Evidence based

Inversion Tables for Back Pain

Last updated: 
March 9, 2020
Raj Chander
Researcher and author
Dr. Juliana Bruner, DPT
Researcher and author, Physical Therapist

Did you know that between medical costs, lost wages, and reduced productivity, back pain costs Americans over $100 billion per year? It’s one of the single most common ailments worldwide (1).

It’s no surprise that the medical community has developed a number of care approaches to treat back pain. One popular approach is inversion traction, the stretching of the spine using specialized machines and gravity.

Research shows that inversion therapy can relieve certain kinds of back and muscle pain and stiffness, especially pain related to the compression or inflammation of nerves responsible for conditions like sciatica. Gravity helps ease the pressure on the spine’s ligaments, nerves, and discs. However, not everyone should use inversion tables to treat their back symptoms, especially people with pre-existing heart conditions or issues related to their eyes or vision.

In this article, we’ll take a closer look at how inversion tables are used to treat the spine, which conditions they can treat, and what the research says about their potential risks and side effects.

What Are Inversion Tables and How Are They Used?

An inversion table is a piece of medical or physical therapy equipment that consists of a flat, padded table placed on a fulcrum. After strapping your feet to the table and laying flat against it, you can use your arms to manipulate the handles to flip yourself upside down. This treatment is referred to as inversion therapy.

There are many approaches for deciding the optimal frequency or duration of inversion traction. Most clinical studies focus on session lengths of anywhere from two to twenty minutes. The duration of your inversion therapy depends on how well you can tolerate the side effects.

You can vary the angle you hang at based on the table configuration and inversion degree necessary for pain relief. Some research suggests that a steeper 60-degree angle is more effective than a moderate angle like 30 degrees (2). However, not everyone can withstand the side effects of a steep inversion, especially those who have conditions involving their heart or blood pressure (3).

Gravity Boots and Other Options for Inversion Traction

Tables aren’t the only inversion devices available for patients who want to stretch out their spines. Inversion chairs employ a similar concept but allow operators to sit instead of lying down. Inversion or “gravity” boots securely attach users to an elevated point that they can hang from, like a rod mounted on top of a doorway. You can also attain the effects of inversion traction through certain yoga poses and headstands. The specific method you choose to obtain spinal traction will depend on your budget, preferences, and physical abilities.


An inversion table allows patients to stretch their spine by strapping themselves to a table and hanging upside down, a technique known as inversion traction. You can also use boots, an inversion chair, or certain stretches and yoga poses to achieve inversion traction.

What Can Inversion Therapy Treat?

By relieving pressure on nerves and increasing circulation to muscles inversion traction can treat several spine and back conditions, including:

  • Sciatica: The compression of the sciatic nerve in the leg and lower back which results in feelings of pain and numbness in the lower back and possibly one leg. Sciatica can also cause pain sitting or squatting. It’s most commonly caused by pressure from a herniated disc on the sciatic nerve, the largest spinal nerve in the human body.
  • Disc degeneration disease: The deterioration of the cartilage discs between adjacent vertebrae which allow the spine to rotate and absorb shock from force on the back. When these discs slip or burst, it can place pressure on nerves in the spinal column, leading to muscle pain or stiffness. Studies suggest inversion tables combined with physical therapy can reduce the likelihood of surgery being required for patients with this disease (4).
  • Increased mobility and flexibility: Studies show that spinal traction improves flexibility in the lower extremities (5). Research in the Journal of the Canadian Chiropractic Association also suggests that inversion therapy can bolster trunk and spinal mobility (6).
  • General lower back pain: Spinal traction through inversion therapy can improve radicular lower back pain, or pain associated with nerve compression and inflammation (7).
  • Muscle tightness: Since inversion therapy reduces pressure on the nerves that control muscles in the back and lower body, studies have shown reduction in at-rest muscle tension (8).

It’s important to remember that research on inversion tables is mixed, and not every healthcare provider encourages the use of inversion traction. Much of the available medical research on inversion tables is older or more anecdotal in nature.

Additionally, inversion therapy has only been shown to be effective in the short-term. It’s not a good option for patients looking to achieve long-lasting relief from spinal issues (9).


Inversion therapy can help treat sciatica, degeneration of spinal discs, and lower back pain due to muscle spasms and stiffness (spasticity). It can also help improve the flexibility and mobility of the upper body.

Risks and Side Effects of Inversion Tables

While inversion tables can be helpful for back problems related to the spine, muscle tension and overall health, hanging upside down for prolonged periods isn’t healthy for everyone. Clinical trials have shown a few common side effects of inversion traction:


Some inversion therapy patients suffer from persistent headaches after using inversion tables or upright suspension devices like gravity boots. Increased blood flow to the head can cause uncomfortable pressure for some people (10).

Increased Blood Pressure

Evidence connecting elevated blood pressure to the use of inversion tables is mixed. Some studies have linked inversion therapy with significant increases in both systolic and diastolic blood pressure. Other studies, however, have shown no significant differences in heart rate and blood pressure before or after inversion (11). If you have hypertension, you may not be a good candidate for inversion therapy. 

Blurred Vision

Some people may experience blurry vision as a consequence of inversion therapy. Use of inversion devices can also cause discomfort for contact lens wearers (12).

For certain patients, especially those with optical conditions, a tear or detachment in the retina of the eye is a potential side effect of inversion traction. This is rare and typically only occurs to inversion therapy patients who have a history of myopia, glaucoma, or eye surgery (13).


The most common side effects of inversion traction are increased blood pressure, headaches, and blurred vision. People who have hypertension or a history of optical issues should be cautious about using inversion tables and should seek medical advice prior to pursuing inversion therapy.

Final Takeaways

Research on the effectiveness of inversion tables and gravity boots for back pain is mixed. Current research suggests that inversion tables may relieve pain and stiffness associated with nerve compression due to slipped or ruptured spinal discs, but more substantiation is needed. Inversion therapy has also been linked to improved flexibility and mobility. They are best for short-term relief; for lasting results, you’ll probably need to incorporate more comprehensive lifestyle changes such as a regular physical therapy routine.

However, inversion tables carry serious potential side effects, especially for patients who also have problems with circulation, high blood pressure, or eye conditions like glaucoma or a detached retina.

If you believe using an inversion table may help your spine or back pain, talk to your doctor about whether you’d be a good candidate for this kind of treatment. Only a medical professional should make the decision about whether or not you should use inversion tables or similar devices for improved spinal health and relief from lower back pain.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Research Citations

Researched, written, and reviewed by:
Raj Chander
Researcher and author
Raj is a seasoned writer and has written for a number of top healthcare publications across a wide range of topics. He holds a degree in English from James Madison University.
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Dr. Juliana Bruner, DPT
Researcher and author, Physical Therapist
Dr. Bruner is a physical therapist who is highly trained and skilled in helping people overcome their physical ailments to live the best life they can. She is also a writer who enjoys spreading knowledge about various topics in the PT and healthcare industry.
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This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of board-certified physical therapists, physicians, and surgeons strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.