedure. “I warn them, ‘If we do try this and you experience pain, we’ll stop. Some clinics say, ‘Let’s go for it.’ Pain is your body’s way of saying there’s something going on,” he says. Most patients who experience pain with VAX-D have spinal stenosis along with herniated discs, Chemaly says.

Strategies for Success

Still interested in VAX-D? Then you may want to follow this advice from seasoned VAX-D practitioners.

Use caution when choosing where to get treatment. “Look for places that do VAX-D with physical therapy. Mills — places that do only VAX-D — tend to be profit motivated. And you’re not going to get the proper care and evaluation in a mill,” Chemaly tells WebMD.

Follow protocol for the recovery process. “If patients receive this treatment five days a week, for a month, 70% of them will be free of pain,” Dyer tells WebMD. “What do they do when it’s done? They go skiing. Dumb!” he says. “When the pain is gone, that doesn’t mean the fracture is completely healed. Exercise does nothing for an intradisk lesion or a herniated disk. What it does is put stress on a disk that’s trying to heal.” Dyer tells his patients to engage only in walking during the month-long recovery process.

When it comes to treatment for something as fragile as an ailing back, it’s imperative to exercise caution when choosing treatment. As for Reiner, he’s convinced he’s made the right choice. “I’m sure I’ll have a flare-up here and there, and I’ll know where to go,” he says.