What Is the High Low Manual Flexion Table?

The High Low Manual Flexion Table is a specialised chiropractic table designed for gentle flexion–distraction and spinal decompression therapy. Instead of using an automatic motor, the flexion is entirely controlled by your chiropractor, allowing precise, hands-on adjustment of the angle, depth, and rhythm of movement.

The table combines:

• High–low (tilt) function : allowing the table to move from vertical to horizontal so patients can step on and off easily.
• Manual flexion and distraction : the lower section bends and stretches the spine in a slow, controlled motion.
• Adjustable head, thoracic, and pelvic sections : for customised positioning of the neck, mid-back, and lower back.

This table is commonly used at Lakeside Chiropractic for patients who need a gentle, low-force option for disc injuries, sciatica, spinal stenosis, or chronic lower back pain.

How Does It Work?

You will lie face-down on the table while your chiropractor adjusts the lower section under your pelvis and lumbar spine. Using a manual control handle, they guide the table through a smooth pumping motion while applying gentle pressure to specific spinal segments.

This controlled movement helps:

Reduce pressure inside spinal discs, assisting in re-centring bulging or herniated discs

• Gently decompress spinal joints, helping stiff or irritated joints move more freely
• Increase disc and joint spacing, reducing pressure on irritated nerves
• Improve circulation and fluid flow to spinal tissues
• Relax tight muscles and ligaments through slow, rhythmic movement

Because flexion is manual, your chiropractor can adjust:

• The depth of each movement
• The speed and rhythm
• The direction (forward, lateral, circular)
• The starting angle

This ensures treatment is comfortable, precise, and tailored to your condition.

Key Features We Use at Lakeside Chiropractic

Our High Low Manual Flexion Table includes:

• High–low tilt function for safer and easier patient entry
• Manual flexion–distraction mechanism controlled entirely by the chiropractor
• Multidirectional headpiece (tilt, elevation, width adjustments)
• Adjustable table height for smoother, more controlled movements
• Elevating thoracic and pelvic sections for optimal spinal support
• Optional drops, when appropriate, for low-force chiropractic adjustments

These features support gentle spinal decompression and targeted, comfortable treatment.

Who May Benefit From Manual Flexion Therapy?

High Low Manual Flexion is commonly used for:

• Bulging or herniated discs
• Degenerative disc disease
• Sciatica and nerve compression
• Spinal stenosis
• Chronic low back pain
• Facet joint irritation
• Post-surgical spinal cases (with medical clearance)

Your chiropractor will always assess your condition first to ensure this treatment is safe and appropriate.

Research & Clinical Evidence

Flexion–distraction therapy (performed on manual flexion tables like this one) has shown benefits in clinical research, including:

• Reducing pain and disability in chronic lower back pain
• Lowering intradiscal pressure in the lumbar spine
• Improving spinal mobility, disc height, and nerve-related symptoms

It is widely considered a safe, conservative, non-surgical option for disc and nerve-related conditions.

📚 Relevant Research & Clinical Evidence

High Low Manual Flexion therapy has been widely researched for spinal, disc, and nerve-related conditions, with strong evidence supporting its effectiveness and safety:

1. Clinical research shows significant pain reduction in patients with chronic low back pain when treated with flexion distraction compared to active exercise programs. A randomized clinical trial reported greater improvements in pain and disability for the flexion–distraction group.
2. A study on lumbar disc herniation found that flexion–distraction decreased intradiscal pressure, increased disc space, and reduced nerve compression, contributing to improved leg pain and neurological symptoms.
3. Research comparing flexion–distraction to high-velocity manipulation showed that flexion distraction was effective in improving mobility and reducing chronic lower back pain symptoms.
4. Additional studies report benefits for lumbar spinal stenosis, with significant improvements in pain levels and daily function after flexion distraction therapy.

While individual results may vary, manual flexion–distraction is considered a safe, low-force, and well-tolerated therapy, especially for patients with disc issues, nerve irritation, or age-related spinal changes.

❓ Frequently Asked Questions (FAQs)

1. What’s the difference between manual and automatic flexion?

• Automatic tables use a motor to move at a fixed speed. The manual High Low Flexion Table allows your chiropractor to control every movement by hand, adjusting instantly to your comfort and response.

2. Does it hurt?

• No, the treatment is gentle. You may feel stretching or pressure, but nothing sharp. The chiropractor can stop or adjust immediately if anything feels uncomfortable.

3. How does the chiropractor control the table?

• Your chiropractor uses a manual flexion control handle to guide the table through smooth forward, sideways, or circular movements.
• This hands-on control allows them to:
• Adjust the depth of each movement
• Change the speed or rhythm instantly
• Modify the angle or direction based on your condition
• Maintain full control and stop immediately if needed

4. How long does each session take?

• A typical High Low Manual Flexion session is included as part of your standard chiropractic appointment.
• Most appointments run 20–30 minutes, depending on:
• Your condition
• Whether additional therapies are used (soft tissue work, mobilisations, cold laser, etc.)
• Your response to the flexion–distraction technique

5. Can this treatment replace a chiropractic adjustment?

• For some patients, yes. The High Low Manual Flexion technique can be used as the main treatment when traditional adjustments are too strong or not suitable.
  
  For others, it works best combined with adjustments, soft tissue therapy, cold laser, dry needling, or rehab exercises. Your chiropractor will choose the safest and most effective combination.

6. Is this suitable for people with severe pain or limited mobility?

• Yes, the high low tilt function allows the table to raise and lower smoothly, helping patients who struggle to bend, twist, or climb onto a flat table.
• The gentle manual flexion is especially helpful for people who:
• Have acute lower back pain
• Cannot tolerate strong adjustments
• Are recovering from injury
• Experience muscle guarding or stiffness