How Does Inversion Therapy Work?

Verywell / Brianna Gilmartin 

Inversion therapy is a physical therapy technique in which you are suspended upside down on an inversion table. This can be done under the supervision of a healthcare professional, but there are also tables sold for home use.

The idea is that this process takes pressure off the lower back, thereby relieving lower back pain, sciatica, and more. However, controversy remains over how effective and safe inversion therapy is.

This article will help you to understand the benefits and risks associated with inversion therapy, and help you to make an informed decision about your care.

How Inversion Therapy Works

Another name for inversion tables or inversion therapy is gravitational traction. The theory behind inversion table use is that by suspending your body, you are able to unload pressure on the bones, joints, and discs in the low back and create traction.

The theories supporting the use of inversion therapy include that:

  • By separating the discs and joint spaces in your spine, you can take the pressure off spinal nerves and relax muscles.
  • Traction force through the spine can decrease low back pain.
  • Traction may allow negative pressure to pull a herniated fragment back into the disc space.

What Inversion Table Research Says

Most studies indicate that inversion therapy does cause some traction force through the lumbar spine. One study found as much as a 3-millimeter (mm) separation between lumbar vertebrae during inversion therapy.

However, most studies have not demonstrated that lumbar traction helps lower back pain.

One small study examined the effect of inversion on the need for surgery in people with single-level disc herniations. The researchers found that 77% of the patients were able to avoid surgery using inversion, compared to 22% of patients not using inversion.

If you are facing surgery for sciatica, you might consider asking your healthcare provider if you should try inversion therapy.

Research suggests that while lumbar traction did not seem detrimental to individuals with low back pain, it also didn’t seem to help much.

Types of Inversion Therapy 

An inversion table is a padded table that is connected to a metal frame with hinges. To use the inversion table, you would be strapped on the table, which would be allowed to slowly tilt backward, thus inverting the body.

The same principle is at work when using an inversion chair, in which you remain in a seat while inverted.

Due to the risks, it is recommended to have medical supervision while using this type of therapy.

Risks and Complications

There are risks associated with inversion tables. The most common of them are:

  • An unsafe rise in blood pressure
  • A rise in pressure in the eyes
  • A rise in heart rate

If you have glaucoma, high blood pressure, or cardiovascular disease, it's recommended that you check with your healthcare provider before attempting inversion therapy. This type of treatment can also be dangerous if you have a risk of increased intracranial pressure.

Falling off the inversion table, especially while getting on and off, can cause serious injuries. So if you try inversion, be extremely careful.

A Word From Verywell

If you have nonspecific low back pain, it's best to remain active. A physical therapist can prescribe exercises for back pain and give you tips on how to change your posture to help your condition. Your physical therapist can also provide strategies to prevent future problems with your low back.

Frequently Asked Questions

  • How does inversion therapy work?

    This therapy changes your body position, with the aim of relieving pressure on structures in your back and providing traction.

  • How long does inversion therapy take to work?

    It depends. For some people, this therapy doesn't work at all. For others, it may work after a few sessions or after many sessions.

  • How long should you do inversion therapy at one time?

    This depends on your overall health. It is best to start with no more than a few minutes at a time. If you feel dizzy, experience head pain, or have any other discomfort, tell your healthcare provider right away.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  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. 2017;166(7):514-530. doi:10.7326/M16-2367

  2. Wegner I, Widyahening IS, Van tulder MW, et al. Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev. 2013;(8):CD003010. doi:10.1002/14651858.CD003010.pub5

  3. Jung SH, Hwang JM, Kim CH. Inversion table fall injury, the phantom menace: Three case reports on cervical spinal cord injury. Healthcare (Basel). 2021 Apr 22;9(5):492. doi:10.3390/healthcare9050492

  4. Prasad M, Gregson BA, Hargreaves B, et al. Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial. Disability and Rehabilitation. 2012;34(17):1473-80. doi:10.3109/09638288.2011.647231

  5. McMonnies CW. Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk? J Optom. 2016;9(3):139–147. doi:10.1016/j.optom.2015.12.001

  6. Kondrashova T, Makar M, Proctor C, Bridgmon KA, Pazdernik V. Dynamic assessment of cerebral blood flow and intracranial pressure during inversion table tilt using ultrasonography. J Neurol Sci. 2019 Sep 15;404:150-156. doi:10.1016/j.jns.2019.07.033

Additional Reading

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.