To Tilt or not to Tilt

One of the most common questions I get from people who suffer from low back pain is, “I was thinking about getting a tilt(inversion) table for my back pain, what do you think about them?”

Honestly, I have mixed feelings.  It is important to understand what tilting upside down can do to your body.  Tilting upside down causes your blood pressure to rise, your heart rate to slow down, and the pressure in your eyes to increase dramatically.  Therefore if you have any blood pressure issues, heart disease, or glaucoma it is very important to check with your physician prior to using an inversion table.  I have found that even if you do not have any blood pressure issues, tilting backwards for any length of time, where your head is lower than your feet, can cause dizziness and light headedness when you return to the upright position.  This puts you at risk for fainting and getting injured.  So please proceed with caution.

Here is a quick review of what an inversion table is for those who do not know.  It looks a lot like a teeter totter but you lie down on it on your back and strap your feet and ankles into the bottom of the table. Then you slowly tilt yourself backwards to the desired angle.  Some people enjoy being tilted fully upside down.  Typically you stay in this position for 10-15 minutes and tilt yourself back up, and off you go.

The reason that most people use a tilt table at home is to self-manage their own back pain.  Tilting backwards or upside uses gravity to reduce pressure on your nerves, joints, and discs that become compressed over time. In turn this should reduce back pain that is caused by too much pressure on these structures.  Unfortunately there has been very little research done with inversion tables, so the evidence is sparse.

Traction TableAt Back in Motion Physical Therapy we use many hands on techniques for reducing pressure through the spine.  PTs perform manual traction where they pull on your legs at different angles, reducing pressure on the spine.  We also have a computerized traction table where we can make many adjustments to give you a mechanical traction.  With this, you lie flat on your back and a harness is put on your shoulders and waist.  Then a machine slowly pulls from your hips which helps reduce pressure through your spine.  Traction and an inversion table can both be useful tools for managing back pain but it is wise to consult with a physical therapist because there are likely some stretches, strengthening exercises, and life modifications that would provide more long term relief of symptoms.   So if you are contemplating using an inversion table, I suggest taking advantage of the free 30 minute consultation that we offer.  During that time we can discuss the topic further and decide if it is a good choice for you.


By Mike Moras, DPT

Back in Motion Physical Therapy – Portland, Maine

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