The 1980’s called. They want their inversion table back.
If I had a dollar for every time someone asked me if they should get an inversion table, I’d probably be able to buy us all a round of drinks. Until now, I always answered honestly that I had never actually read any research on it and couldn’t offer sound advice. Well, after being asked one too many times, I finally dug into some research on the topic!
A good place to start is upside down. Anyone who knows me, knows I enjoy being upside down. Though I’ve never used an inversion table, you can frequently find me in a handstand at my office throughout the day. For me, being upside down does a number of things. It allows some blood flow to my brain, which is advantageous when I’m sitting down writing piles of notes for patient visits. Another thing I notice when I’m on my hands is that my back feels better. Even with an active job, I find myself sitting for longer chunks of time while working at my computer, which my back does not like. When I do a handstand, my spine feels unweighted and happy. I also notice all of my scapular muscles working, a necessary wake up after all of that inactive time doing paperwork or administrative stuff (Scapular dysfunction from prolonged sitting is a major cause of neck and shoulder pain, by the way!) But most importantly, handstands are fun and they make me happy, so there.
Don’t just take my word for it. Yogis have insisted since forever that inversion helps increase circulation (particularly to your face, head, and scalp), improves intestinal function, enhances your mood, and helps with relaxation. While there is limited research available on inversion poses specifically, there is a fair amount of data on yoga in general. A systematic review in 2011 revealed that participation in yoga helps to lower anxiety, heart rate, respiratory rate, blood pressure, and cardiac output. Yoga has been found to have positive effects on stress and depression, as well as arthritis, back pain, carpel tunnel, and cardiovascular function. Yoga has been associated with a decreased risk for stroke or heart disease due to its effect on blood and circulation. Inversion poses help return blood from lower extremities back to the lungs to be oxygenated. A more recent study linked yoga practice to improved heart rate variability, which is a measure of general health and autonomic function.
After searching research databases for articles specific to use of inversion tables, here’s what I found: there is not a lot of solid research on this topic! Of the limited research, data is conflicted, and all of the studies are lacking in power. There are lots of opinion pieces. But few well-done studies, and most of the research is 20 or 30 years old.
“The short answer: Inversion therapy has shown positive effects on low back pain and some other aspects of mobility, but you should be cautious....”
The short answer: Inversion therapy has shown positive effects on low back pain and some aspects of mobility, but you should be cautious if you have any cardiovascular or eye issues. A study in 1983 revealed a significant increase in blood pressure, heart rate, central retinal arterial pressure and intra-ocular pressure after 3 minutes of full inversion using gravity boots. Another study in 1985 showed that 3 minutes in an inverted chair (suspended from thighs rather than ankles) had no significant negative impact on cardiovascular function, but showed improvement in overactive low back muscles, increased disc space, and improved forward trunk flexion after 3 minutes. In 2012, a small study demonstrated satisfactory resolution of sciatic pain due to single level, one-sided disc herniation in 76% of its participants (though, 76% equates to 10 people in the study, it’s still something).
After reviewing all of this research, I stand by my default answer to whether or not you should use an inversion table:
“I mean, if you have one laying around, collecting dust, and have no heart or eye problems or other health issues that would be impacted by increased blood pressure, then sure. Otherwise, I wouldn’t rush out and spend $600 on one.”
I don’t want to give you the wrong idea. There is some evidence that inversion tables are beneficial for relieving back pain, and for 3 minutes or less, they have been proven to be safe without prior screening for cardiovascular or other health issues. But my personal opinion is that an inversion table is not worth the cost in most cases. If you need to satisfy a need to be inverted (and you don’t enjoy handstands), here are some cheap, easy, and generally safe (as long as you have no major health issues) options:
Legs up wall pose:
This can be performed against a wall or free standing, and with or without a yoga block. This is one of my personal favorites!
2. Downward dog pose:
A well known yoga pose that stretches low back, hamstrings, and shoulders as well as improves circulation.
3. Shoulder Stand:
This post can be held for up to 10 minutes! But I think 2 or 3 would also be beneficial. :)
As always, this blog is not prescriptive and you should consult a medical professional if you have any questions regarding your health. Remember, low back pain is common, but not normal. If you can’t shift your symptoms, check in with your physical therapist!
Feel free to comment with your experience using inversion therapy (table or yoga) for your own low back pain!