Quite frequently a patient with low back pain will ask about Inversion Tables and whether such equipment can be helpful for treating back pain. The idea of the table is to tip you upside down so that the pull of gravity acting on the weight of your trunk, head and arms stretches the spine to counteract the compression which occurs when we are upright. By stretching the spine in this way (therefore producing a “traction” type force on the vertebral joints) and reducing compression, the expectation is that spinal pain can be alleviated. My experience earlier in my career with traction applied on a horizontal table was mixed, some patients were relieved, some were no different and occasionally some were worse and I suspect that if a clinical trial of inversion table treatment was done the results would be mixed also. A key consideration when evaluating any treatment is balancing safety (risk) with efficacy (effectiveness) Applying traction type forces to the spine can be helpful in alleviating symptoms in the short term particularly if done as part of a more comprehensive program of exercise and patient education. What are the possible risks associated with tipping yourself upside down? Mechanically, the traction type force if excessive might aggravate your pain or the “straight” position of your spine as you are suspended from your feet might not be tolerated by patients with degenerative or stenotic type spines who don’t like to be in extension. The other consideration is the effect that tipping will have on other body systems/tissues. For example, in a recent Mayo Clinic Newsletter (firstname.lastname@example.org) an article on Inversion Tables/Therapy highlighted the cardiovascular implications of a slower heart rate and higher blood pressure and an increase in eyeball pressure therefore warning against this type of treatment where those medical conditions are present. Another consideration for applying caution might be in cases where dizziness/vertigo are an issue due to inner ear problems. Discussing these medical issues with your health care professional would be a smart thing to do before considering whether this type of equipment is suitable for your condition.