Episode notes
🎙 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.