The Practice Builders

56. Decompression Case Review


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🎙 Episode 56 – Decompression Case Review

In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down two real decompression cases that show why this therapy belongs at the center of a modern chiropractic practice — and how to frame it so patients choose it over pills, shots, and surgery.

Both cases are a lesson in patience and patient selection. First, a man with years of recurring low back pain that chiropractic used to fix — until a 2025 injury and a large L5-S1 extrusion changed everything. He was only 25% better at month three; by month four he hit 75%, and today he's on maintenance feeling his best in years. Second, a 57-year-old post-surgical patient no one could help who reached 98% improvement with the right protocol.

You'll learn:

  • Why chronic patients whose pain has stopped responding to standard care are your most natural decompression candidates — they already trust you
  • Why large disc extrusions often respond better than small bulges
  • Why breakthroughs often come late — and how setting the full 24-visit expectation keeps patients from bailing early
  • The post-surgical waiting periods that make a patient a safe candidate
  • Why you always correlate MRI findings with a thorough exam — the pain generator doesn't always match the imaging
  • How to frame decompression against surgery using the real numbers: 85–93% success versus surgery's ~72% first-time rate
  • What the research actually says about muscle relaxers, opioids, gabapentin, injections, and ablations

A must-listen for any doc who wants to become the go-to authority on disc and spine care in their market — because when you can show patients the data on every alternative, decompression stops being a hard sell and becomes the clear choice.

🎧 Tune in and learn how to turn complex disc cases into some of the most rewarding wins in your practice — clinically and for the patients whose lives you change.

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The Practice BuildersBy Dr. Vince Leone and Dr. Kyle Pankonin