Back Braces Offer Mixed Bag of Risks and Benefits
If you walk into any drug store, mega-box store or sporting goods store, you’ll be sure to find a variety of lumbar supports, back braces and alike. Because these devices are readily accessible, many users grab one off the self before seeking professional advice. That’s not necessarily a good idea because back braces offer a mixed bag of benefits and risks.
Now, strapping on an elastic lumbar support is tempting as a means to relieve pain and keep on going. And for the most part, these medical devices can help to accomplish that goal. The wrap-around support mimics the internal support that supposed to be provided by the abdominal muscles. Because many people have weak core muscles, the extra bracing does help sometimes. It’s probably most helpful in someone with disc degeneration as opposed to someone with lumbar stenosis. And it’s probably most helpful in average-weight individuals that don’t carry a lot of belly fat. Even if you don’t get a great deal of actual support from a brace, these medical devices when worn do provide physical cues that serve as reminders about using proper body mechanics.
The most beneficial back braces that are on the market are usually only available through an orthotist or specialty medical supply company. A basic example is a lumbar-sacral corset like the Aspen Quick Draw which has some rigid reinforcements in addition to the elastic support. Those who have a need for extra-support because of a spine fracture might be prescribed a brace like the chair-back lumbar brace or a brace that incorporates the thoracic spine called a TLSO (Thoracolumbar sacral orthosis). After surgery, some surgeons order a custom fit, hard-shelled orthosis that looks like a turtle’s shell and supports the entire thoracic and lumbar spine. No matter which brace your doctor thinks is best for you, your doctor will eventually want to you to gradually stop wearing a brace as your injury heals and as the muscle strengthen. This weaning process is best accomplished by sending you to physical therapy to strengthen your natural, built-in back brace.
Your natural back brace is your abdominal muscles, your spine muscles, and your core muscles. If you wear a lumbar support too much, you’ll weaken these muscles. Your body will become dependent on the use of the back brace to the point that the muscles will get lazy. Once that happens, your pain will get worse when you remove the back brace.
If you are already at that point, you’ll need to wean off your back brace dependency slowly. Weaning involves removing the support for brief periods of time every day and gradually increasing that "no brace" time week by week. In order to avoid lumbar support dependency, don’t wear it all the time. Wear your brace only as prescribed by your doctor or only when you are doing some heavy activities that require extra support to do them. However, when you buy that brace at the store, you don’t get these warnings or directions for use.
So buyer beware: back braces provide mixed bag of benefits and risks. You may experience temporary pain relief but you also risk becoming dependent, too.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.