Cash-based services should add unique and discernible value to your patient’s plan of care. If your patients feel a difference within just a few treatments, the value of this service will exceed its costs. For this reason, selecting cash services that focus on quickly reducing pain complaints is a smart strategy.

Chattanooga® offers numerous medical devices that help decrease pain and improve patient outcomes. Three popular cash treatment options are in the areas of therapeutic laser, radial pressure wave therapy, and traction/ decompression treatments.

While each device imparts different mechanisms to help treat various conditions, they all share the ability to reduce pain in short periods of time.1-3

LightForce® Therapy Lasers

LightForce® Therapy Lasers are one of the most popular devices used in the cash pay market.  Key reasons include:

  • Laser can be applied to chronic and acute conditions and is well tolerated by most patients.4
  • It has the ability to reduce minor muscle and joint pain, muscle spasm, as well as pain and stiffness associated with arthritis.
  • Laser assists with tissue repair by promoting relaxation of muscle tissue and temporarily increasing local blood circulation.
  • Treatment can be applied as cash supplement to most treatment sessions as the billing codes associated with laser (LLLT) are generally not recognized by third party payers. **(Check with billing professional)

Chattanooga® Radial Pressure Wave Therapy

Radial Pressure Wave therapy is another non-invasive treatment option that uses high intensity sound waves to impact pain and increase blood flow to various tissues.

It has been shown to help treat a variety of soft tissue dysfunctions.  These include, but are not limited to, trapezius muscle pain, shoulder pain, elbow pain, knee pain, Achilles tendon pain, or plantar and heel pain.

Primary benefits include:

  • Radial pressure waves have the ability to effectively reach pain generating tissues at up to 6 cm.
  • Large areas can be scanned and treated in a short treatment time.
  • Most plans of care consist of about 3 treatments.5
  • Treatment tool for locating and treating active and latent trigger points.2
  • Pain can be impacted after a single treatment.2
  • Treatment can be applied as cash supplement to most treatment sessions as the billing codes associated with shockwave treatments (ESWT) are generally not recognized by third party payers. **(Check with billing professional)

Chattanooga Traction/ Decompression Therapy

Low back pain (LBP) is one of the most common reasons adults in the US seek out a primary care doctor.  A 2020 study showed that 55% of LBP patients present with intervertebral narrowing of the lumbar spine.  Additionally, 25% of LBP patients present with radicular complaints into the lower legs.6 Intervertebral narrowing and radicular complaints are both associated with disc pathology. Traction has been shown to decrease disc bulging, improve intervertebral narrowing,7 and to be a more effective treatment option for reducing pain and disability scores than exercise alone for patients with disc pathology.8

Chattanooga traction devices are a potential treatment option for these patients.  A 2023 post market survey of 272 low back pain cases found that Chattanooga traction devices were 87.5% effective in reducing low back pain.9

Primary benefits of incorporating traction therapy include:

  • Can be used for chronic LBP with radicular complaints.8
  • Can provide predictable amounts of tension to help decompress spinal structures.7,10
  • Treatments are easily replicated.
  • Can provide longer duration and higher force traction that is difficult to perform manually.
  • Is an unattended treatment that helps reduce pain.9
  • Ability to charge cash for this service is dependent on reimbursement rules for various carriers. ** (Check with your billing professional)

All three of these solutions address different types of patient conditions.  However, they are all focused at reducing pain and providing treatment options for patients looking to avoid surgery and/ or reduce the need to rely on pain medications.

Many practice owners in the Breakthrough community have adopted one or more of these technologies with great results. Practice owner Tony Cere has added $300,000 in annual cash-based revenue. “Patients will come in for the laser, and turn into physical therapy patients,” he said. According to Tom Loyd, Practice Owner at Bryn Mawr Sports Therapy, “The Lightforce 40-watt laser generates improved patient outcomes and adds an accessory form of income.”

Interested in learning more about Chattanooga's portfolio of cash-based technology? Click HERE to request a demonstration.

* Cash-pay services vary from market-to-market. Please discuss with your local insurance company for guidance in your market.


  1. Fritz JM, Lindsay W, Matheson JW, et al. Is there a subgroup of patients with low back pain likely to benefit from mechanical traction? Results of a randomized clinical trial and subgrouping analysis. Spine (Phila Pa 1976). 2007;32(26):E793-E800. doi:10.1097/BRS.0b013e31815d001a
  2. Kartaloglu IF, Kus AA. Evaluation of Radial Extracorporeal Shock Wave Therapy on Treatment-Resistant Trigger Points Using Sonographic Shear Wave Elastography. J Coll Physicians Surg Pak. 2023;33(10):1159-1164. doi:10.29271/jcpsp.2023.10.1159
  3. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials [published correction appears in Lancet. 2010 Mar 13;375(9718):894]. Lancet. 2009;374(9705):1897-1908. doi:10.1016/S0140-6736(09)61522-1
  4. Arroyo-Fernández R, Aceituno-Gómez J, Serrano-Muñoz D, Avendaño-Coy J. High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med. 2023;12(4):1479. Published 2023 Feb 13. doi:10.3390/jcm12041479
  5. Schmitz C, Császár NB, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116(1):115-138. doi:10.1093/bmb/ldv047
  6. Kamal KC, Alexandru DO, Kamal D, et al. Managing Low Back Pain in Primary Care. Curr Health Sci J. 2020;46(4):396-404. doi:10.12865/CHSJ.46.04.11
  7. Chung TS, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction [published correction appears in Radiology. 2015 Jun;275(3):934-5]. Radiology. 2015;275(3):755-762. doi:10.1148/radiol.14141400
  8. Wang W, Long F, Wu X, Li S, Lin J. Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med. 2022;2022:5670303. Published 2022 Jun 21. doi:10.1155/2022/5670303
  9. (2023). Post-Market Clinical Follow-Up Retrospective Study Report: Traction and Decompression Therapy Systems. Internal Enovis report. Unpublished.
  10. Chow DHK, Yuen EMK, Xiao L, Leung MCP. Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study. Musculoskelet Sci Pract. 2017;29:78-83. doi:10.1016/j.msksp.2017.03.007