“Do you think a back brace will help my condition?” This is a question that is frequently asked of many health care providers who treat low back pain. The answers typically vary, as there is support for and against the use of a brace when low back pain is present. In a Feb. 2009 study, the use of an elastic lumbar belt was studied in a group of subacute low back pain patients for its effect on functional capacity (lift and carry types of activities), pain intensity, and the effects on health care service costs. This study was unique in that it was carried out in several different locations and, the patients were randomized and received either a lumbar belt or nothing (“control group”). 197 patients were included in the study, which is a good sample size for research purposes. The results of the study, at the end of 90 days, revealed a higher score for the back brace treated group than the non-braced control group. The pain scale improved greater in the brace treated group as an improvement of 42 points vs. 32 points was reported. Similarly, 61% in the brace treated group used no medication compared to 40% in the non-braced group. It was concluded that patients with subacute low back pain improved significantly in functional status, pain reduction and medication utilization.
The use of back braces has been considered a “standard” in the treatment of patients with LBP for many years. One argument against using back braces centers around becoming “dependant” either physically or mentally on its use and this has long been a concern amongst health care providers. For most patients, this is not a concern as most do not “enjoy” the use of a brace and they look forward to discontinuing their use of it. Braces are particularly helpful when the patient cannot stop performing needed activities, such as work. This is especially true for farmers who have to tend to the animals and crops during planting, cultivating and harvest times of the year. In addition, single moms or dads who have to go to work in order to provide for their children are driven to stay on the job. In these cases, the use of a back brace can be of utmost importance.
There are many types of back braces. Some are narrow and are particularly favored when frequent bending and/or twisting movements are required by a job, sport, or other daily activity. Other braces are taller in the back and taper in the front, which give better support but still allow some bending / twisting movements. Some braces are more rigid and can actually stop movement in certain directions. These types include a hard, rigid surface that is placed in the area of the back where movement is not desired. These are used at times when there are fractures of the spine, after spinal surgery and in scoliosis bracing. Some braces are to be worn low on the pelvis to support that area, while most are placed in the center of the low back region. There are also rib belts sometimes used when ribs fracture, soft and rigid neck braces sometimes used after car accidents, and braces for the arms or legs. The decision to use a brace rests on the degree of injury and the patient’s ability to avoid certain activities or positions. When the injury is significant and/or the patient cannot control his/her activities (such as work), then the use of a brace may be one of the most important treatment approaches for that patient. It’s similar to having stitches when a deep or wide cut occurs. Ask us about the use of supports, braces, or belts if you or your family or friends are suffering with low back pain.
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