Loyola's Windy City Lab & Cox Technic Flexion Distraction Research

Cox® Technic & Its Research: Ramifications for Patient Pain Relief

Non-surgical distraction and decompression spinal manipulation is first line treatment for patients with back and radicular pain who do not demonstrate progressive neurological deficits. A specialized form of this spinal manipulation discussed here is Cox® Technic Flexion Distraction and Decompression Spinal Manipulation.

Cox® Technic (aka flexion distraction) is the development of Dr. James M. Cox, a chiropractic physician who is committed to documenting the biomechanical and clinical benefits of this system of protocols in reducing spinal pain.

Cox® Technic is safe and well-studied  spinal manipulation which drops intradiscal pressures to as low as -192mmHg and widens the intervertebral foraminal area by as much as 28%. 91% of patients report satisfaction with their care and attain maximum improvement in 3 months. Meeting the demand for evidence-based medicine, Cox® Technic gives patients, practitioners and payers expectations of care.


63.7% of chiropractors report that they use flexion distraction in their practices. About 3% of chiropractors are actually certified in the proper protocols and application of Cox® Technic. Many who go through the post-graduate training comment that “I didn’t know what I didn’t know about Cox® Technic application until I took the course.” The certification course develops a core of physicians who provide care that is similar, based on clinical research and documented protocols, and disseminates the latest research literature and laboratory findings regarding Cox® Technic.


Research publications about flexion distraction abound. Biomechanical studies document what happens inside the spine, and clinical trials – randomized and large scale – document how patients respond. For simple back pain to sciatic radiculopathy and pregnancy-related back pain to cervical spine and arm pain, Cox® Technic protocols offer a path to relief.


Cox® Technic sets forth clinical algorithms of decision-making regarding the care of the non-discogenic patient and discogenic patient. The frequency of care is guided by the Rule of 50%: 50% relief of pain is expected within 30 days or further testing or surgical consultation is arranged. Collaborating with healthcare colleagues for the benefit of the patient is quite similar to collaborating with healthcare researchers to document what is best in patient care.

Research Collaboration

Cox® Technic research brings together talented people from the medical, surgical, chiropractic, anatomical, statistical, and computer-related worlds. Starting in the 1980’s, Dr. Cox brought together chiropractors to collect data on 1000 patients. In the 1990’s, Dr. Ram Gudavalli arrived at National College of Chiropractic as a biomechanist/researcher whose interest spurred the first HRSA grant for chiropractic research.  Then in the 2000’s, NIH grants became available and have propelled even more studies. Federally funded grants allow much in the way of documenting the beneficial, non-surgical means to spinal pain relief.

Cox® Technic is committed to developing evidence-based protocols and documenting the clinical outcomes for physicians who are back pain specialists, focused on the non-surgical treatment of spinal pain.
Video of Dr. Cox's Cox Technic Demonstration

Watch this video about Cox® Technic. Then, contact Cox® Technic with any questions. Sign up to receive a monthly newsletter about the latest happenings in Cox® Technic. We look forward to working with you.