Orthopedics Assistive Devices & Orthotics How Does Inversion Therapy Work? By Brett Sears, PT Brett Sears, PT Facebook LinkedIn Twitter Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. Learn about our editorial process Updated on June 10, 2022 Medically reviewed by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Expert Board Print Verywell / Brianna Gilmartin Table of Contents View All Table of Contents How It Works What Research Says Types of Inversion Therapy Risks and Complications Frequently Asked Questions 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. The 7 Best Inversion Tables of 2023, Tested and Reviewed Risks and Complications There are risks associated with inversion tables. The most common of them are: An unsafe rise in blood pressureA rise in pressure in the eyesA 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. 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 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 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 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 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 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 Lerebours VC, Rohl AJ, Shaikh S. Bilateral retinal detachments associated with inversion table therapy. Cureus. 2017;9(3):e1098. Published 2017 Mar 15. doi:10.7759/cureus.1098 By Brett Sears, PT Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit