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Back Brace – Do I Need One?

Previous studies confirmed that a back brace might not help to prevent back problems. But does current data show any utility for the management of back pain? Here’s a quick summary of the latest evidence on four of the most common back braces.

1. Elastic Lumbar Support Belts

back brace for back pain

Non-rigid, elastic-type braces that provide support while allowing movement

“Five of the six randomized controlled trials were of good quality, with all of them showing the use of lumbar support usually reducing discomfort and improving quality of life in individuals with low back pain. The prescription for wearing lumbar support for 6-8 hours per day for at least one month showed positive results.”

2019 Journal of Health & Allied Sciences Systematic Review

How does it help?

  • Elevates intraabdominal pressure
  • Decrease lumbar lordosis
  • Reduces trunk range of motion regionally and segmentally
  • Decreases lumbosacral compressive force and spinal load
  • Decreases intradiscal pressure
  • Protects from soft tissue creep

Benefits:

  • Reduces muscle fatigue
  • Decreases pain intensity and functional limitations
  • Decreases need for medications
  • Over 80% of stenosis patients wearing a lumbar belt report >30% improvement in walking distance
  • Improvement correlates with compliance
  • No negative effect for long-term use (6 months)

Who should wear this belt?

This back brace may be right for you, if you have been diagnosed with any of the following:

  • Acute or sub-acute low back pain
  • Segmental instability
  • Uncomplicated compression fracture
  • Spinal stenosis

2. Rigid Lumbosacral Orthosis (LSO)

back brace for disc herniation

Rigid, non-elastic braces designed to limit trunk movement as a non-surgical alternative for stability.

How does it help?

  • Added trunk stiffness over elastic braces
  • Improved postural control
  • According to BCBS of North Carolina, LSO brace medical necessity includes:
    • “To reduce pain by restricting mobility of the trunk”
    • “To facilitate healing following an injury to the spine or related soft tissues”
    • “To support weak spinal muscles and/or a deformed spine”

What are the benefits?

  • Reduces muscle fatigue
  • Decreases pain intensity and functional impairment

Who should wear this belt?

This back brace may be right for you, if you have been diagnosed with any of the following:

  • Spinal instability
  • Spondylolysis
  • Degenerative spondylolisthesis
  • Post-surgical low back pain

3. Pregnancy Support Belt

Back brace for pregnancy

Elastic maternity abdominal support garment.

The study concluded that wearing maternity support garments during pregnancy could have beneficial effects in women such as low back pain and pelvic girdle pain alleviation, improvement of functionality and mobility, and reduction of risk of fall during pregnancy”

2019 Journal of Pregnancy Systematic Review

How does it help?

  • Supports the abdomen and lower back of pregnant women

What are the benefits?

  • (Limited) evidence suggests symptomatic benefit
  • Alleviation of low back pain and pelvic girdle pain
  • Improvement of functionality and mobility with reduction of fall risk

Who should wear this belt?

  • Pregnant women with low back pain

Clinical Considerations

4. Sacroiliac Support Belt

Back brace for SI joint pain

Elastic pelvic compression belt worn slightly above the trochanters to stabilize the sacroiliac joints. Aka trochanteric belt.

“Pelvic belts improve health-related quality of life and are potentially attributed to decreased SIJ-related pain. Pelvic belts may therefore be considered as a cost-effective and low-risk treatment of SIJ pain.”

How does it help?

  • Decreases motion around the SI joint transverse axis
  • Decreases ligamentous strain
  • Decreases rectus femoris activity

What are the benefits?

  • Decreases pain and improves function
  • Improves gait cadence and velocity
  • Improves postural steadiness during locomotion

Who should wear this belt?

This back brace may be right for you, if you have been diagnosed with any of the following:

  • Sacroiliac dysfunction, particularly hypermobility

In conclusion, current literature indicates that back brace are safe with few side effects.  These orthoses are not necessarily protective; however, they may help manage symptoms. And contrary to popular opinion, long term use will not likely cause muscle weakness.

If you think a back brace may benefit you, check with a Chiropractor in Friendswood to find the right belt for your diagnosis.