Inversion Treatment Of Low Back Pain

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DEFINITION
Low back pain (LBP) is one of the most common
reasons for a visit to your physician, second
only to the common cold. It can be caused by any
number of reasons including poor sitting posture,
heavy lifting, or frequent bending. If you have
had LBP, you might have realized that a lot of
people have experiences with back pain just like
you. That also means that many people have tried
many different treatments and modalities to help
decrease their LBP and improve their
function. An inversion table is a padded table
that is connected to a metal frame with hinges.
To use the inversion table, you strap yourself
onto the table and slowly allow the table to flip
over, thus inverting the body. Inversion tables
typically range in cost from 100 to 400. The
similiar device, called Gravity boots, was
popular in the 1980s. Another name for inversion
tables or inversion therapy is gravitational
traction.
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CLAIMS
The theory behind inversion table use is that
when the body's weight is suspended from the
lower body rather than borne on the hands as in
handstands or headstands or hanging from a bar
with arms at sides, which are also forms of
inversion the pull of gravity may decompress
the joints of the body below the anchor. Hanging
by the feet, as with gravity boots or inversion
tables, causes each joint in the body to be
loaded in an equal and opposite manner to
standing in an identical position of joint
alignment. This is thought to create a traction
force through the spine, and it has been
commercially advertised as a relief for back pain
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RISKS
People who have heart disease, high blood
pressure, eye diseases (such as glaucoma), or are
pregnant are at higher risk for the dangers
related to inversion therapy and should consult
their doctors about it first. The first time
anyone tries inversion therapy with gravity, they
should be sure to have someone standing by, in
case assistance is required to get out of the
apparatus, or if health problems are experienced.
People with Gstroesophageal reflux disease (GERD)
are also at risk. During an episode of acid
reflux, small amounts of stomach acid manage to
escape out the stomach's doorway and into the
esophagus. Fortunately, gravity keeps much of
the stomach acid away from this doorway. However,
in an inverted position, gravity cannot do its
job. Combining an inversion table and acid reflux
can be a painful, nauseating and potentially
dangerous combination.
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EFFECTIVNESS
Most studies indicate that inversion therapy does
cause some traction force through the lumbar
spine. One study found as much as a 3 mm
separation between lumbar vertebrae during
inversion therapy. So the question arises Does
lumbar traction help low back pain? A review of
available research was published in 1995 and
found that most studies about the efficacy of
traction for low back pain were of poor quality.
Those studies that were of high quality were not
able to demonstrate that lumbar traction helps
LBP. Conclusion While lumbar traction did not
seem detrimental to individuals with LBP, it also
didnt seem to help much. A paper in the 2001
issue of Physical Therapy Journal examined
published evidence for various treatment
modalities for acute ( 12 weeks) non-specific
LBP. In short, the findings indicate that
traction for acute, sub-acute and chronic LBP
received a grade of "C" (no benefit
demonstrated). To date, no other high quality
studies have been published to refute these
findings. The same paper in the 2001 Physical
Therapy Journal that reviewed LBP concluded that
the best treatment for non-specific acute low
back pain is to remain as active as possible. For
sub-acute and chronic low back pain, the evidence
shows that exercise received a grade of A
(benefit demonstrated). The paper concludes
There is evidence to support and recommend the
use of continued normal activities for acute
non-specific LBP and therapeutic exercises for
chronic, subacute, and postsurgery LBP.1
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CONCLUSION
There are no clear indications, however, that
traction is an ineffective therapy for back and
neck pain. Further trials may prove
othervise. But if you are suffering from low
back pain or pain in the leg that is coming from
the back (sciatica), the best treatment for you
to engage in is continue normal routines and
perhaps add exercise. The use of mechanical
traction seems to offer little or no benefit for
low back pain.
Comparing the risks associated with inversion
tables (glaucoma, blood pressure changes, heart
rate changes) with the benefits expected with
using inversion for low back pain, it would seem
that your time (and money) would be better spent
exercising to help treat your pain. A visit to
your physical therapist is a reasonable plan of
care for your low back. He or she can prescribe
exercises for back pain and help you change your
posture to help your condition. Your physical
therapist can also teach you why your back is
hurting and can help provide strategies to
prevent future problems with your low back.