Orthopedics Assistive Devices & Orthotics 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 November 18, 2019 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Laura Campedelli, PT, DPT Medically reviewed by Laura Campedelli, PT, DPT LinkedIn Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Review Board Print Verywell / Brianna Gilmartin Table of Contents View All Table of Contents How Inversion Therapy Works What Research Says Types of Inversion Therapy Risks and Complications Frequently Asked Questions A Word From Verywell Inversion therapy is a physical therapy technique in which you are [suspended] upside down on an inversion table, or using TKTK. The idea is that this takes pressure off the back and provides traction for the spine, [and relieves lower back pain, sciatica, etc]. : The effectiveness and safety of inversion therapy [is controversial, etc, therefore it's important to understand the risks and benefits ...] How Inversion Therapy Works The theory behind inversion table use is that by flipping your body over, you are able to unload the bones, joints, and discs in the low back. This is thought to create a traction force through the spine, and it has been theorized that traction can decrease low back pain. Another name for inversion tables or inversion therapy is gravitational traction. By separating the discs and joint spaces in your spine, it is theorized that you can take the pressure off spinal nerves and relax muscles. An inversion table is a padded table that is connected to a metal frame with hinges. To use the inversion table, you strap yourself on the table and slowly allow the table to flip over, thus inverting the body. What 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 mm separation between lumbar vertebrae during inversion therapy. So the question arises: Does lumbar traction help low back pain? Several studies about the efficacy of traction for LBP were of poor quality. Those studies that were of high quality were not able to demonstrate that lumbar traction helps LBP. In other research, findings indicated that traction for acute, sub-acute and chronic LBP received a grade of "C" (no benefit demonstrated). 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, inversion may then be a last-ditch attempt to avoid the knife. If studies show that inversion traction is not likely to help, should you forget about it altogether? Not necessarily. Simply understanding the expected benefits and risks associated with inversion, or any other treatment for back pain can help you make an informed decision about your care. 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 inversion table Risks and Complications The most common risks associated with inversion tables are an unsafe rise in blood pressure, a rise in pressure in the eyes (glaucoma), or a rise in heart rate. It is therefore recommended that if you have glaucoma, high blood pressure, or cardiovascular disease you check with your healthcare provider before attempting inversion therapy. Falling off the inversion table while getting on or off it is another small risk, so if you try inversion, be careful. Frequently Asked Questions How does inversion therapy work? (answered inline text “How Inversion Therapy Works”) How long does inversion therapy take to work? How long should you do inversion therapy at one time? A Word From Verywell The best treatment for nonspecific acute low back pain is to remain as active as possible. For sub-acute and chronic low back pain, the evidence shows that exercise received a grade of “A” (benefit demonstrated). This means that when back pain strikes, it is best to remain active and engage in the right exercises for your condition. Your physical therapist can show you the best exercises for you. If you are suffering from low back pain or pain in the leg that is coming from the back (sciatica), the best treatment for you to engage in is to continue normal routines and perhaps add exercise. The use of mechanical traction seems to offer little or no benefit for low back pain. Comparing the risks associated with inversion tables (glaucoma, blood pressure changes, heart rate changes) with the benefits expected with using inversion for low back pain, it would seem that your time (and money) would be better spent exercising to help treat your pain. A visit to your physical therapist is a reasonable plan of care for your low back. He or she can prescribe exercises for back pain and help you change your posture to help your condition. Your physical therapist can also teach you why your back is hurting and can help provide strategies to prevent future problems with your low back. Was this page helpful? Thanks for your feedback! Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 4 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 Prasad M, et al. Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial. Disability and Rehabilitation. 34(17); 2012. 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 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 Veltri, D. (2017). The Effects of an Inversion Table on Lower Spine Flexibility (Doctoral dissertation, The William Paterson University of New Jersey).