Back Brace For Lower Back Pain

Goals and Mechanisms of Back Support Pain Relief

Post-bracing prescriptions typically have several complementary goals:

  • Reduce muscle tension and low back pain
  • Improve posture to redistribute the weight of the spine
  • Provides a healthy healing environment for the spinal structure
  • Add functionality to everyday activities

The above goals are achieved through the basic mechanism of the back brace in use. The mechanism of pain relief varies by brace design, but in general, braces can:

  • Provides additional spinal support. Back braces can add stability when the lower back is unstable due to injury or weak spinal structures. By keeping the torso in a safe, supportive position, back support can help provide a healthy healing environment for the current injury and prevent additional injuries.
  • Reduce stress on spinal structures. Back braces can help take some of the weight that normally rests on your lower back, reducing stress on the spinal joints, discs, and muscles in the process. By reducing spinal pressure, a back brace can relieve painful muscle tension, a common protective response after an injury.
  • Reduce range of motion during healing. Back braces are used to prevent or limit painful movements, such as twisting the spine or bending forward, backward, or to one side. Pain-limiting movements and postures also help increase awareness of body positioning (proprioception), which allows the wearer to consciously adjust posture to improve back health.
  • Reduces fretting between vertebral segments. Braces can also limit excessive fretting at specific spinal segments or vertebral fractures, thereby limiting muscle tension and pain from irritated joints or nerve roots.

Back Support Pain Relief Is Controversial

While back braces are widely believed to help relieve pain, the medical literature suggests that more rigorous research is needed to address issues related to back braces, such as:

  • What are the medical indications for using a back brace?
  • How and when do back braces work best?
  • Will the back support cause any negative effects?

Much of the available medical literature points to limited patient participation and low-to-moderate quality research methods and study designs, which limit the available information on back support.

Additionally, some doctors suggest that back bracing may cause core muscle atrophy due to the reliance on support, potentially making the back more prone to injury. However, some studies have found that using a back brace does not significantly reduce core muscle strength. The general consensus is that atrophy is unlikely to be a problem when the brace is worn as directed by your doctor.

It is important to realize that a dorsal brace is almost never a permanent part of the treatment plan. Lumbar braces are usually prescribed for a certain number of hours per day, and treatment options may vary from a few days to a few weeks. The physician outlines and monitors the time frame for the brace to limit reliance on the brace, prevent muscle wasting, and mitigate other negative effects of long-term use, while ensuring maximum effectiveness.

Conditions that can benefit from bracing

In addition to other non-surgical treatments, a back brace may help heal and relieve pain caused by:

  • Postoperative healing. Rigid braces may be prescribed after spine surgery with the aim of reducing stress on the spine, increasing stability, and limiting movement and micromotion to provide a healthy healing environment. A questionnaire completed by spine surgeons found that the most common reason for a postoperative brace was restriction of activity and movement. The same questionnaire showed that back braces are generally recommended between 3 and 8 weeks after surgery, but the duration varies depending on the patient's needs. 1
  • Isthmus spondylolisthesis. Treatment of isthmic spondylolisthesis with a rigid back brace has been shown to minimize the amount of spondylolisthesis and significantly improve walking ability and pain levels. 2 Rigid braces limit excessive movement of the fractured segment, help manage pain and possibly reduce damage to joints, nerves, and muscles.
  • Spondylolysis. Similar to isthmus spondylolisthesis, semi-rigid or rigid braces may be recommended to minimize painful fretting at the level of the fractured vertebral body, reducing pain and potentially allowing the fracture to heal. Lumbar braces are thought to prevent or reduce spondylolisthesis (isthmus spondylolisthesis).
  • Osteoarthritis. The use of rigid or semi-rigid back braces can reduce the instability and painful fretting of spinal osteoarthritis. Additionally, braces can reduce pressure on the affected facet joints, reduce pain and make daily movements easier, such as moving from a sitting to a standing position and vice versa.
  • Vertebral compression fractures. For vertebral compression fractures, rigid or semi-rigid posterior braces are recommended to reduce micromotion at the level of the fractured or affected vertebral body, as well as reduce stress on the spine.
  • Degenerative disc disease/lumbar disc herniation. When a disc ruptures and/or herniates, rigid or semi-rigid posterior braces can help stabilize and reduce micromotion of the affected spinal segment. Back braces can also be used to limit bending and twisting and help carry some of the weight that the discs normally carry.
  • Spinal stenosis. Braces for lumbar spinal stenosis are designed to relieve pressure on the lower spine and limit fretting, both of which can lead to nerve root irritation and nerve root pain. In some cases, a brace can help adjust posture or transfer weight to the abdomen to relieve pressure on the spine.
  • Muscle tension and strain. In relatively rare cases, a flexible back support may be recommended to treat a lower back muscle strain. Back braces can help relieve muscle tension by reducing spinal pressure, thereby reducing the amount of force the muscles need to support the spine. Additionally, the heat from the brace can help relax tense muscles, which can help relieve pain. Muscle injuries or weak back braces are generally not recommended for use beyond 2 to 4 days.
  • Factors underpinning success

Some known factors that help underpin success include:

  • Wear braces as recommended. Consistently wearing a back support is one of the most important factors for success, although there are many reasons why a back support can be difficult to wear, such as discomfort or interference with daily activities. If the back brace is too bulky or uncomfortable, your doctor can help adjust the brace. It is advisable to consult a doctor before giving up the stent entirely.
  • Think of the brace as a positive help. A study found that back support provided more effective results when it was seen as potentially beneficial and positive about its effects. 4 Encouragement and support from family, friends, or colleagues can help improve attitudes toward back support and its end result.
  • Stents that do not depend on long-term relief. Back braces are generally recommended for short-term use. Wearing a brace longer than recommended is thought to lead to muscle wasting and dependence on the brace, which ultimately weakens the back, increases the chance of injury, and exacerbates pain.

Wearing a back brace is not recommended in any way if the doctor believes there is no benefit to a back brace.