Flexion distraction is a gentle, non-surgical chiropractic procedure used primarily to decompress the spine and alleviate pain in the lower back and legs. This hands-on technique involves a rhythmic, passive stretching motion that targets spinal structures to promote healing and restore mobility. It is frequently associated with the Cox technique, named after its developer, Dr. James M. Cox. The core purpose of the method is to apply controlled forces to the spine, carefully moving the vertebrae to relieve pressure on the nerves and discs.
The Specialized Chiropractic Table
The procedure relies entirely on a specialized piece of equipment often referred to as a Cox table or a flexion-distraction table. This table is engineered with multiple segmented sections that allow for controlled movement and passive mobilization of the patient’s spine. The unique design features a movable caudal section, which is the foot-end piece where the patient’s legs rest, that can glide, flex, and distract.
The practitioner controls the movement of this section, allowing for gentle, repetitive traction along the long axis of the spine. Some advanced models incorporate additional features, such as drop pieces, lateral flexion, and circumduction. The table design facilitates specific, low-force adjustments distinct from high-velocity manipulations. This mechanical assistance ensures that the distraction and flexion forces are applied in a precise and controlled manner.
How Flexion Distraction Works on the Spine
The therapeutic effect of this technique is achieved through the combination of flexion (bending) and distraction (stretching or separation), which works to decompress the spine. This controlled movement increases the space between the vertebrae, a process known as spinal decompression. Research indicates that this action can enlarge the intervertebral foraminal opening, the passageway through which spinal nerves exit, by up to 28 percent.
The rhythmic pumping motion creates negative pressure within the intervertebral disc. This negative pressure can help pull bulging or herniated disc material back toward its central position. Decompression also promotes the movement of metabolites and nutrients into the disc, which aids in recovery. Additionally, the treatment works to restore a more normal range of motion to spinal joints.
Common Conditions Treated
Flexion distraction is primarily used for conditions that benefit from spinal decompression and increased joint mobility in the lumbar spine. Common indications include lumbar disc herniation and degenerative disc disease. The technique is also frequently chosen for patients suffering from sciatica. Other conditions that respond well include spinal stenosis and facet syndrome. Because the procedure is gentle, it is often suitable for patients who might not tolerate traditional high-velocity manipulation.
What Patients Should Expect
Patients undergoing flexion distraction treatment lie face down on the specialized table, usually focusing on the lower back. The experience is described as a gentle, rhythmic stretching or pumping sensation, without any twisting or high-velocity thrusting. The doctor maintains precise control over the force and motion to ensure patient comfort and safety. A typical session lasts between 10 and 20 minutes, often starting two to three times per week for several weeks. The technique is considered safe, but contraindications exist, such as severe osteoporosis, spinal tumors, or acute fractures, requiring a thorough evaluation beforehand.