No. Posture Pump® is simple to use and can be used on any flat surface such as carpet, yoga mat, firm mattress, chiropractic or massage table. With the neck Posture Pump® you’ll place the deflated unit on a firm comfortable surface, untangle the Comfort Visor® strap at back of unit, lay down then slide and center unit under the back of your neck, snugly against the top of your shoulders. Then center your neck on the neck cradle. Put the Comfort Visor™ strap on. Grasp the hand pump and slowly pump unit up to your own comfortable level, never to the point of pain. Hold for about 10 seconds, push white button on hand pump to deflate, and repeat this process. Do this about 5–10 times. This up and down motion is what creates alternating hydration of the soft discs and gentle stretching of the muscles. After 5-10 times of doing this, simply pump it up to your own comfort level and relax on inflated unit for about 15 min. maximum (this is the postural reshaping phase). Gradually work your way up to this 15 minute goal by adding a few minutes to each session. Inflate unit at lower levels the first week, thus reducing soreness commonly caused by aggressive treatments. Be sure to read and follow all cautions and instructions before beginning.