Can Inversion Therapy Relieve Your Chronic Back Pain?

Written by Kim Grundy, PT | Reviewed by Sanjai Sinha, MD Published on December 14, 2022

Key takeaways:

• Inversion therapy is a treatment in which you are suspended upside down in order to relieve pressure on the spine. 
• It may ease low back pain, improve flexibility, and reduce the need for surgery. 
• You should talk to your healthcare provider before you try inversion therapy. This is especially important if you have conditions such as high blood pressure or heart disease. 

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If you have chronic low back pain, you’re not alone. An estimated 16 million adults in the United States live with this condition. One alternative treatment approach is inversion therapy, in which you are suspended upside down for a brief period. It’s designed to take the pressure off of the discs and nerves in the back and may help relieve back pain.

How does inversion therapy work? 

Inversion therapy started 2,400 years ago in ancient Greece. Hippocrates, often credited as the father of medicine, used the technique. He would use ropes to hoist patients up on a ladder and hang them upside down to relieve back pain. Today, there are specially designed tables, chairs, and anti-gravity boots that healthcare providers may use to offer inversion therapy. 

When you stand for long periods, it can cause or exacerbate back pain. Standing reduces the space between your vertebrae and compresses the nerves in your spine. Inversion therapy uses gravity to stretch the spine, creating space between the vertebrae and taking pressure off the nerves and disks that may be causing pain. 

You might not have to hang all the way upside down to reap the benefits of inversion therapy. Research suggests that just three minutes spent at a 60-degree tilt may relieve pressure and pain. 

Are there different types of inversion therapy? 

There are various methods of inversion therapy. A healthcare provider can help you determine which technique is right for you. Common forms of inversion therapy include: 

Inversion tables or chairs

The inversion table is the most well-known and most thoroughly tested method. It is essentially a padded platform that the patient is strapped onto. You use handles, footrests, and your body weight to adjust the table and tilt it to various degrees. For inversion therapy, you’ll usually be somewhere between a 45-degree tilt and a full 90-degree upside-down inversion. 

Inversion chairs allow you to start from a seated position before leaning back into an inversion. An inversion chair is a good option for people with limited mobility, older adults, and those with foot or ankle problems. 

Gravity boots

Gravity boots are heavy-duty ankle straps that you can attach to a bar in order to hang upside down by your feet. Compared with inversion tables and chairs, gravity boots make it harder to get into an inverted position. They also don’t allow you to tilt at different angles. The only option is to hang completely upside down. 

Gravity boots were popular in the 1980s, but there aren’t recent studies on their effectiveness. One older study found that using gravity boots for more than 2 to 3 minutes can raise your blood pressure to dangerous levels. And they may not be right for people with mobility issues. 

Inverted yoga positions

Yoga has many potential benefits, including relief for chronic back pain. For those who want a more active approach, inverted yoga positions may offer benefits similar to those of inversion tables and chairs, though there are currently no studies showing this. Inverted yoga positions include the plow pose, headstands, and handstands. You can use a yoga headstand bench for stability and support to help you hold the pose longer. Make sure you work with a yoga instructor until you can safely master the poses. 

What are the benefits of inversion therapy? 

Inversion therapy is a form of spinal traction — a therapeutic approach that uses weights and gravity to stretch the spine — so you might hear it referred to that way as well. 

A healthcare provider may recommend inversion therapy for a number of spine-related conditions, including:  

• Herniated or bulging disks (also known as lumbar disk disease)
• Sciatica
• Spondylolisthesis
• Scoliosis
• Muscle spasms

A 2021 study looked at how inversion therapy affects those with lumbar disc disease and sciatica. Participants used an inversion table daily, in six intervals spread over 30 minutes, with each interval lasting at least two minutes. After six weeks, 75% reported less pain and better function. But it’s worth noting that Teeter Inversion Tables sponsored the study. Other research suggests that inversion may provide short-term benefits for people with herniated disks but no long-term results. So there’s a need for more studies on this topic. 

That said, research suggests that inversion therapy may offer additional benefits, including: 

• Reduced need for pain medication and back surgery: The same 2021 study found that only 16% of those who had inversion therapy needed surgery after one year, compared with 43% of those who did not receive this treatment. Participants also said they needed less pain medication after treatment. Another small-scale study examined the effects of inversion therapy in people with lumbar disc disease and sciatica. And 77% of them were able to avoid surgery after treatment. Although the results are promising, larger studies are needed to confirm these benefits.
• Increased flexibility: Inversion therapy has been found to decrease stiffness, reduce muscle spasms, and increase range of motion in the spine. 
• Improved spinal health: Inversion therapy may improve spinal disk circulation, lubrication, and rehydration. This helps keep your spine healthy and functioning. 

What are the risks of inversion therapy?

It’s always a good idea to talk to a healthcare provider before starting a new treatment. Although inversion therapy is non-invasive, it is not safe for everyone. The practice may increase blood pressure, circulation, and pressure in the head. So people affected by the following should avoid inversion therapy or talk to a healthcare professional first: 

• High blood pressure
• Heart conditions, including heart disease 
• History of a stroke
• Hernia
• Osteoporosis
• Broken bones
• Eye conditions such as glaucoma, retinal detachment, or pink eye
• Ear infection
• Vertigo
• Severe acid reflux
• Pregnancy
• Certain medications, including blood clotting medications or blood pressure medication

Is it safe to do inversion therapy alone? 

If your healthcare provider gives you the OK, you can try inversion therapy at home. Remember these safety tips before you get started: 

• Try it with a professional first: Work with a physical therapist or another medical professional before you try inversion therapy by yourself at home. A professional can monitor you and instruct you on the proper technique.
• Make sure you are strapped in correctly: Carefully read the instructions that come with your inversion therapy device. And use all the safety straps provided. This can help you avoid serious injuries, including from falling off the table. 
• Practice with a spotter: Make sure an adult is nearby as you get used to using the inversion tool.
• Ease into inversion: You don’t have to be fully upside down to get the benefits of inversion. So ease into it, starting with a tilt between 20 and 45 degrees. (The inversion tool you use should show you the angle you are inverted.) You can then work your way up to 60 degrees and then to a full 90-degree inversion. This may take several weeks, and there’s no need to get to a full inversion at all, if you aren’t comfortable. 
• Limit inversion time: Start with short inversion times. Experts recommend trying inversions of less than 60 seconds, with at least a 90-second recovery time between sets. Then, you can work up to two- or three-minute intervals, with rests in between. You can scatter inversions throughout the day or do a daily 30-minute session.. 
• Stop if you feel dizziness or pain: Always listen to your body and use comfortable inversion angles. Stop if you experience pain, dizziness, or other uncomfortable symptoms. 
• Relax: To get the full benefits of inversion, you should take deep breaths and relax your body. As you adjust to the feeling of being inverted, you can gently oscillate (rock up and down) while tiled. You can also stretch by holding onto the handles. This can help relax your muscles and lubricate your spine.
• Slowly return to the upright position: Make sure you return to the upright position slowly, no matter what angle you use with inversion therapy. And try to avoid sudden movements on the way up. 

The bottom line

Inversion therapy can ease low back pain, especially in people who have a herniated disk. The treatment involves hanging upside down for short periods of time. It may reduce muscle stiffness and help prevent or delay the need for back surgery. Inversion tables are the most popular type of equipment for this therapy, but you can also use an inversion chair or even certain yoga poses. Inversion therapy may not be safe for everyone, so it’s best to talk to your healthcare provider before trying it.