When do you need a back brace? & Which back brace do doctors recommend? & Why?
Consultation with a doctor is recommended before using a back brace. A doctor’s evaluation will help determine whether a brace is likely to be beneficial, as well as the type of brace needed and how it should be worn.
It is important to remember that back braces are prescribed as one aspect of a comprehensive treatment program and that wearing a brace on its own or wearing a brace not according to a doctor’s recommendation may cause further injury and increased pain.
Conditions That Can Benefit from Bracing
In addition to other nonsurgical treatments, a back brace may help heal and relieve pain from the following conditions:
- Post-operative healing
- Isthmic spondylolisthesis
- Spondylolysis
- Osteoarthritis
- Vertebral compression fractures
- Degenerative disc disease/lumbar herniated disc
- Spinal stenosis
- Muscle tension and strain
Factors for Bracing Success
Some known factors that contribute to bracing success include:
- Wearing the brace as advised. Adherence to wearing a back brace is one of the most important factors for success, although there are many reasons braces may be difficult to wear, such as discomfort or interference in daily activities. If a back brace is too cumbersome or uncomfortable, a doctor can help adjust the brace. It is advised to consult with a doctor before giving up on the brace entirely.
- Viewing a brace as a positive aid. One study found that back bracing provides more effective results when it is thought of as potentially beneficial, and a positive attitude is maintained regarding its effects. Encouragement and support from family members, friends, or coworkers can help improve attitudes about a back brace and its ultimate outcomes.
- Not depending on the brace for long-term relief. Back braces are typically recommended on a short-term basis. Wearing a brace longer than recommended is thought to contribute to muscle atrophy and dependence on the brace, which can ultimately weaken the back, increase the chance of injury, and worsen the pain.
Would Wearing Back Brace Weaken Spinal Muscles?
Although this is something that you may hear often, wearing a back brace would likely only ever cause weakness if you put the back brace on, lie down, and did nothing for long periods of time. In fact, if putting a back brace on allows your patient to be up walking for longer periods, doing activities that they would not be able to do otherwise, this is a positive move towards recovery. The main thing that is very important when using/wearing a back brace is that the patient is given an EXERCISE PROGRAM for strengthening and stretching to do in addition to wearing the brace.
Keeping the core musculature that supports the spine strong and flexible is important whether the patient's back is injured or not injured. The exercise program becomes VITAL when wearing a back brace.
Benefits of Bracing a Patient with Low Back Pain
Many back injuries or back conditions end up in a revolving circle of inflammation and muscle spasm due to an acute injury or a chronic condition that flare-up. Although the causes of back pain are varied, because of the anatomy and function demanded of our spinal column, bracing is a good choice for conservative treatment.
When there is back pain (no matter what the cause) the reaction of the spinal musculature is to contract into involuntary spasm or voluntary contraction of the muscles to protect the injured or inflamed joint or soft tissue structure(s). The muscles often go into “overdrive” with good intentions of protecting the spine. In effect, what happens is the vicious circle of pain and spasm begins.
There are several ways to break that vicious circle: physiotherapy (including ice, heat, modalities, stretching, strengthening, manual therapy, etc.) And, as an external stabilizer: a back brace.
Can a Patient Become Too Reliant on a Brace?
This question brings us back to the importance of maintaining core musculature by maintaining an exercise program. If your patient does wear the back brace and allows the back brace to do ALL the work ALL the time, then you may be asking for trouble. But by incorporating other forms of treatment and therapy into the patient's plan for care, which would assist in rehabilitating your patient, the likeliness of a patient wanting to continue wearing the brace would be low since it would no longer be necessary for them to comfortably perform their daily functions.
Goals and Mechanisms of Back Bracing for Pain Relief
A back-bracing prescription usually has a few complementary goals:
- Reduce muscle tension and low back pain
- Improve posture to redistribute weight in the spine
- Provide a healthy healing environment for spinal structures
- Increase function during daily activity
It is important to recognize that a back brace is almost never a permanent part of a treatment plan. A lumbar brace is typically prescribed to be worn for a certain number of hours each day, and the regimen may range from a couple of days to several weeks. The time frame for bracing is outlined and monitored by the physician to limit dependence on the brace, prevent muscle atrophy, and mitigate other negative effects of prolonged use while ensuring maximum effectiveness.
The bottom line is if you are a patient experiencing low back pain or maybe have already been diagnosed with a disc-related condition it is best to see a physician like Dr. Casey Walker to see if your condition may benefit from a back brace. To book our new patient special click here or call our office at 219-696-8916.