Some people believe hanging upside down, also called “inversion therapy,” relieves back pain and provides other benefits. However, the therapy is controversial due to potential risks and a lack of evidence of its efficacy.

A person may hang upside down suspended on a specially designed table during inversion therapy to relieve back pain. They may do this with a healthcare professional or at home.

However, the American College of Physicians (ACP) states in its 2017 guidelines that there is a lack of clinical evidence to support the effectiveness of inversion therapy. Using inversion tables also carries potentially serious risks, such as severe spine injuries from falls.

This article looks at why a person might hang upside down, the benefits and risks of inversion therapy, and how a person may use the technique safely. It also looks at signs that a person should stop inversion therapy and alternative options they can try.

A person using an inversion table to hang upside down -1.Share on Pinterest
SergeyChayko/Getty Images

Inversion therapy is a type of traction therapy. It involves a person lying on a special inversion table, locking their ankles, and leaning back until the table inverts and the person is suspended upside down.

While the individual hangs upside down, parts of the vertebra, which are the small bones that form the spine, separate. The muscles and bones of the spine stretch as gravity pulls them downward.

People may use inversion therapy to alleviate lower back pain.

A healthcare professional may also guide a person through inversion therapy to treat a herniated disk, also called a slipped disk, in those with lumbar discogenic disease.

The theory is that hanging upside down allows the negative pressure to pull the herniated disc back into the correct space.

Although some people report temporary relief from pain after inversion therapy, inconsistencies across research make it difficult to determine whether the technique is effective.

Some people report experiencing benefits after inversion therapy, and the studies outlined below suggest it may help with certain conditions.

However, more research is necessary to determine the efficacy and safety of inversion therapy to treat back pain.

Avoiding surgery

A small 2021 study focused on people on the waiting list for lumbar disc surgery and people experiencing the following:

The authors found that 16% of the 85 people in their study who had done inversion therapy underwent surgery within 1 year, and 21% had surgery within 2 years.

Comparatively, 43% of patients with sciatica and leg pain who did not do inversion therapy underwent surgery.

However, the study had various limitations, such as its small, nonrandomized sample size. The researchers also cited other studies that did not find inversion therapy significantly beneficial.

More research is necessary to determine whether inversion therapy can reduce the need for surgery.

Reducing back pain

A person may want to treat back pain without taking medication or trying more rigorous therapies.

While there is no clear evidence that inversion therapy can relieve back pain, people widely use the technique for this purpose.

Hanging upside down in inversion therapy may allow the vertebrae to separate and allow the muscles and bones of the spine to stretch. This may alleviate pressure on the nerves and muscles in the spine, which might relieve pain.

The negative pressure of the suspension may also help pull a slipped disc back into position.

Health professionals associate certain risks with inversion therapy, especially for people with certain conditions.

Risks include:

  • Increased blood pressure: Doctors associate various risks with high blood pressure, including strokes and heart attacks.
  • Falls: A person may sustain severe injuries to the spine and head if they fall while inverted, even from a short distance. Falls of this nature can cause irreversible harm and may be disabling. They can even be fatal.
  • Pressure behind the eyes: Researchers associate inverted body positions with glaucoma, a buildup of pressure behind the eyes that can damage the optic nerve.
  • Increased intracranial pressure: Inversion can cause changes in intracranial pressure, which is pressure inside the skull. A sudden increase in intracranial pressure can lead to severe complications, such as a stroke or coma. It can also cause death.

Can a person die from hanging upside down?

Hanging upside down may carry a risk of death, as it can lead to complications such as stroke, severe injuries from falls, and increased intracranial pressure.

If someone wants to try inversion therapy, it is best that they discuss it with a healthcare professional first.

People with health conditions that may increase the risk of the potential complications of inversion therapy should not attempt it.

If a healthcare professional has advised a person that their health does not pose a risk for inversion therapy, they may want to begin the therapy with a trained professional, such as a physical therapist.

Individuals will need to carefully inspect the inversion table before using it. Inversion tables with a single-pin ankle lock may increase a person’s risk of falling and injury.

A person should use an inversion table with additional safety devices and double locks if possible.

How long can a person remain upside down safely?

According to research, a person should hang upside down for less than 1 minute at a time on an inversion table and wait at least 1.5 minutes before the next inversion.

This is because the ankle muscles that hold a person in position lose a significant amount of force after 1 minute, which could lead to a fall.

Who should avoid hanging upside down?

People should avoid inversion therapy if they have:

It also may not be safe for pregnant people to use inversion therapy.

Is it safe to sleep upside down?

It is not safe to sleep upside down.

Remaining upside down for a prolonged period could increase a person’s risk of high blood pressure and a buildup of pressure in the skull and behind the eyes. These could lead to severe complications or even be fatal.

A person should stop inversion therapy immediately if they experience any pain, discomfort, or signs of complications.

These may include:

A person should contact a doctor if they experience complications from inversion therapy, which may indicate a medical emergency such as a stroke.

There are various alternatives to inversion therapy for treating acute and chronic back pain. These include the following and more:

Complementary and alternative therapies

Alternative therapies include:

Lifestyle adjustments

A person can make certain changes to help relieve back pain, such as:

  • maintaining a healthy body mass index
  • getting regular physical activity
  • correcting posture
  • avoiding activities that worsen pain
  • using the correct technique to avoid strain when moving any heavy objects

Home remedies

Home remedies for back pain include:

Physical therapy

A physical therapist can provide exercise routines to strengthen back muscles and improve posture and mobility.


A doctor may prescribe or suggest medication such as:


The type of surgery a person may require will depend on the cause of their pain. Surgeries to relieve back pain include disc replacement surgery and spinal fusion.

Some people believe that hanging upside down, or inversion therapy, can help relieve back pain. However, there is currently a lack of evidence to suggest that inversion therapy is effective as a treatment for back pain.

There are also potential risks of inversion therapy, such as falls, increased blood pressure, and a buildup of pressure in the skull and behind the eyes. These could lead to potentially severe complications.

Other methods of back pain treatment may be safer and more effective.