The Benefit of Inversion Table Exercises for Back Pain Relief

Marshfield Clinic: “Lean back: Inversion table tips and warnings.”

What Are Inversion Tables?

Could you really ease back pain, sciatica, or kidney stones by tipping backward on a table with your feet in the air?

There’s some research to back up the value of inversion therapy for back pain and other disorders. You do it on an inversion table that looks more like a lounge chair. You lie on it, and then tip it so you lean back at an angle or are upside down. You hang this way for a few minutes.

What is inversion therapy?

Inversion therapy is also called spinal traction. The theory is that being upside down eases the pressure of gravity on your nerves and the disks in your spine. You use it to temporarily create more space between vertebrae that are smushed together.

You can use these tables to relieve:

• Back pain
• Muscle spasms or tense muscles
• Compressed spinal disks
• Sciatica pain
• Kidney stones

Some people also use them as a general way to gently stretch joints and muscles, or just to relax.

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They aren’t the only way to do this therapy. You can also hang upside down with your feet strapped into gravity boots attached to a bar in a doorway. Fabric yoga slings help you hang upended, and then gently return you to an upright position. You can also do yoga poses that flip you over.

Does it work?

Evidence is mixed on whether or not these tables are an effective treatment for pain.

Back pain. Some people find that they offer short-term relief from low back or compressed disk pain. It’s probably not an effective long-term treatment. Studies suggest that inversion therapy works no better than sham treatments for relief in this area.

Sciatica. A 2012 study from England showed that inversion therapy combined with physical therapy was an effective treatment for sciatica pain from a protruding disk. It may reduce the need for back surgery.

Kidney stones. This type of therapy may be helpful for painful kidney stones. Research shows that it can help you clear stones when you do it along with diuresis. This procedure, which you have in the hospital to get fluids so you can pee, can help clear kidney stones. You do this combo therapy after a shockwave treatment helps to break up the stones.

What to expect

How do you use an inversion table? Lie back and strap yourself onto it so you’re secure. Then you can tip over until your head is lower than your heart.

You can use one under the guidance of your physical therapist or at a clinic. They can show you how to do it and keep an eye on you while you hang out.

If you’re younger and don’t have any cardiovascular problems, you can use one at home, but follow these safety tips:

Have someone watch you. Don’t hang upside down on a table without a spotter. Ask someone to watch you in case you can’t get back up.

Don’t lean back all the way. Try to just tip back at a 30-degree angle, or as little as 10 degrees if you’re an older adult.

Buckle up. Use the safety straps or harnesses so you don’t slip off.

Do it in short spans. When you first do it, try it for 1 or 2 minutes once a day to see how you feel. Limit your inversion table sessions to 5 minutes twice a day.

Tip up slowly. After you’ve done it, come back up slowly to an upright position. If you jerk up too quickly, you may trigger muscle spasms or disk pain in your back.

Combine it. This therapy may be more effective if you also stretch and stay flexible. Ask your physical therapist or doctor to suggest stretches.

Possible side effects and interactions

Inversion tables cause your heartbeat to slow down and your blood pressure to rise. You’ll feel the pressure in your eyes go up.

Because of these effects, they’re risky if you have high blood pressure, glaucoma or any other eye disease, heart disease, a history of strokes, hiatal hernia, inner ear problems, or are pregnant.

If you have knee or hip arthritis, using an inversion table may put you at risk for a joint injury.

Check with your doctor before you use one. Be sure that this therapy is safe for you.

Where to buy inversion tables

There are many different kinds you can buy online or at specialty stores. Some have handles, safety straps, padded surfaces, or water bottle holders. You can fold some models for easy storage.

Bear in mind that they aren’t cheap: Prices range from $120 to more than $1,000 for the fanciest models.

Show Sources

Providence St. Joseph Health: “Change Your POV: Can Hanging Upside Down Improve Your Health?”

FSHD Society: “Ask the Physical Therapist: Inversion Tables, Trigger Points, and Chronic Pain Management.”

Mayo Clinic: “Inversion therapy: Can it relieve back pain?”

StartStanding.org: “Best Inversion Tables for Back Pain 2019.”

Disability and Rehabilitation: “Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial.”

Indian Journal of Urology: “Diuresis and inversion therapy to improve clearance of lower caliceal stones after shock wave lithotripsy: A prospective, randomized, controlled, clinical study.”

Cochrane Systematic Review: “Treatment for low back pain with or without sciatica.”

Marshfield Clinic: “Lean back: Inversion table tips and warnings.”

The Benefit of Inversion Table Exercises for Back Pain Relief

Hanging upside down from your feet may look like a special form of torture — but for some people, it’s an important form of back pain relief.

Based on the concept of distraction traction, inversion therapy uses your body weight and gravity to help pull the spinal bones apart, allowing for increased space and movement between the vertebrae, which may decrease pain caused by pressure on the nerves. Traction is also thought to help straighten spinal curves and stretch the muscles surrounding the spine.

Inversion tables, or tilt tables, are long tables that have a hinge in the center with a place at one end to anchor your feet or legs. The user safely fastens their feet in the device and slowly tilts it into a head down position until they reach the desired angle.

Gravity-assisted traction can be a convenient and efficient means of applying force to the spine. The concept behind its use is simple: When issues arise due to spinal compression, you use mechanical energy to help pull them apart. You may find an inversion table in a health club or physical therapy clinic. They can also be purchased for home use.

Some doctors and physical therapists use traction for patients with chronic low back or neck pain. It may also be beneficial for patients with a disk herniation or nerve pain due to compression of a nerve root, often known as radiculopathy.

It’s used for people with abnormal spinal curves, like those with scoliosis and hyperlordosis, as well. Lastly, it can be beneficial to those with tight muscles of the trunk and spine.

There are several benefits of using the inversion table.

Decreased Pain

One study looked at the effect of inversion traction on pain, low back flexibility, and muscle strength in patients with chronic low back pain.

The authors found that inversion traction at an angle of 60 degrees reduced back pain and improved low back flexibility and trunk extensor muscle strength in patients following an eight-week program.

Improved Flexibility

Flexibility of the spine is important to allow joints to move through their full range of motion and to maintain good posture, balance, and prevent injuries.

The previously mentioned study also found a significant change in trunk flexibility after an eight-week inversion program.

Muscle Relaxation

When the body is placed in an upside down position, the muscles of the trunk and back are pulled by the weight of the body, allowing for them to stretch and lengthen, which may contribute to increased relaxation.

There is little high-quality evidence to support physical changes due to traction. It may temporarily take the pressure off compressed nerves and help stretch the muscles, but without functional restoration through physical therapy and chiropractic care, results may be temporary.

Conservative Treatment to Avoid Surgery

A 2012 study looked at the effects of intermittent extreme traction with an inversion device in patients with pain and disability due to low back disc compression.

Surgical intervention was avoided in 10 patients (76.9 percent) in the inversion group and avoided in only two patients (22.2 percent) in the noninversion group. Therefore, inversion therapy may help avoid surgery in a safe and economical way.

Inversion Table Exercises

Most inversion tables are designed to simply stretch the back. The user can choose if they want to be partially inverted or completely upside down, and they may remain inverted for short periods of time, or stay inverted for longer sessions.

Some people choose to do exercises such as torso rotations, ab crunches, or inverted squats, but there is no evidence to support that exercises while done inverted on the table are better than similar exercises in standing or lying positions.

Inversion therapy increases the pressure and blood flow to the head and upper body. People that are advised against the use of inversion tables include those with:

• heart or circulatory disorders
• high blood pressure
• glaucoma
• retinal detachment
• swelling
• unhealed fractures
• joint problems
• pregnancy

Although there is some evidence to support the use of gravity-assisted traction, a 2013 Cochrane review concludes that there is not enough high-quality evidence to say that traction helps patients with low back pain with or without sciatica.

The Cochrane review evaluated 32 randomized controlled trials and found that “traction, either alone or in combination with other treatments, has little or no impact on pain intensity, functional status, global improvement or return to work among people with low back pain.”

That being said, if you are safe to engage in activities upside down, it may be something fun to try before you consider more invasive treatments.

Last medically reviewed on February 3, 2016

How we reviewed this article:

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