Does an Inversion Table Help Low Back Pain?

Many people with back pain or sciatica benefit from the skilled services of a physical therapist to help them recover. Your PT may help choose the best treatments for your condition. If you have back pain, you may wonder if an inversion table can help. So, do inversion tables help low back pain?

Low back pain (LBP) can be caused by any number of reasons including poor sitting posture, heavy lifting, or frequent bending.

If you have had LBP, you might have realized that a lot of people have experiences with back pain just like you. That also means that many people have tried many treatments and modalities to help decrease their LBP and improve their function. Treatments for back pain may include:

• Exercise
• Joint manipulations
• Dry needling
• Heat or ice
• Ultrasound
• TENS
• Traction

This list is in no way exhaustive. There are a host of available treatments for back pain, and the challenge is finding the best one for your specific condition.

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.

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 doctor 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.

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.

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.