Who Should Not Use an Inversion Table: The Contraindications, With the Evidence

The Inversion Table Contraindications, in One List

The list most people quote comes from one manufacturer, Teeter, which says the same list is printed in its owner’s manual (Teeter). We use it here because it is the only maker’s list we have read in full.

Teeter’s wording is broad on purpose. Its manual says not to invert until a licensed physician approves if you have “any medical or health condition that may be made more severe by an elevation of blood pressure, intracranial pressure or mechanical stress of the inverted position, or that may impact your ability to operate the equipment,” and it adds that this includes “the side effects of any drug or supplement (prescribed or over-the-counter)” (Teeter).

What the Manufacturer Lists

Teeter groups its contraindications into seven families:

Teeter writes “optic hypertension”; the clinical term is ocular hypertension, meaning eye pressure above the normal range.

Manufacturer Caution Is Not the Same as Proof

A maker’s list is written to protect users and the company at once. It is not a summary of trials, and several of these inversion table contraindications have never been studied in inverted people. That does not make them wrong.

Two things the evidence does measure: blood pressure rises when you invert, and eye pressure roughly doubles. Everything else on the list is reasoning from those two facts, from the mechanics of hanging by the ankles, or from the maker’s legal prudence.

Where a study exists, we give you its numbers and its limits below. Where none exists, we say so.

An Early Warning List, From 1983

Lists like this have a long history in the research, too. In a 1983 letter to The Western Journal of Medicine, Klatz and colleagues reported hanging 20 healthy volunteers fully head-down in gravity boots for three minutes, and measured blood pressure rising from 119/74 to 157/93 mmHg and eye pressure from an average of 19 to 35 mmHg (Klatz et al., 1983). From those numbers, the authors suggested that extended head-down inversion could prove dangerous for people with glaucoma, high blood pressure, uncompensated heart failure, narrowing of the carotid artery, a hiatal hernia or spinal instability, people taking anticoagulants or aspirin, anyone over 55, and anyone with a family history of stroke.

Two cautions go with that list. First, it was the authors’ speculation, not something their study tested: the volunteers were healthy, and none of those groups was measured. Second, the measurements came from boots at full vertical, a harder position than a table at a partial angle. Read it as early context for the kind of list you see today, with several of the same conditions on both, not as proof that each item is dangerous.

Glaucoma and Other Eye Conditions

Eye pressure is where the numbers are largest, and they come from several separate groups of researchers.

Eye Pressure Roughly Doubles Upside Down

In a clinical study published in 1984, eye pressure was measured after five minutes of full inversion. In normal eyes it rose from 16.8 to 32.9 mmHg. In eyes with glaucoma it rose from 21.3 to 37.6 mmHg. The authors wrote: “We recommend that patients with ocular hypertension or glaucoma refrain from this activity” (Weinreb, 1984).

The same authors note that visual fields were unchanged after inversion. The worry is the transient spike itself, in eyes that may not tolerate it, not damage that was measured in the study.

Partial Head-Down Positions Raise It Too

You might hope that a shallower angle solves the problem. The yoga research does not support that. In a 2015 study of 10 people with glaucoma and 10 without, eye pressure in Downward Dog, held for two minutes, rose from about 17 to 28 mmHg in the glaucoma group and from about 17 to 29 mmHg in the others. It returned to baseline within two minutes of coming out of the pose (Jasien, 2015).

In a headstand study of 75 experienced yoga practitioners, eye pressure showed “a uniform 2-fold increase” that was maintained for as long as the pose was held, measured at five minutes (Baskaran, 2006).

Neither study used an inversion table. They are useful as support: if partly head-down poses raise eye pressure this fast, full inversion on a table is unlikely to do less.

Retinal Detachment and Ocular Hypertension

Teeter’s manual lists a history of retinal detachment and “optic hypertension” alongside glaucoma (Teeter). We found no study of inversion in people with a past retinal detachment. The listing is precaution, and a reasonable one given the pressure figures above. If you have had eye surgery of any kind, ask your eye doctor specifically about head-down positions.

Get a Baseline Eye Pressure Reading First

Raised eye pressure usually causes no symptoms, which is why one eye specialist’s advice is worth taking even if you have no eye condition on record. In a 1985 letter, ophthalmologist Thomas Friberg of the University of Texas wrote that anyone planning to take up inversion should first have a baseline eye pressure measurement to see whether they are at special risk, because raised eye pressure usually causes no symptoms (Friberg, 1985). He also suggested that keeping sessions to 10 or 15 minutes would probably reduce the risk to the eyes, while noting that it was uncertain whether healthy users would suffer any permanent damage.

Bone and Spine Conditions

This group surprises people, because many buy an inversion table for their back.

Osteoporosis, Fractures and Implants

Teeter’s list includes osteoporosis, fractures, dislocations, medullary pins and surgically implanted orthopedic supports, as well as acutely swollen joints (Teeter). The reason given is the “mechanical stress of the inverted position”: your ankles, knees and hips carry your whole body weight in the wrong direction, and the spine is pulled. We found no trial that inverted people with osteoporosis. The listing is the maker’s caution.

Spinal Curvature and Existing Nerve Symptoms

“Significant spinal curvature” is on the same list (Teeter). So are unexplained tingling, weakness and neuropathy. That second point matters for people with sciatica or a disc problem.

In a Cochrane analysis of traction for low-back pain, seven of the 32 included trials reported adverse effects, among them “increased pain, aggravation of neurological signs and subsequent surgery” (Wegner, 2013). That analysis covers traction in general, manual and mechanical, not inversion tables specifically. Still, if you already have numbness or weakness, the direction of risk is clear enough to ask a doctor before you invert.

If a disc is your reason for looking at a table, our guide to inversion tables for a herniated disc walks through what the trials found for that group.

Recent Surgery

Recent surgery sits in Teeter’s “exercise restricted by a physician” group (Teeter). That covers spinal surgery, and also any operation where straining or a sudden pressure rise is a problem. Your surgeon sets the timeline, not the table.

Balance, Dizziness and Medication

The risk here is not blood pressure. It is losing control of the table.

Why Falls From an Inversion Table Are Serious

A 2021 report described three people with cervical spinal cord injuries after falling from inversion tables. The authors explain the mechanism: “once the ankle power is lost or it slips, the user will land on top of their head,” much like diving into shallow water, and “falls from 1 or 2 feet high are by no means negligible” (Jung, 2021). The injuries included tetraplegia.

This is a three-case report from South Korea. It cannot tell you how often this happens, and we will not call it common or rare. It tells you what a fall looks like when it does happen, and why anything that weakens your grip or balance matters.

Dizziness, Vertigo and Neurological Conditions

Teeter’s manual lists lightheadedness, dizziness, disorientation, seizures, sleep disorders, fatigue, vertigo, motion sickness, and brain conditions such as trauma, intracranial bleeding or severe headaches (Teeter). Read that list next to the fall mechanism above. Being dizzy upside down, with your feet as your only anchor, is how a fall starts. The same applies with more force to gravity boots, which hang you fully inverted from a bar with no partial angle at all; our gravity boots guide covers what that changes.

Medication and Supplement Side Effects

Teeter’s wording covers “the side effects of any drug or supplement (prescribed or over-the-counter)” (Teeter). That includes anything that makes you drowsy, lightheaded or unsteady, as well as the blood thinners named in the heart section. If a label warns about dizziness, it applies to inversion too.

What the Evidence Says for Everyone Else

If none of the contraindications apply to you, the next question is whether inversion is worth doing. The evidence is mixed, and the best-known results point in different directions.

The Cochrane Analysis: Little or No Effect

A Cochrane review published in 2013 pooled 32 trials with 2,762 people and found that traction, “either alone or in combination with other treatments, has little or no impact on pain intensity, functional status, global improvement and return to work” in low-back pain, with or without sciatica (Wegner, 2013). Its limit: it covers traction in general, most of it not inversion.

The Surgery Trials: Fewer Operations

A 2012 pilot trial randomized 24 patients who were already on the list for single-level disc surgery. In the group that added inversion to physiotherapy, 10 of 13 avoided surgery. In the physiotherapy-only group, two patients did. Pain and disability scores did not differ significantly between groups (Prasad, 2012).

A follow-up registry of 85 inversion users by the same team reported a two-year surgery rate of 21%, against 39% in a matched control group (Mendelow, 2021). Teeter, which makes inversion tables, supplied the tables and funded the study’s administrator; the authors state the analysis was independent (Mendelow, 2021).

How to Read Both Together

The pilot was small, and its authors asked for a larger trial. The registry was not randomized, and it came from the same group. The Cochrane analysis is large but mixes many kinds of traction.

None of them settles the question for inversion tables specifically. For what inversion may and may not do for you, see our page on inversion table benefits.