The efficacy of using inversion therapy in the treatment of lower back pain

M.Tech. (Chiropractic)Purpose: The purpose of this study was to determine if inversion therapy is beneficial for participants with lower back pain and if there is an additive effect when combining it with manipulation. Three treatment approaches were utilized: inversion therapy, lumbar spine manipulations and a combination of inversion therapy with lumbar spine manipulations. Method: Thirty participants who qualified for the study were randomly divided into three equal groups consisting of ten participants each. Depending in which group the participant was allocated, determined if they received lumbar spine manipulation (Group 1), inversion therapy (Group 2), or a combination of inversion therapy performed after the lumbar spine manipulation (Group 3). Procedure: Each participant was treated a total of six times over a course of three weeks, furthermore there was a seventh day of final data collection. The measurements were taken on the first, fourth and seventh visit. Subjective measurements consisted of the numerical pain rating scale (NPRS) and the Oswestry Low Back Pain Disability Index. Objective measurements were done with the inclinometer (lumbar range of motion) and the flexicurve (lumbar lordosis measurement). Results: It is clear that there were statistically significant improvements in all three of the groups in both the NPRS and the Oswestry disability index. The inversion therapy group performed the best with the NPRS and the Oswestry disability index, with the spinal manipulation and combination group following narrowly. However, there were no statistically significant differences on the intergroup analysis with regards to the subjective results. The results of the subjective measurements indicated that there was a relative decrease in lumbar spine lordosis measurements, over the trial period, but with no statistical significance. With the lumbar range of motion-flexion measurements it was clear that the spinal manipulation group and the inversion therapy group had superior results compared to the combination group, with both indicating statistical significance over the trial period. Extension, lateral flexion and rotation did not show any statistical significance over the trial period. Conclusion: There were statistically significant improvements within each of the three groups on intragroup analysis, but no statistically significant differences were found on intergroup analysis. Therefore, none of the groups could be singled out as being the superior treatment for mechanical lower back pain. All three groups’ demonstrated improvement. There was no significant additive effect by combining the two treatments. Therefore there is no benefit to adding inversion therapy to the treatment protocol. Manipulation alone demonstrated to have similar effects. However, should a patient not be able to see a chiropractor for treatment, home based inversion therapy can be beneficial. A concern that should be addressed is that home based treatment wouldn’t be supervised and as such it is not advised to do without some form of professional management. Inversion therapy can definitely be utilized as a home based treatment option for a patient with LBP, patients that can’t make use of regular chiropractic care due too logistical or financial restraints will benefit from inversion therapy home usage. Home usage will provide the patient with regular general traction therapy and can result in patient pain relief, increase overall functioning of the patient and the patient compliance may improve