[gap height=”30″]Study Finds Sciatica Relief with Cox Treatment

Sciatica is a painful condition that will affect as many as 35-45% of people at some point in their lives (1).  If you are one of these people you know how important it is to receive proper and effective treatment so you can get out of pain and get your life back.

While there are many treatment options available it is often difficult to know which one is best.  However, a recent study published in the Journal of Manipulative and Physiological Therapeutics found that Cox Flexion-Distraction Technique, in combination with basic low-level exercises, was effective in treating 79% of patients affected by sciatica (2).

Here are the details of the study….

A Spine Centre in Rhode Island tracked the progress of 49 consecutive patients diagnosed with sciatica caused by a lumbar disc herniation.  Baseline data was collected with respect to pain as well as the level of disability due to the sciatica symptoms (for example, how did their sciatica affect their ability to perform daily activities such as work, walk, sleep, sit, etc.).

Patients were treated with Cox Flexion-Distraction technique, along with specific exercises aimed at reducing tension on injured spinal discs and decreasing sensitivity in painful nerve roots.

Following treatment 90% of patients reported their improvement to be ‘good’ or ‘excellent’, with an average self-rated improvement of 77.5%.  Based on study criteria 79% of patients had significant improvements in pain, and 70% of patients had significant improvements in disability scores. This is clearly an impressive success rate, especially considering the average patient only needed 13 treatment visits.

Perhaps most promising is that the outcomes were as good, or in some cases even better, when looking at how these sciatica patients did a year later.  This suggests that treatment effects are stable and can be maintained over time.

  • 79% of sciatica patients demonstrated significant improvement with Cox Treatment
  • 90% of patients reporting their improvement to be ‘good’ or ‘excellent’

What is Cox Treatment?

Cox Flexion-Distraction therapy is performed using a specially engineered treatment table that gently pulls and stretches the spine. This motion slowly lengthens the spine, which pulls the vertebrae away from each other and increases space within the spinal canal (3,4) reduce pressure within the intervertebral disc (5,6).  These actions will not only reduce pain coming from the discs and joints of the lower back but will also relieve pressure on the painful nerve root.

As the spine stretches the doctor is able to focus the decompression at the level of the damaged disc by stabilizing the vertebra above the damaged disc 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 held for about 5 seconds, and is repeated 20 to 30 times per treatment session.


  1. Hurwitz EL, Shekelle P. Epidemiology of low back syndromes. In: Morris CE, editor. Low back syndromes: integrated clinical management. New York: McGraw-Hill; 2006. p 83-113.
  2. Murphy DR, Hurwitz, EL, McGovern, EE. A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disc: A prospective observational cohort study with follow-up.  Journal of Manipulative and Physiological Therapeutics 2009; 32(9), 723-733.
  3. Gudavalli MR: Estimation of dimensional changes in the lumbar intervertebral foramen of lumbar spine during flexion distraction procedure. Proceedings of the 1994 International Conference on Spinal Manipulation. June 10-11, 1994, Palm Springs, CA, p81
  4. Gudavalli MR, Cox JM, Baker JA, Cramer GD, Patwardhan AG: Intervertebral disc pressure changes during a chiropractic procedure. Presentation and publication at the ASME IMECE 97 Bioengineering Convention, November 16-21, 1997, Dallas, Texas. – Advances in Bioenginneering 1999; BED, vol. 39, pgs 187-188
  5. Gudavalli MR, Cox JM, Baker JA, Cramer GD, Patwardhan AG: Intervertebral disc pressure changes during the flexion-distraction procedures for low back pain. Presented at and in the proceedings of the International Society for the Study of the Lumbar Spine Meeting, June 1997, Singapore.
  6. Gudavalli MR, Cox JM, Baker JA, Cramer GD, Patwardhan AG: Intervertebral Disc Pressure Changes During a Chiropractic Procedure. Abstract from the Proceedings of the Bioengineering Conference, Phoenix, 1999

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