Can an Inversion Table Help a Pinched Nerve?

What the Evidence Says About Traction for a Pinched Nerve in the Neck

An inversion table is a traction device. So the relevant evidence is the evidence on neck traction, and the first thing to know is that none of the studies below used an inversion table.

The NASS Guideline: A Consensus Opinion, Not a Recommendation

The North American Spine Society publishes an evidence-based guideline on cervical radiculopathy from degenerative disorders. On traction, its only statement reads: cervical halter traction and combinations of medications, physical therapy, injections and traction “have been associated with improvements in patient reported pain in uncontrolled case series. Such modalities may be considered recognizing that no improvement relative to the natural history of cervical radiculopathy has been demonstrated” (NASS, 2010).

That statement carries no grade. It is labelled a Work Group Consensus Statement, which the guideline itself explains is used when “in the absence of reliable evidence, it is the work group’s opinion that” a treatment may be appropriate (NASS, 2010). For comparison, the society’s guideline on lumbar disc herniation at least gives traction a formal grade, even if that grade is I, for insufficient evidence (NASS, 2012). For the neck, there was not enough evidence to grade at all.

What “Halter Traction” Means, and Why It Is Not an Inversion Table

Look at the device in that sentence: cervical halter traction. A halter is a harness around the head and jaw that pulls on the neck alone, usually with a weight or a machine. The NASS guideline never mentions inversion tables (NASS, 2010). So even the weak support it gives applies to a neck-only device, not to a table that tips your whole body upside down.

The One Study Behind It

The traction part of that statement rests on one retrospective case series by Olivero and colleagues: 81 patients with mild cervical radiculopathy, of whom 75% reported some pain relief with halter traction and a collar over about six weeks. NASS criticized it for using no validated outcome measures and a very short follow-up, and rated it as the lowest level of evidence (NASS, 2010).

There was no comparison group, and that matters more here than usual. The same guideline’s work group states, again as consensus, that “it is likely that for most patients with cervical radiculopathy from degenerative disorders signs and symptoms will be self-limited and will resolve spontaneously over a variable length of time without specific treatment” (NASS, 2010).

The Dose in That Study Looks Nothing Like Inversion

The details of the Olivero series, recorded in the guideline’s evidence table, show how modest the treatment was. Patients used 8 to 12 lb of halter traction, three times a day for 15 minutes, for six weeks, with more traction only if they were improving, alongside a cervical collar. “Patients with severe symptoms excluded from study,” the table notes (NASS, 2010).

The same table records “63 (78%) of patients responded to traction,” a slightly different figure from the 75% in the guideline’s recommendation text, and the guideline does not explain the gap. Either way, it is a single case series with no control group, in people whose radiculopathy was mild.

Set that beside an inversion table. The study’s pull was a measured 8 to 12 lb on the neck, chosen and repeated on a schedule.

An inversion table has no setting in pounds. It puts your whole body weight on your ankles, and the pull on each part of your spine depends on how much of you hangs below it, not on a dose anyone picked. If your symptoms are severe, you also fall outside the only group this study looked at.

A 2020 Meta-Analysis: Statistically Significant, Clinically Small

The most thorough look at neck traction for a pinched nerve is a systematic review with meta-analysis by Colombo and colleagues, published in the Journal of Clinical Medicine in 2020. It pooled seven randomized trials with 589 patients with cervical radicular syndrome, comparing traction added to other treatments with those other treatments alone (Colombo, 2020).

Adding traction did lower pain, and the difference was statistically significant: 5.93 points on a 0 to 100 scale, with a confidence interval running from 11.81 points down to just 0.04 (Colombo, 2020). But the authors had set 20 points in advance as the smallest change that would matter to a patient, and the result came nowhere near it. The quality of the evidence was low, and the authors concluded that “none of these effects were clinically meaningful” and that traction “does not appear to be essential in clinical practice” (Colombo, 2020).

None of Those Trials Used an Inversion Table

The traction in those trials was mechanical in six of the eight comparisons and manual, applied by a therapist, in the other two (Colombo, 2020). No inversion table appears anywhere in the review.

That cuts both ways. It does not prove an inversion table fails for a pinched nerve in the neck. It does mean that the best available analysis of neck traction contains no trial of an inversion table, so a claim that inversion is proven for neck nerves has nothing in this body of evidence to stand on.

We also looked for a UK guideline to set beside NASS. For the lower back, NICE’s advice is blunt: “Do not offer traction for managing low back pain with or without sciatica” (NICE, 2016). We found no equivalent NICE guideline for neck pain or cervical radiculopathy with a recommendation on traction.

What the Manufacturers Say, and What They Sell for the Neck

Inversion table makers write about pinched nerves. What they write is marketing, and it should be read that way.

Teeter’s Blog on Pinched Nerves

Teeter’s blog suggests “inverting 2 to 3 times per day, ideally to an angle of 60 degrees or greater,” and says routine stretching while inverted “can help target the muscles that oftentimes contribute to pinched nerves in the neck, back, hips and legs” (Teeter, 2012). The post cites no study for that schedule or that angle, and it does not separate a pinched nerve in the neck from one in the back. Treat it as the manufacturer’s usage advice, not as evidence.

Neck Restore Is Not an Inversion Table

If you search for Teeter and neck nerves, you will also find Teeter’s Neck Restore. It is a separate accessory, not a table: a self-massage tool with a rubber insert you can freeze, “for cooling relief that can help reduce inflammation, nerve activity, and joint pain,” usable on its own or strapped to a Teeter table (Teeter). It works by cold and pressure at the base of the skull, not by pulling on the spine. Whatever you think of it, its existence is not evidence that inversion helps a pinched nerve.

A Neck Pad Is Comfort, Not Neck Traction

Innova’s ITM6000 has a dual heat and massage pad, “one for the neck area and one for the back area” (Innova). That is the only dedicated neck feature we found on a table from either brand, and it is heat and vibration during ordinary whole-body inversion. It is not a separate mechanism for pulling on the neck, and Innova does not claim it is.

Before You Try One: Contraindications and When to Stop

A pinched nerve in the neck puts you inside the manufacturers’ own caution lists before anything else is considered.

Nerve Symptoms Are on Teeter’s Own List

Teeter’s contraindication list, which it says also appears in the owner’s manual, tells users not to invert until a licensed physician approves if they have “any condition, neurological or otherwise, which results in unexplained tingling, weakness or neuropathy,” or “any bone, skeletal or spinal cord condition or injury” (Teeter). Tingling and weakness in an arm are exactly the symptoms that bring people to this page. By the manufacturer’s own standard, that means a doctor’s approval first.

Innova Lists Spinal Injury

Innova’s ITX9600 manual tells users not to use the table without a licensed physician’s approval and lists conditions including spinal injury, weak ankles and/or feet, osteoporosis and high blood pressure, while noting the list “is for reference only and it is not a complete listing” (Innova). Both lists include other conditions, such as glaucoma and heart problems, that have nothing to do with your nerve but still apply. Our page on who should not use an inversion table goes through each item with the evidence behind it.

When to Stop and See a Doctor

When Cochrane reviewers pooled the traction trials for the lower back, seven of the 32 reported adverse effects, including “increased pain, aggravation of neurological signs and subsequent surgery” (Wegner, 2013). That was the lumbar spine, not the neck, but the warning sign translates directly.

Our page on inversion table side effects covers the other effects people report.