Complete Guide to Inversion Therapy – Benefits, Risks & How it Works

Lower back pain can be a debilitating disorder that can substantially impact your life, such as your capacity to work, walk, and even sit. In more severe conditions, you may experience constant symptoms, including unrelenting pain, burning, numbness, and even weakness down the legs. Additionally, it is one of the most common conditions with roughly 80% of Americans experiencing low back pain sometime during their life.

In most circumstances, lower back pain can be effectively managed through traditional means, such as physical therapy, Clinical Pilates, and exercise. However, in less common scenarios, more invasive treatments, including corticosteroid injections and surgical interventions, might be used. In these situations, seeking more conservative treatment such as inversion therapy should be considered.

Although inversion therapy has been around for decades, recently increased research and personal inversion equipment have become more accessible. As a physical therapist who has incorporated similar treatment, I will be answering some common questions about inversion therapy.

What is inversion therapy?

Inversion therapy is a technique designed to help with ‘spinal decompression’ in order to ease the compressive forces that pass through our spine.

It is commonly used to help ease conditions, such as lower back, nerve-related issues, or sciatica.

Examples of inversion therapy include:

  • Hanging yourself upside-down, through the use of gravity boots.
  • Positioning yourself in a slanted position towards the ground, using an inversion therapy table.

An example of an inversion table by Teeter.

Both these devices work to reverse the effect of gravity and open up the space between the bones of your spine, giving you relief from your pain.

Although inversion therapy can help temporarily reduce symptoms, it’s most effective when combined with long-term therapies, such as physical therapy, rehabilitation, and pilates. These traditional treatments aim to improve your strength, function, and provide a long-term resolution of pain.

It is important to note that inversion therapy is not for everyone and should be considered when other traditional approaches have not been successful. However, inversion therapy may be a suitable option before considering more risky and expensive treatments such as injections or surgery.

How does Inversion Therapy work?

Inversion therapy works on the simple principle of reversing the direction of gravity on your spine. When we stand, sit or walk during the day, gravity is working to pull us down towards the Earth.

The compressive forces of gravity constantly squeeze the bones, discs, and ligaments in the back.

This is comparable to compressing a metal spring, the longer the force is applied, the longer the spring takes to return to its original shape.

In some cases, these forces can start to aggravate our low back pain by increasing pressure on your discs or pinching the spinal nerves.

Gravity can have the same effect on your spine as it does on a spring, slowly compressing it over time.

Inversion therapy acts to relieve this compression and take the pressure off the structures in the back. The most significant relief will be achieved when you are inverted closer to the ground.

Other forms of inversion therapy can also include:

  • Hydrotherapy
  • Hanging from a pull-up bar
  • Traction table therapy (supervision is required from a qualified health professional)

How do you use an inversion table?

Inversion tables will function differently depending on the brand and the model. How you use the inversion table will rely on your condition and how your body reacts to the therapy. Below will be a list of steps we would recommend before and during the use of an inversion table.

  • Set-up your table as per your body’s height. Depending on if you have long or short legs, you may need to re-calibrate the settings on the back stretcher.
  • Adjust the ankle grip so that your feet feel secure and snug. You may slide down the table if your ankle straps are too loose.
  • Once you find the right settings for you, you can begin to slowly lower yourself towards the ground. You can use your arms to bring yourself forward and back as needed.
  • You should feel your back stretch as your head begins to invert towards the ground.

Before using an inversion table, consulting a physical therapist is advised to ensure that the treatment is being delivered safely and effectively. The video below will help summarize the instructions above.

Can you ‘reverse’ bulging discs or spinal stenosis?

Inversion therapy equipment (e.g. inversion tables, gravity boots, etc.) were designed to help relieve symptoms for low back injuries, including:

  • Sciatica
  • Spinal stenosis
  • Disc herniations
  • Other back conditions

Specifically, in both bulging discs and spinal stenosis, the weight of the body increases strain on structures, such as the spinal cord and nerves. Inversion therapy pulls your body against gravity to temporarily reduce the pressure on these structures.

To date, there is a lack of strong evidence to indicate the ability of inversion therapy to reverse these types of conditions. However, there is emerging research for the use of inversion therapy as a short term solution to help with pain and flexibility and to improve the function of the low-back muscles.

Inversion therapy helps relieve symptoms temporarily but may not be an appropriate long-term solution for low back disorders.

How long should you use an inversion table for?

Currently, there is no established consensus on the specific timeframe recommended for the safe and effective delivery of inversion therapy. However, the table below has outlined some suggestions from several relevant research articles.

Timeframe Recommendations
Daily recommendations 6-15 minutes  (3-5 sessions of 2-3 intervals)
Weekly recommendations 3-4 days per week
Overall time required to experience benefits 4-6 weeks

For some individuals, inversion therapy can help immediately but temporarily reduce symptoms. However, for more obvious long-lasting benefits, you may need to perform these types of therapies for a longer duration of time, as outlined by table 1. The accumulated benefits of inversion therapy will take persistence and patience.

In the earlier stages, some of you may not be able to tolerate the times listed in the table. Consequently, you may opt to start with even less time and begin to increase the duration slowly. If your symptoms worsen or you begin to experience discomfort, you may want to cease treatment momentarily or reduce the treatment time even more.

Are there any side-effects and risks of inversion therapy?

As previously mentioned, we would recommend consulting a relevant health professional (e.g. physical therapist) before undertaking inversion therapy. By having the correct set-up and gradually increasing inversion duration, any risk of side-effects can be minimized.

Although not comprehensively researched, below will be a list of side-effects that users have experienced. If any of the mentioned symptoms occur, the therapy should be stopped immediately and you should seek professional guidance.

  • Aggravation of lower back pain
  • Worsening neurological symptoms (e.g. pins and needles, numbness etc.)
  • Dizziness
  • Retinal detachment
  • Cardiovascular dysfunction

Additionally, there are specific conditions and factors that can predispose you to a higher risk of developing side-effects. If you have any of the following, you should avoid using inversion therapy unless you have been medically cleared by a physician or physical therapist.

  • Osteoporosis
  • Fractures
  • Cardiovascular disorders, such as high blood pressure, stroke, or heart disease
  • Ear infections
  • Eye conditions such as glaucoma
  • Cerebral sclerosis.
  • Pregnancy
  • Obesity
  • Using blood clotting medication

Disclaimer: The content written on this page was created for educational purposes. Information on this page should not be used as medical advice or a substitution for seeking the services of a health professional. Anyone suffering from low back pain should book in a consultation with their primary healthcare practitioner (e.g. physical therapist, family doctor, etc.).

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Leon Mao
Leon Mao

Leon is an Australian physiotherapist who specializes in working with musculoskeletal conditions. He graduated from the University of Melbourne with his Doctorate in Physiotherapy before entering the workforce. He is now consulting from Top to Toe Health as a clinical and telehealth physiotherapist and primarily works with office-based workers and athletes. For any inquiries or further information, please visit Digital Physio.

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