Do Inversion Tables Help With Back Pain?

'The Benefits Of Hanging Around'

The Short Answer –

Inversion tables offer a much more controlled version of inversion therapy, rather than hanging upside down with inversion boots or racks. But do inversion tables work for back pain? And who should consider trying them?

The evidence is presented below…

What Is Inversion And What Is The Difference With Inversion Tables?

Inversion is the process of turning the effect of gravity back. Gravity by it’s nature pushes everything downwards including your spine. Over time, and due to a number of factors including body weight, the spine can gradually compress, causing considerable back pain.

Inversion therapy has been around since 400BC, when sufferers would hang upside down by their ankles as a way of uncompressing the parts of their body previously pulled down by the earth’s ultimate force (gravity).

Things have moved along a lot since the time of Hippocrates, although ‘inversion boots’ or racks are still used in some areas still today as ways of suspending someone upside down.

Modern times however, have seen the development of the inversion table – a much less extreme option to suspend yourself at a gravity-defying angle.

When it comes to back pain, these tables are designed to use gravity and ‘click back’ the spine to it’s original position, thus getting rid of back pain – not dissimilar in many ways to spinal traction.

The basic concept is that by suspending yourself either completely upside down or at least at more than 50%, gravity is pulling towards your head, rather than pushing you down and you can stretch your spine back – ‘decompressing’ it.

The concept isn’t too different from yoga – which derives benefits from stretching a whole range of muscles by adopting different yoga positions.

In theory, your spine should actually lengthen as it decompresses, although don’t expect to suddenly grow a few centimetres!

It is worth also mentioning that specialised chairs can achieve a similar result, but as the inversion table is the most used and well developed, I have covered this today. There are possible benefits to using chairs as well, but I’ll cover that in another article.

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Do Inversion Tables Help With Back Pain – The Benefits…

One of the biggest benefits with using an inversion table over other forms of inversion is that you don’t have to be completely upside down.

Advantage 1…

This has a number of advantages – firstly you can ease into inversion therapy gradually, stopping if you feel uncomfortable or suffer side effects. You can start with a small tilt and work up to more extreme angles.

Advantage 2…

The second advantage is that you don’t land on your head if something goes wrong. It sounds ridiculous, but if you use inversion boots or even do a handstand to hang upside down and then you slip, you will most often end up hitting the floor head first.

Inversion tables are generally much safer for 2 key reasons –

  • You have something to hold on to if a strap slips
  • If disaster strikes, you are much more likely to slide down in a more controlled manner (rather than head first).

Other Side Benefits Of Inversion Tables.

Inversion tables allow not just the spine, but the whole body to effectively ‘stretch itself’ back out. This has been reported as having a number of benefits, especially for people who suffer with muscle spasms.

The process of stretching is considered to stimulate the lymphatic glands, which helps to clear some of the body’s waste – effectively giving yourself a full body detox!

It can also allegedly help considerably with motion sickness, not least because of the impact of inversion on your inner ear. This impact can also help with balance in general.

Who Should Consider Using An Inversion Table?

Inversion therapy, even with the use of an inversion table, is not for everyone. Tilting yourself so that the ‘blood runs to your head’ can have serious consequences for pre-existing conditions.

It is especially important that you consider speaking with your doctor first before starting inversion therapy.

They can assess your general health (blood pressure/ lung capacity etc) to make sure that you are fit enough, beyond your back pain, for inversion.

There are many conditions that may be made dramatically worse if you go through inversion without getting the sign off from a doctor first.

These typically include –

  • Pregnancy
  • General Spinal Injury (specifically a spinal fracture)
  • An Implanted Device (such as a pace-maker)
  • A Heart Problem (especially one with implications for pulmonary circulation)
  • High Blood Pressure
  • A History of Stroke
  • An Existing Hernia
  • Obesity
  • Glaucoma
  • A Detached Retina
  • Middle Ear Infection
  • Eye Infection
  • Osteoporosis
  • Broken or Fractured Bones
  • Pink Eye

This list however is only indicative, so please do consult either a family doctor or an orthopaedic surgeon, before trying inversion therapy.

Do Inversion Tables Help With Back Pain – The Facts

Research into the effect of inversion therapy as a whole is somewhat mixed, with the American College Of Physicians openly admitting that further research is required to demonstrate it’s effectiveness against other non-surgical options.

Certainly, it’s long-term efficacy for back pain relief is highly limited, since logically if your spine decompresses so quickly, it will likely recompress almost as fast.

However, perhaps a regular routine on your own inversion table may be more effective.
Indeed, one particular clinical trial in the Journal of Disability and Rehabilitation carried out on patients that were considered candidates for spinal surgery showed that 76.8% of patients who tried intermittent inversion with an ‘inversion device’ avoided spinal surgery.

This is against 22.2% deemed not requiring surgery after just physiotherapy in the control group. The theoretical conclusion then is that inversion devices can greatly reduce the need for spinal surgery.

Flaws In The Trial…

Dig deeper into the trial though and you find the ‘76.8%’ was just 10 patients out of a total of 13 and the 22.2% was 2 patients out of 11. The natural random fluctuations in a group of just 13 and 11 participants is huge, so nothing substantial could really be pulled from the trial.

Add to that the fact that the results were only measured after 6 weeks, so all of the 10 that reported positive results may have been back in 3-6 months requiring surgery and it wouldn’t register in the trial.

We just don’t know what might have happened in the long run.

However, a different study in 2012 in the Isokinetics And Exercise Science Journal reported similar results – testing different patients 4 times a week at 30 degree or 60 degree angles and measuring against those without inversion.

The results showed not only a more positive outcome for the groups that did the inversion, but also that the group doing the 60 degree scored best of all.

This suggests that 60 degrees is an optimal incline that not only allows for full decompression, but also produces better clinical outcomes than 30 degrees (which in turn outscored the control group).

The numbers still were not high, but to some extent we have to forgive that on the alternative nature of the procedure and difficulty finding the perfect volunteers.

The final study that I would draw your attention to that perhaps completes the argument IN FAVOUR of inversion therapy comes from a Dr Lennart Dimberg who actually ran a trial over a full 12 months, based around reducing workplace absence from back pain. 

The so-called ‘Volvo study’ showed a marked improvement in the number of days lost to back pain by workers undertaking the inversion therapy.

This trial does lose some credibility because it was based around the use of one branded inversion table which claims that only it’s products can be claimed to create those results and it should not be extrapolated to cover other inversion tables.

In reality though, how you choose to interpret the study is your choice and given that in the 9 years since, the development of inversion tables both in terms of comfort and function has improved markedly, it is fair to assume most tables would be at least comparable, if not significantly better.

How To Start Inversion Therapy

Like most back pain treatments, what works for one person, my not necessarily help the pain of another.

Inversion therapy however has it’s fans and if you are struggling to contain your pain, it may be a good non-surgical treatment to try.

As mentioned previously, the advantage of using an inversion table for back pain is that you can set it at the required level first.

This means it is not a case of being completely vertical or nothing.

And that is absolutely key, because even at 15 degrees off lying down, you will feel some change – most likely increased circulation.

You can then try gradually more extreme inclines as you feel comfortable. It is unlikely you will need to exceed 60 degrees, as that is now considered enough to decompress the spine.

However, if you do, just make sure you are always happy with it (and preferably accompanied by someone else).

You can actually increase the stretching benefits if you a decent quality inversion table – one with a comfortable locking backrest and sturdy securing mechanisms, by doing gentle exercises.

Abdominal crunches or stretching yours arms/ arm will all help to stretch your full body out and should theoretically improve the inversion tables’ effectiveness.

In terms of time – again start short and work up making sure you feel comfortable. Typical timings were sessions of 3-5 minutes, maybe 2 or 3 times a day. 

It really depends on what you feel most comfortable with. The most important advice I can offer is start small and work up.

The Final Word –

Inversion therapy has long been considered an option in managing chronic back pain and particularly, for avoiding spinal surgery.

Hanging completely vertical however, carries substantial risks for the rest of your body. 

The inversion table offers the option of a slightly more conservative inversion – with all the benefits but reduced risk. As a result, inversion tables have become very popular.

Do inversion tables help with back pain? The scientific data (if you forgive it’s technical flaws), would suggest yes – albeit only for short-term relief.

This means however, that to get any consistent benefit, you would need regular inversion – which in turn throws up issues of convenience as an inversion table should be used with someone else on standby to help.

The ‘next step’ then may well be an inversion chair – a further step up in safety and one that, is is widely accepted, can be used alone.

Check out our article on inversion chairs, if you are serious about inversion. ‘Inversion Chairs For Back Pain.’

Alternatively – if you already use inversion therapy, please leave a comment below on how you find it!

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References –

1. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med

2. Prasad KS, Gregson BA, Hargreaves G, Byrnes T, Winburn P, Mendelow AD. Inversion therapy in patients with pure single level lumbar discogenic disease: A pilot randomized trial [Abstract]. Disability and Rehabilitation.

3. Kim, J.-D., Oh, H.-W., Lee, J.-H., Cha, J.-Y., Ko, I.-G., & Jee, Y.-S. (2013, April 24). The effect of inversion traction on pain sensation, lumbar flexibility and trunk muscles strength in patients with chronic low back pain. Isokinetics and Exercise Science

4. Dimberg, L, et al: Effects of gravity-facilitated traction of the lumbar spine in persons with chronic low back pain at the workplace. Various

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