Lower back pain is nothing less than debilitating. And between pain medicines, massage, chiropractic, pain injections, core exercises and surgical options, there is no shortage of ways to manage it.
One controversial approach to managing back pain and improving overall spine health is with an inversion table.
The questions are 'is an inversion table effective?' and 'is it a good fit for my spine?'
First... A Very Short Anatomy Lesson
Your spinal column is made up of vertebrae that are stacked on top of each other from about the level of your belly button up to your head.
While the spine is designed to provide protection for the spinal cord as well as keep you upright much as a pole might keep a tent erect, its design also allows you to bend, twist, rotate, and otherwise move your upper body in every direction.
The bones themselves do not actually bend or twist. The mobility stems from the joints formed by each spinal bone joining up with the one below and above. Between each set of spinal bones is a disc (called an inter-vertebral disc) which connects to the spinal bone above and below it.
The discs not only act as shock absorbers but also have the added burden of creating a space between the spinal bone above and below is so that nerves branching out from the spinal cord to all areas of the body including muscles, organs and skin.
The discs are made of tough rings of fibrous elastic material called cartilage. At the center of the outer tough rings is a thick fluid with the consistency of thick molasses.
Secondary to old injuries and micro-trauma (i.e. sitting long periods, repetitive work, bad posture, etc) the discs and joints can get compressed and degenerate prematurely over time.
The Role of the Inversion Table
While the disc has a limited blood supply and thus cannot easily heal once compressed or degenerated or damaged, some studies indicate that the disc does have some nutrient supply arising from load-induced fluid movement in and out of the disc.
Research is controversial on how much nutrient supply the disc can obtain by compressing and decompressing it.
Why is this important?
In short, if the disc is not getting nutrients in some way, it will be begin to break down or degrade. As noted above, once this occurs it is not going regenerate or heal - at least not in an adult.
The role of the inversion table is to essentially decompress or stretch the discs and joints in the spine. Although controversial on the benefit, in theory you are reducing pressure on the tissues around the nerves that exit out between the spinal bones while also helping to improve the amount of nutrients and blood flow to the area.
Is Inversion Right for You?
Whether or not an inversion table is the right for you to add as part of your spine health and maintenance regimen really depends on two factors.
First, does it give you pain relief? If using it reduces any pain you are experiencing at that time then it's a no-brainer that an inversion table is a great fit for you; for that reason alone.
Second, does it improve function with long-term use? If it improves your ability to walk, lift, exercise, sit at work comfortably, work in the yard, do house work or any other activity of daily living then it is again a great asset for you.
A Simple Inversion Protocol
While an inversion table will likely come with a recommended protocol to follow, as a 'degenerative disc' sufferer and chiropractor in Keller, Texas, I have some recommendations as well.
While the most recent research sites moderate compression of the disc as the most beneficial treatment for improving disc related spine health, it would make sense that alternating moderate compression and de-compression would be have a positive impact on overall health and function of the inter-vertebral discs and spinal joints.
This would be most analogous to the care a patient would receive in a physical therapy or chiropractic center that offers spinal decompression services. I have seen firsthand the positive impact such therapy can have on a chronic lower back pain sufferer.
Based on the success of in-clinic decompression therapy, it only makes sense to try and follow this same logic in a home inversion unit.
When you first begin using an inversion table, start slow!
I recommend inverting about 15 degrees and holding it 30 seconds and then coming back to horizontal (or even a little beyond) for 10 seconds so you are exacting a little gravity back onto your spine. Repeat this cycle 10 times. Do this daily for 10 days.
Even at a 15-degree angle your body will feel a mild muscular stretch and the benefits of increased blood and lymph circulation. Most people do not need to exceed 60-degrees as you will start to naturally fight the decompression at this angle. Don't exceed what your body tells you!
Additionally, if you have glaucoma or blood pressure related issues, hanging upside down for any extended period of time can have adverse effects.
Beyond the 10 day introduction of 'decompression followed by recompression' to your spine, I recommend 3 days a week holding the inverted position for a minute at 15-45 degrees followed by going back to horizontal or slightly re-compressing the spine for 20 seconds and then repeat. I have been doing about 10 cycles of this and have found it to improve my overall function level and reduce any aching in the lower back.
Anything you add to the decompression protocol is up to you and what you are comfortable with adding. This might include moving the head from side-to-side, stretching the arms overhead, or performing slow pelvic tilts.
When coupled with a rehabilitative exercise program, using an inversion table really makes sense when you consider how compressed our discs and joints are because of sitting long periods and poor posture and how commonly we have premature degenerative joints and discs because of past trauma and ongoing micro-trauma.
However, just as with stretching, strengthening, diet and hydration, you are going to get the best long term results if you find a schedule of use and stick to it. Once you have been using it for a couple of months, inverting even just twice a week is probably plenty but each person is different in the frequency that will work best for their spine.
Talk to your chiropractor or physical therapist about how often you should invert and specific movements to enhance your inversion, and as with any home therapy program, if you experience unusual pain stop immediately until you can consult your health professional.