Lower Back Pain Treatment: Resolving Lower Back Pain With Cox Flexion-Distraction Treatment

Back pain is a common problem that often interferes with your ability to work, sleep, and enjoy your favorite activities like walking, gardening, golfing, and exercise.

And to make matters worse back pain tends to be recurrent in nature, meaning that even after it goes away it tends to come back again later on, and when it does subsequent episodes tend to be longer lasting and more severe.

But there is some good news…. a treatment technique known as Cox Flexion-Distraction treatment has emerged as one of the most effective and safest treatments for lower back pain. In fact, Cox Technique can often provide relief from lower back pain even when other more traditional treatments have failed.  

In fact, Cox Flexion-Distraction can help with a wide variety of lower back conditions, including muscle or ligament strains, disc bulges or herniations, osteoarthritis, facet syndrome, and even compression of nerves in the lower back (sciatica). 

So in this article we will discuss what Cox Flexion-Distraction therapy is, and how it works to help almost all types of lower back pain. Keep in mind that what we will present here is the abbreviated version of how this treatment works. For more in-depth information of Flexion-Distraction treatment you can also download our free Lower Back Pain report, or review our video on Resolving Lower Back Pain With Cox Flexion-Distraction.

Lower Back Pain Treatment: Restoring “Normal” Motion Is Critical


When dealing with virtually all types of LBP the most critical goal is to get the injured or painful joints of the lower back moving properly again. Remember, muscle and joint movement can be a powerful way to reduce swelling and inflammation at the site of injury, to control pain, and to guide tissue healing. 

Think of a basic ankle sprain as an example. In this situation you wouldn’t just ignore the pain and go out for a run. This would just lead to more pain and injury. This is clear and obvious to everyone. 

But on the other hand, we also wouldn’t want to just put the foot up for a week or two to rest the injured area. Sure, the ankle might not hurt too much when it’s resting, but when we go to stand on and use the foot again it’s not going to go well. If the injured ankle doesn’t move it’s going to get stiffer and tighter, more swollen, and the injured ligaments aren’t going to heal properly.

So as you can see, getting injured tissue and painful tissue moving again is critical. But that’s not to say we just ignore the symptoms and move haphazardly. We need to move the right way. So with our simple ankle example here, we might prescribe some simple non-weight bearing movements and range of motion exercises to help control swelling, reduce pain, and guide tissue healing. Then as the injury starts to heal we can progress to more advanced weight bearing and strength exercises to rehabilitate the injury.

But Moving The Spine Is Different


As I said, these principles apply across the body, including for back pain and injury. But when applying these principles with lower back pain there’s a catch, because we don’t have a lower back in the same way that we have an ankle or knee or hip. These regions are single joint systems, so creating focused movement at these areas is easier. To move the ankle we just move the foot.

But the spine is different. The spine is composed of a series of joints that connect to form a moveable column. And when the lower back becomes injured we wouldn’t expect all the joints to become injured – we would expect the problem to be more isolated to an individual area or specific spinal joint segment.  

So the challenge with lower back pain is (1) “how do we direct movement at the specifically affected segment?” And (2) how do we do this in a way that we can control the intensity of the motion so it does not exacerbate the condition?

I would argue that with many approaches to back pain, this is very difficult and really doesn’t happen.

The Problems With Traditional Lower Back Pain Treatments

Traditional Stretches Don’t Work

Stretching is commonly prescribed to help with lower back pain. But consider common stretches like a prone extension stretch or spinal twist, or a knee-to-chest stretch. Ask yourself, which specific joints are moving with these stretches? 

The fact is, we don’t really know? 

In fact in a lot of cases there will be muscle tension and spasm around an injured joint, so what we often see with these stretches is not controlled movement at the injured area, but compensatory motion at the other adjacent spinal joints. 

To be clear, I’m not saying that stretching or exercise are bad or shouldn’t be done. I actually believe that home exercises are essential, and developing a personalized home movement routine is something we do with every single back pain patient. I just think there are better exercises than the ones that are typically prescribed or that show up on the top of a google or youtube search.


The Limitation of Traditional Decompression Or Traction Tables

What about common in- office treatments and traditional manual therapy? Well, I would suggest there are some limitations here as well. For example, some clinics will use expensive and sophisticated decompression tables or machines to stretch and decompress the spine. But these tables work by tractioning one end of the spine away from the other, and therefore are unable to create motion at an isolated joint segment, so they have the same limitations as we saw with traditional stretching exercises.

What About Traditional Chiropractic Adjustments?


Finally, some people may suggest that traditional joint adjustments or joint manipulation is better to get specific joints moving again. But there are some studies to suggest that the specificity of spinal manipulation may not actually be as specific as some may believe (1). 

Furthermore, if we go back to our sprained ankle example, it’s not just getting the motion to the right area that matters, but also the intensity and the force of the movement. And with an acute or sensitive lower back sometimes spinal manipulation may be too aggressive, at least in some patients.

So as you can see, there are several limitations and shortcomings of some of the most common treatments for back pain, and solving these problems is really where Flexion-Distraction treatment comes in.

Resolving Lower Back Pain With Cox Flexion-Distraction Technique


Cox Flexion-Distraction treatment is a gentle, low-force treatment technique that allows the doctor/clinical to create focus, isolated motion at a specific spinal joint.

It is performed using a specially engineered treatment table that gently pulls and stretches the spine. 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. Because of the connection between the hips, pelvis, and lower spine, as the table moves the legs are pulled away from the spine. This motion will stretch and lengthen the spine.

This part of the motion is similar to traditional traction or decompression tables, but what makes Cox Flexion-Distraction treatment so unique and effective is that as the spine is moving the doctor can use a hand contact on each spinal joint to both assess the movement of one bone on another. When a restriction is felt we can use this same hand contact to focus the stretch and motion at that specific joint.  So with the treatment we are able to assess and treat/release each specific joint of the lower back. 

The other really key feature of this treatment is the fact that the motion we can produce with the table isn’t just limited flex-extension. The table also allows motion in the lateral (side-to-side) direction. This is critical as it allows us to target not only each individual spinal joints, but it also allows us to stretch and release the joint in all directions.

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 per treatment session. 

Get Relief with Cox Technique

To book an appointment to see if Cox Flexion-Distraction will be able to help with your back pain simply call our office at (905) 685-7227, or book an initial appointment using our online scheduling system.