Inversion therapy tables are see-saw like contraptions designed to use gravity to decompress the spine. They have been around for more than twenty years already, so today’s models offer more in terms of comfort and ease of use. But the principle is the same: use a platform balanced on a horizontal rod, with a mechanism to offer some controlled resistance. You lie face up on the platform (more expensive models allow you to be face down), lock your feet into the foot carriage either by hooking your insteps onto rollers, or wearing gravity boots strapped to the carriage; and raise your arms in varying angles to control the amount of tilt. Arms extended straight above your head result in the maximum angle, usually around 45 degrees. The weight of your torso pulls gently on your spine, and you get some degree of stretch to your back.
So is inversion therapy good for your back? Can it relieve lower back pain? The answer is “yes” for some cases of low back pain. I wrote about how low back pain can come from bulging discs, an acute or chronic low back strain, and even abnormal communication between the brain and the postural muscles. Low back stiffness is usually caused by inactivity, carrying too much abdominal weight, which places too much pressure on the small facet joints in the back of the spine; and basically “turned off” muscles; i.e. poorly conditioned, inactive erector spinae and multifidi muscles that surround the spine. This is common in people who sit more than four hours a day on a regular basis and don’t exercise.
Inversion table therapy should be helpful for some cases of disc bulges and back stiffness. Do not do it for an acute lumbar strain. And if your problem is due to miscommunication between the brain and postural muscles, inversion therapy may offer some relief, but the symptoms will quickly return, as this type of back problem originates in the motor neurons of the brain, not the back muscles.
Before you go out and buy one, realize that you must be able to physically handle being inverted. Although you shouldn’t stay inverted for more than 30 seconds or so, for some people, just a few seconds of being inverted (upside down) can be unpleasant, and dangerous. If you have the following conditions, you should not use inversion therapy for back pain:
- metal plates, hardware in spine or lower extremities
- history of migraine headaches
- eye diseases (especially glaucoma)
- history of vertigo, tinnitus, Meniere’s disease
- recent surgery to ankles, knees, hips, spine
- cardiovascular disease; heart problems
- risk factors for stroke
- aortic aneuyism
Basically, aside from back pain, you need to be in fairly good physical shape to do inversion therapy; otherwise the risks exceed the benefit. Ask your doctor if it is OK for you to do it.
Now, for those who meet the physical criteria. As in anything new, start slowly. Get used to your machine– how it feels, how responsive it is to your movements. Know how long you can be inverted before you start feeling dizzy. The proper way to do it is to start with small angles first, maintaining the position for a minute or so. Attempt steeper angles, but in small increments. You will find that the steeper you go, the less time you are able to hold the position, due to blood pressure increasing in the head from the effects of gravity. Take your time. Do not attempt a 45 degree incline your first day. You don’t even have to go that far, ever, as long as you can get a good stretch to your low back.
As you get comfortable with your inversion therapy table, you can do some gentle and slow spinal twists as you are inverted. Just rock your upper torso and shoulders from side to side. You may hear some pops as some vertebral facet joints decompress. The popping sound is just air pockets shifting in the joint capsules as the space increases from the stretching.
Lastly, adhere to this tip, which most people forget when doing inversion therapy: concentrate on relaxing your spinal muscles. In fact, before you start your inversion therapy session, close your eyes and take three, deep breaths through your nose, and slowly exhale through your mouth. Focus on your diaphragm expanding, drawing in the air, then relaxing it as you exhale. If you are tensed up, your back muscles will NOT allow the table to decompress your spinal joints. Back muscles are strong and can easily prevent the spine from elongating if they are under contraction. Remember, the goal of inversion therapy is to target the spinal discs and facet joints, not the back muscles themselves. The spine is where most of the symptoms of back pain and stiffness originate.
There are many brands of inversion tables, and varying degrees of quality. The basic ones are rated to about 250 pounds max (person’s weight). The Teeter Power VI Inversion Table with Gravity Lock Ratchet table is a higher-end table that doesn’t require you to raise your arms in order to tilt the table. A motorized inversion table may offer better traction to the lumbar spine, as the act of raising the arms contracts the back muscles which is definitely undesired when attempting to stretch the spine. And if money is not an issue, you may consider the Teeter DFM – Decompression and Functional Movement Table, a commercial-grade table designed with input from doctors and therapists. This table can be used in the prone (face down) OR supine (face up) position, and offers progressive decompression therapy.
My advice is if you are a chronic back pain sufferer, go with a higher end machine because you will be using it a lot. That way, you can rest assured that you’ll be getting a sturdier machine with better construction that will last longer. The cheaper models still can do a decent job, but they are made of weaker material and tend to be more “rickety” as they are held together by bolts and thinner metal tubing.