COVER

AN ATTACK ON PAIN

A NEW TREATMENT RELIEVES DISCOMFORT

JAMES DEACON September 30 1991
COVER

AN ATTACK ON PAIN

A NEW TREATMENT RELIEVES DISCOMFORT

JAMES DEACON September 30 1991

AN ATTACK ON PAIN

COVER

A NEW TREATMENT RELIEVES DISCOMFORT

For Dr. Allan Dyer, agony was the mother of invention. Ten years ago, the onetime Ontario deputy minister of health suffered a herniated disc—a compression of a joint in his spine. But after conventional therapy, including drugs and hot and cold packs, failed to ease his excruciating pain, he said that he began to formulate the theories behind his revolutionary Vax-D treatment table. “It was either staying in bed for three months or figuring out how to fix my back,” he said. “So I developed this table.” The table, on which patients have their spines carefully and minutely. stretched, is quietly building a reputation among some doctors and physiotherapists as a major step forward in the treatment of lower-back pain. Dyer, a younglooking 68-year-old who is a doctor of both medicine and pharmacology and who retired from the ministry in 1988, still grimaces when he recalls the misery of his herniated disc. And he said that the memory fuels his excitement about the prospects for the Vax-D—or vertebral axial decompression—therapy that he says has so far successfully eased pain in about 70 per cent of the more than 200 patients who have undergone it.

With thousands of Canadians and millions around the world suffering from lower-back problems, Dyer says that his invention could provide huge financial rewards. But he added that he has not let the potential for profit cloud his medical judgment. Before he allowed the Vax-D table to go into commercial production (retail price is $60,000), he submitted it for clinical trials at University Hospital in London, Ont., and at the HCA Rio Grande Regional Hospital in McAllen, Tex. More recently, clinics in Bramalea, a Toronto suburb, and Pittsburgh began treating a small group of patients.

Effectiveness: But Dyer’s Vat-Tech Inc. decided to accelerate the table’s commercial launch when reports of its effectiveness reached therapists for some professional sports franchises. Dyer is currently treating Cito Gaston, manager of the Toronto Blue Jays baseball club, who in July was forced to turn over the club to an interim manager because of the debilitating pain of a herniated disc. And Mario Lemieux, the Pittsburgh Penguins’ star centre who was forced to tum down an invitation to play for Canada in the recent Canada Cup hockey tournament because of back spasms, was successfully rehabilitated in two weeks of treatments at the Pittsburgh clinic in August. But while the table has been registered with federal government health agencies in both Canada and the United States, it is still

in limited circulation and viewed with skepticism by some experts.

Still, while doctors using the table say that they are excited by its capabilities, they insist that it is not a cure-all for every kind of back pain. Dr. John Toman, a Bramalea general practitioner who has had a Vax-D table in his office for a year, says that he uses it only to treat problems in the lumbar, or lower, region of the spine. He added that those with upper-back pain,

congenitally deformed spines or muscle pain will not get any relief from the treatment. “People with muscle problems will know right away that the table is not for them,” Dyer said. “The stretching will make their pain worse.”

The theory that drives the Vax-D table is simple. Patients lie facedown on it with a pelvic belt gripping their hips while they grasp handles in front of them. Then, while the patient hangs on, the belt gradually pulls the pelvis at pressures ranging from 50 to 100 lb., depending on the needs of the sufferer. On a rotation of one minute on, one minute off, for half an

hour, the table gradually stretches the spine, pulling apart the vertebrae by a microscopic amount, and then gently lets them return to their proper alignment.

Dyer told Maclean ’s that his original plan had been to stretch the spine and temporarily relieve the pain of herniated and degenerative discs in the lumbar region of the spine. Through injury or degeneration, the discs in the joints between vertebrae become compressed, squeezing out the protective gelatinous material that cushions the joint. What he had not anticipated, Dyer said, was that clinical trials provided evidence that stretching the vertebrae actually creates suction, which draws the bulging herniated material back into the joint. In effect, that restores the joint to its original, unharmed state, he said.

Praise: Many of those who have gained relief have high praise for the equipment. Bruce Hood, a former professional hockey referee, has been relieved of most of the severe back pain that had forced him into hospital last July. He added that he received his first six treatments in the Blue Jay locker room at Toronto’s SkyDome along with Gaston. Dyer would not talk about his work with Gaston because he did not want to appear to be gaining publicity for his product from his patient’s pain. But, according to Hood, “Cito’s about six-foot-four, but the day he walked in he looked about five-foot-eight. In the first three days, he was like three different people. There was a tremendous change in him. He said, ‘I don’t know whether God did it or the machine did it, but I feel better.’ ” And Lee Kasper, an Encino, Calif., businessman who flew to Toronto for treatment after suffering through seven years of severe pain, said that he had been scheduled for surgery when he heard from a Canadian relative about the Vax-D treatment table. “I was going to make sure I tried everything before surgery,” Kasper said in an interview. After six days of treatments with Toman, Kasper said that he was completely pain-free. He added: “I feel perfect today. It’s too good to be true.”

Scientific documentation of the table’s effectiveness has been compiled by Dr. Gustavo Ramos, the neurosurgeon who conducted the tests in Texas. Ramos and radiologist Dr. William Martin evaluated the treatment for publication in Spine, a Philadelphia-based medical journal (the paper is currently being adjudicated). Ramos and Martin chronicled the treatments of 40 patients and followed up by assessing them six months after their therapy. Ramos said that seven out of 10 patients appeared to have significantly recovered, and

rumors of the treatment’s effectiveness spread to other physicians who then referred new patients to him. “Once the information about the table gets around,” he said, “I think that more people will want to try the treatment.” Toman, too, is preparing a clinical report for publication in Canada, and he says that he has been unable to find any danger with the treatment. “The worst thing that can happen is that the patients won’t feel any better,” he said. “But they are not going to feel any worse.” According to its users, the table is effective not only on herniated discs, but also on misaligned facet joints and degenerative discs. Ramos said that the table was most effective in resetting facets, or vertebral joints, that had slipped out of alignment. In many such cases, Ramos said, patients who were unable to move without experiencing severe pain were fully relieved by having their spines stretched and

realigned in one or two sessions on the table.

Dyer says that another application of the Vax-D is in conditioning athletes. James Kittelberger, the Pittsburgh physiotherapist who treated Lemieux last month, says that other members of the Penguins have used the table for stretching after severe exertion. Kittelberger said that although Lemieux no longer experiences the back spasms that forced him out of the Canada Cup, he continues to use the treatment table. “It helps him maintain an effective range of motion and performance,” Kittelberger said.

But some health officials have expressed skepticism. Specialists in several Canadian clinics told Maclean’s that they needed to see more scientific evidence of the table’s effectiveness over a longer period before they could endorse its use. And others question the price. “The cost sounds like it would be prohibitive

for the average clinic,” said Janie Cole-Morgan, a therapist at the University of British Columbia Sports Medicine Clinic.

Skepticism: After years of development and what Dyer describes as “millions” of dollars of research spending— provided by Dyer (although hospitals and other doctors supplied materials and services free)—Vax-D is now ready for wide distribution. Michael Donia, chief executive officer of Vat-Tech, said that three southern Ontario manufacturers are building the parts of the table, which include the electronic components of a monitoring console. Vat-Tech is negotiating with leasing companies to make the tables available to doctors on a monthly basis. Donia estimates that the company could produce 100 units a month under its current manufacturing arrangement. But he added that to achieve greater sales, VatTech will have to overcome the skepticism of some physicians and physiotherapists. Said Donia: “They don’t understand how something so simple could work so well.” Still, Donia says that the market for the tables is nearly limitless. He said Vat-Tech has received dozens of inqui§ ries from insurers and worka ers’ compensation agencies around North America who are interested in the savings I in health payments that the 1 equipment might make possible. Donia said that a 1987 study by the Harvard School of Public Health estimated that the health-care costs of lower-back problems were about $25 billion a year, before accounting for lost wages. He said that surgical repair of herniated discs in Canada costs between $7,000 and $14,000, depending on complications, whereas many of Toman’s patients achieve the same results at a cost of $750 to $1,000. (Treatments are not covered under Canadian health-care programs.)

Dyer owns Vat-Tech with his wife, Natalie, a physician, but he is already at work on his next project. “I want to rebuild discs,” he said. “No one has ever done that, but now I think it can be done.” Natalie Dyer said that since her husband retired from the health ministry, he has been busier than ever. “You can’t stop him,” she said. For some people with lower-back problems, Dyer’s pain has become their gain.

JAMES DEACON