Back Pain

Understanding the Causes and Best Treatment Options

Back pain is a common problem.   Studies show 80% of the population will suffer with back pain at some point in their lives, with as much as 30% of people having back pain at any given time.  While most cases of back pain will eventually go away on its own, there is a very high likelihood of that back pain coming back, and when it does subsequent episodes tend to be longer lasting and more severe.  In some cases back pain can progress to seriously affect one’s mobility and quality of life.

Obviously low back pain is a major problem, fortunately, Cox Flexion-Distraction Treatment has emerged as one of the most effective, safest, and well researched treatments for low back pain.  In fact, Cox Technique can often provide dramatic relief when there are few other effective treatment options available. But before we talk about how Cox Technique works so effectively, it is helpful to first discuss how back pain develops in the first place.

Cox Flexion-Distraction Technique has emerged as one of the most effective, safest, and well researched therapies for treating Back Pain, and can often provide dramatic relief when there are few other effective treatment options available.

Understanding Back Pain

While some back pain problems may be associated with sciatica, or can caused by conditions such as arthritisspinal stenosis, or disc problems, by far, the most common type of back pain is classified as “mechanical back pain”.   Unlike traumatic back pain, which is associated with a specific event such as an accident or injury, mechanical back pain develops slowly over time, and results from abnormal motion of the joints in the the back. This is often confusing to patients as it is difficult to link their symptoms back to a specific cause or event.

Here’s how this work….

The back, or lumbar spine, consists of a series of 5 block-shaped bones stacked together to form a moveable column. As the back flexes, bends, or twists each of these bones (anatomically referred to as vertebrae) will move such that each each vertebrae will contribute to the overall movement of the lower back. This pattern of ‘shared mobility’ allows the the joint stress and muscular demand associated with these movements to be evenly distributed across a larger area, thereby helping to prevent overload at individual spinal joints and minimize the risk of injury.

Of course, proper health and mobility of the lower back as a whole requires each individual vertebrae to be able to adequately flex, bend, and twist. But if any of the lumbar joints become restricted it will force the other joints in the back to move excessively in an effort to compensate for the restricted segment. This altered balance within the lumbar spine will create excessive stress and strain at the joints, ligaments, muscles, and nerves of the lower back.   As this process continues over time it will lead to joint and soft tissue injury, inflammation, and back pain. In addition to the back itself, it is also common for symptoms such as pain and muscle tension to be referred to the hips and legs (see figure below).

Traditional Treatments for Back Pain

In an attempt to treat back pain, a variety of treatment methods are commonly used, including medications, massage, stretching or strengthening exercises, or chiropractic/joint manipulation techniques.  While in many cases these approaches can be helpful in managing back pain and stiffness, many of these therapies are often limited in their effectiveness and/or provide only temporary relief.

Medications generally address the back pain symptoms but do not address the actual health, stiffness, or abnormal motion of the spinal joints.   Stretching exercises can be helpful, but stretches and exercises but must be done properly, and at the right time and in conjunction with care to correct the joints.  With the majority of cases of mechanical low back pain stretching needs to be directed at the hips, not the back.  Core strength  will help protect and stabilize loose joints, but will have no effect on joint restrictions.

Traditional chiropractic adjustments/joint manipulation procedures to loosen tight and restricted joints can also be helpful in some cases, but can often be uncomfortable, or some patients may be nervous to receive such treatment.  Furthermore, research has shown that it is difficult to affect specific joints with this type of treatment, which leads to the same problems associated with stretching (1,2).

Resolving Back Pain with Cox Flexion-Distraction

Cox Flexion-Distraction Treatment is a safe, effective, research-proven, gentle treatment technique used to correct tight, painful, and dysfunctional joints in the spine.  This technique is performed using a specially engineered treatment table that gently pulls and stretches the spine.

Here is how Cox Flexion-Distraction works….

With the patient lying face down on the table, the lower section of the table (the part of the table supporting the patient’s legs) can be slowly pulled down and away. This motion lengthens the spine, which gently pulls the spinal bones away from each other and acts to “decompress” and stretch the painful and restricted joints. As the spine stretches the doctor is able to focus the stretch/decompression at very specific levels of the lower back by stabilizing the vertebra above the restricted vertebrae using a specific hand contact. This focal pressure applied by the doctor makes Cox Technique more effective than traditional traction therapies or inversion devices which apply only a general traction, and do not provide feedback to doctor with respect to the health of the disc and spinal joints.

Each decompression stretch is applied in a rhythmical push-pull action five or six times for a total of about 20 seconds. This process is usually repeated three to four times.  The decompression of the damaged disc or spinal joints achieved with Cox Flexion-Distraction has a number of important effects which help to reduce pain and promote healing.   For example, this procedure has been shown to dramatically reduce pressure within the intervertebral disc which reduces strain and stimulates healing of the damaged discs. It also helps to reduce pressure pressure and irritation of the posterior joints of the spine, and stretch the ligaments and muscles around the spinal bones (and remember, with this approach this stretch can be specifically applied to the restricted, tight, and painful areas).

Get Relief with Cox Technique

To book an appointment to see if Cox Flexion-Distraction will be able to help with your arm or neck problem simply call our office at (902) 407-7207. For more information send us an email at


1) Ross JK, Bereznick DE, McGill SM.  Determining cavitation location during lumbar and thoracic spinal manipulation: is spinal manipulation accurate and specific? Spine 2004; 29:1452-1457.

2) Perle SM, Kawchuck GN, Parrault T, Adams W. Radiographically determined anatomical location of point of peak pressure during pisiform and hypothenar contact manipulation procedures.  Proceedings of the International Conference on Spinal Manipulation Oct 5-6. Toronto: Foundation for chiropractic Education and Research; 2002. p20.