Cox Technique

Cox Flexion Distraction Manipulation


Looking for evidence-based, state-of-the-art decompression treatment?

The COX 8 has arrived

cox technique

How is Cox different from other decompression?

Cox technique is a highly skilled, very specific form of spinal manipulation/adjustment.  The doctor places his hand on the specific vertebra that he wants to adjust. He then applies a decompressive force until he feels the joint separate.  That is how he knows when to stop the movement of the table. Different joints need different amounts of traction to separate. While decompressed, the doctor is able to take a specific joint through all of its normal motions- flexion, extension, left and right bending, and even rotation. He can then move on to another joint and repeat the process. 

Traditional traction tables and similar machines utilize straps to hold you in.  A percentage of your body weight is calculated to determine how hard to pull. There is no way to isolate a specific joint. It is a non-skilled procedure. No one feels for specific joints to move in your spine. These tables only pull in one direction. They do not take your joints through their normal motions.    

Why would i use cox decompression over other treatments?

Conditions such as herniated discs, lumbar and cervical stenosis, sciatica and radicular arm pain all involve compressive forces. It makes sense that when compression is a problem, then decompression should be an effective way to combat this. As people age, their discs lose fluid which often results in degenerative discs and arthritic joints. These spines become more rigid, sometimes osteoporotic, and they often don’t tolerate traditional manual manipulation as they once might have. Scoliosis patients with rotated spines like this table. The table allows us to de-rotate their spines prior to decompression, making it a more comfortable experience.  Patients who don’t want manual manipulation that involves popping or clicking, can be effectively treated with this table.

Why use a cox-certified doctor

As the saying goes, “putting a scalpel in your hand does not make you a surgeon.”  Owning some type of flexion distraction table does not mean the doctor has had sufficient training or experience with the technique. Following the Cox protocols and continued study to maintain certification are important in assuring that the patient is receiving the best care possible with this technic. Once certified, the doctor must complete a minimum of 12 hours of Cox continuing education at least every two years to maintain that certification.

Dr. Patterson has been using Cox technique since 1988. (prior to a certification process being developed)  In 1998, he became one of the first Cox certified doctors in the state of Kansas.  Currently there are only 3 active Cox certified doctors in Kansas.



Flexion-Distraction Effects

  • dropping intradiscal pressure to as low as -192mm Hg in the lumbar spine and lowering pressures in the cervical spine (C4-C7) 96 to 1583 mm Hg
  • widening the spinal canal foraminal area by 28%
  • reducing pressure on the spinal nerves
  • returning motion to the spinal joints

In the early years of technique development, clinical observations were published by Dr. Cox and other colleagues. In the early 1990’s, the first federally funded grants began. For those detail-oriented patients who just can read enough, click the button below to link to Dr. Cox’s website providing an exhaustive list of research. 

flexion distraction. Flexion distraction therapy is good for many things. spinal decompression in overland park. S



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