How long to wear back brace for compression fracture?

What is a spinal brace and why do I need it?

A spinal brace is a device designed to limit movement of the spine. It is most commonly used to manage spinal fractures but can also be used for other reasons such as supporting your spine after surgery.

Limiting the movement of the spine through wearing a spinal brace helps the healing process. It may also help to prevent further injury or damage and can help to minimise discomfort.

Can there be complications with wearing a spinal brace?

Movement cannot be completely stopped within your spine and so occasionally a spinal brace may not be sufficient to manage your condition and you may require other treatments.

Wearing a spinal brace will cause some weakness of the muscles around your spine, as the spinal brace will essentially be doing some of the work of these muscles. However, when you no longer require your spinal brace, you will be advised to gradually stop using it and you will be provided with an exercise programme to strengthen your muscles again.

Applying your spinal brace

Use of the spinal brace could cause pressure leading to redness or, in extremely rare circumstances, breaking of the skin. Experienced physiotherapists will measure and fit you into the spinal brace and you will be taught and monitored on your application of the spinal brace to ensure it is not ill fitting. You will be instructed to remove your spinal brace daily when you lay down to sleep.

The physiotherapist is will measure you and determine which spinal brace is most suitable for your size and shape. This spinal brace may or may not have a chest plate (depending on your diagnosis) however the instructions are the same for both.

Initially your physiotherapist will fit your spinal brace while you are lying down. They will then give you instruction on the way in which the spinal brace should be applied and removed.

Important information

Please note the following:

• A thin layer of clothing should be worn between you and the spinal brace to prevent rubbing or sores.
  
• The spinal brace should be tight but comfortable.
• If excessive sweating occurs, please remove the spinal brace and rest for short periods lying down – this is especially important if you have a wound from surgery.
• The spinal brace should be kept on at all times except when lying flat in bed – unless you have received different instructions from your physiotherapist or consultant.
• The spinal brace will only limit movement within your back, not eliminate it completely. It is important that you monitor your posture to prevent slouching and avoid any bending, lifting or twisting.
• The pads within the spinal brace are removable and can be hand washed. They should be dry fully prior to wearing them and the spinal brace should not be worn without them.
• Bathing and showering is not permitted unless you are given special instruction from your consultant.
• If you feel you may need guidance with washing and dressing techniques please discuss this with the Occupational Therapist on the ward prior to discharge.
  

When to stop wearing your spinal brace

The spinal brace is usually worn for a period of 8 weeks, to support your back and prevent movement around the fracture site but this can alter depending on your healing rate and your consultant’s opinion.

After your final X-Ray, you will be told if your fracture has healed sufficiently for you to be able to remove the spinal brace. The physiotherapist will discuss this with you and give you further instruction at this point.

You will be advised to wean from your spinal brace gradually to prevent sudden strain on your back and also to help to strengthen your spinal muscles slowly to minimise discomfort. Your physiotherapist will advise you on this, recommending you decrease the time spent in the spinal brace daily over 1-2 weeks.

You may feel stiff initially in the affected part of the spine when you start to wean the use of your spinal brace; this is normal and will improve as your activity levels increase. The physiotherapist will provide you with exercises to improve this, and also to build up the muscle strength in your spine. If required, you may also be referred for out-patient physiotherapy to further support your recovery.

Once out of the spinal brace, you should try to maintain a good upright posture. The spinal brace will have supported you up until this point and slumping will cause additional strain on your muscles. Heavy lifting should be avoided and return to activity should be controlled. If you have any specific activities you wish to return to please discuss this with your physiotherapist for advice.