The Cox Technic SYSTEM of Spinal Pain Management

Cox® Technic is a system, not simply a treatment technique. A system is defined as “a set of things working together as parts of a mechanism or an interconnecting network.” The Cox® Technic System is a set of protocols for doctors and their patients to follow that allow reduction of spine-related pain...and a system of like-minded chiropractic physicians practicing the same way.


The parts of the Cox® Technic system foundationally include Cox® Technic Flexion-Distraction And Decompression Spinal Manipulation treatment with trigger point therapy, exercise, and nutrition and adjunctively may include electrical stimulation (low volt galvanism, tetanizing current, interferential, etc.), ultrasound, acupuncture, etc. The Cox® Technic physician is well-trained in treatment modalities to use to help his/her patients as appropriate, so this list is not exhaustive. It takes the effort of both the doctor and patient to obtain the best clinical outcomes possible, and realistic expectations are discussed up-front and based on the latest spine research publications.

  1. The Cox® Technic treatment part is well-researched, evidence-based, research-documented with its protocols and with supporting research (federally funded biomechanical and clinical research by NIH and HRSA of the US government’s health department). Much of the research was done using The Cox® Table by Haven Innovation. From case reports to cases series, biomechanical studies, and randomized controlled trials involving chiropractic and medical institutions like the National University of Health Sciences, Palmer College of Chiropractic/Palmer Research Center, Loyola Stritch School of Medicine, Hines VA Hospital, University of Iowa, Auburn University, etc. The list of publications is extensive. Incorporated trigger point therapy relaxes the specifically involved paraspinal musculature and calms the nervous system between sets of treatments.
  2. The exercise part is vital and reliant upon the patient to do routinely. It’s known that in back pain and/or neck pain the extensor muscles tauten, the paraspinal muscles grow weaker, hip muscles weaken, hamstrings tighten, core muscles reduce. All of these support the spine. They must be strong for the spine’s sake.
  3. The nutrition part is important. It’s known in back pain and disc herniation that the disc loses its vital nutrients – glycosaminoglycan, chondroitin sulfate - when it degenerates. It’s known, too, that there is potential for regeneration with the proper nutrition and treatment together. For example, 28 days of compression degenerated a disc while 28 days of distraction brought that disc back. Adding nutrition to the treatment plan puts the nutrients in the body for potential imbibition of them along with fluid into the disc.  Discat Plus Enhanced is the disc formulation Dr. Cox formulated initially in the 1960s and has enriched over the years according to the research literature’s findings. A good daily multiple like Formula One is foundationally important to supply the nutrients, vitamins, minerals, trace minerals, amino acids for protein metabolism, fat-lowering agents, digestive enzymes to enhance absorption, herbs, and antioxidants usually recommended via 5 or 6 different formulae. Formula #2 Calcium Citrate plus Vitamin D3 supports bone health and works to prevent osteoporosis. Flax Plus Fiber stimulates bowel health as constipation for a back-pain sufferer is not enjoyable. Then the Disc & Joint Pain Relief Enhanced Complex is a natural-sourced pain-relieving supplement with curcumin, white willow bark, black pepper (piperine) to enhance the action of curcumin, and more. Ensuring the proper nutrients are in the body to support healing is a worthy effort.


The list of conditions the Cox® Technic System is appropriate for based on tolerance testing is extensive: chronic low back pain, acute low back pain, herniated disc, ruptured disc, prolapsed disc herniation, extruded disc herniation, neck pain, acute neck pain, chronic neck pain, sciatica, radicular arm pain, radicular leg pain, radiculopathy, DISH, pregnancy-related back pain and leg pain, degenerative scoliosis, spondylolisthesis, headache, degenerative disc disease, degenerated disc, synovial cyst, etc. Each condition has its own little difference, but realistic expectations of relief are possible.


The Cox® Technic System has always sought 50% relief of pain within a month of starting care, care that is consistent and observed by both the doctor and the patient. The 50% Rule guides the Cox® Technic System. 50% relief - measured objectively (physical tests) and subjectively (patient reported improvement) – guides the treatment frequency and treatment protocol. When 50% relief is obtained, visits are reduced by 50%. If you are seen daily, you would then be seen every other day. Such improvement is most common within the first visit or two for many patients. When 50% is obtained, the doctor may change from treating with Protocol I (single level flexion distraction and decompression) to Protocol II (single level flexion distraction and decompression with range of motion to that segment [flexion, lateral flexion, circumduction in the low back, coupled motion and rotation in the neck]). 50% is a realistic goal for many with chronic back and neck pain conditions like spinal stenosis, and “control not cure” becomes a welcomed outcome. It is a welcomed hope for many to get 20% or even 30% after years of suffering or post-surgical continued pain after back surgery for which Cox® Technic is gentle and effective treatment. 50% has always been a guidepost for Cox® Technic while medicine is now publishing that 20% or 30% is the minimal clinical improvement determinant the makes a medical intervention like back surgery worthy of doing. Cox® Technic most often exceeds such minimal clinical improvement goals when performed by well-trained, experienced chiropractic physicians.


Chiropractors who are specially trained in the Cox® Technic System are around the world. In the US, 63.7% of chiropractors reported to the National Board of Chiropractic Examiners that they use “flexion distraction” in their practices. About 3% of US chiropractors are actually certified and have gone through formal training with Cox® Technic. The referral directory of active certified chiropractors is available online. The list is specific to actively certified doctors who have been in re-certified / certified within the prior 2 years to ensure they continue their interest in Cox® Technic and similarly provide its care in their practices as their other Cox® Technic colleagues do. Find a Physician online referral directory is available 24/7.

The Cox® Technic System of Spinal Pain Management is a sum of its parts that come together in a personalized treatment plan for each patient, one to which both the patient and doctor commit for optimal and desired spine pain relief. It’s a system of spinal pain relief. 

To see a video about Cox® Technic application and goals, please see this video: