Back Brace For Lower Back Pain

A back brace for lower back pain may be recommended to help relieve pressure on the spine for people who have acute (short-term) back pain. Back braces, also known as lumbar orthoses, may also be recommended for the following reasons:

• For added spinal support
• To help control back movement
• To correct an existing deformity
• To promote recovery after back surgery or an injury
• To prevent the progression of muscle or spinal damage
• To reduce axial load bearing on weakened spinal segments
• To stabilize and immobilize weak or damaged spinal segments

A back brace is also beneficial for individuals who occasionally participate in strenuous activities that involve lifting heavy items or bending repeatedly. Orthopaedic research reports that when used for short periods of time, back braces can offer good support for the spine and help distribute body weight more evenly to lower the risk of future back injuries. However, it is important to note that the use of a back brace is typically a temporary approach to back pain management.

Back Braces Offer Individualized Support

The lumber area or lower back is particularly prone to back pain due to the way the body is designed, as the spine carries more weight in the lower back. Poor posture or weak muscles can compound this problem. A properly fitted back brace can improve posture by helping the back muscles and spine return to their normal alignment. In addition, back braces with straps can pull the shoulders back, creating a more upright stance, while the waist strap provides support for the lumbar region. This form of temporary postural training can help individuals maintain proper posture even after the back brace is no longer used.

Types of Back Braces

There are braces that are mainly designed to promote steadiness such as a support belt or a support brace with a pad. Others are designed for enhanced stabilization such as a support brace with steel rods or a frame brace. Back braces are described as flexible, semi-rigid, and rigid. Flexible and semi-rigid braces help target mild to moderate pain. Rigid braces are generally used for moderate to severe cases of lower back pain and spinal instability that may develop due to a spinal fracture, or after back surgery. 

Flexible Back Braces

Flexible braces are made from soft fabrics such as elastic, cotton-elastic blends, neoprene (synthetic rubber), or canvas. These types of braces include lumbar support belts, sacroiliac belts, and corsets. They provide pain relief by steadying the spine during activity (e.g., lifting, bending) and are often sleek enough to be hidden underneath clothes. In particular, they offer a practical means of added back support as individuals go about their daily routines. They are especially comfortable for use in an office chair, car, or even while relaxing at home. In addition to providing extra back support and reducing pain, flexible braces help relax tense muscles. Accordingly, they may be recommended for acute nonspecific lower back pain or minor instability problems.

A corset brace may have a similar appearance as a woman's corset. It often includes plastic or metal stays at the front, sides, or back that provide heightened stability through the moderate restriction of torso movements. Lumbar support belts or sacroiliac belts are typically made from sturdier fabrics and do not contain stays. They also restrict movement to a certain degree but allow for limited bending. For example, wearing a flexible brace makes it possible to bend forward far enough to touch the knees, but restricts movement past the knees that could lead to further injury.

Flexible corsets and support belts target lower back pain by:

• Gently compressing the torso. This helps adjust posture by shifting weight off the spinal column.
• Providing added back support to reduce pressure that is being placed upon weakened or damaged muscles.
• Slightly limiting mobility and range of motion. This allows an individual to bend, twist, or lift more carefully.
• Reducing micro-motions at injured or weakened joints through gentle compression of the pelvis or torso. Lumbar and sacroiliac joint support belts are especially useful for this type of support.

Rigid and Semi-Rigid Back Braces

A rigid back brace generally consists of a sturdy fabric such as canvas or cotton, that wraps around the torso. It may include rigid panels on the front, sides, or back of the brace. Certain braces may also incorporate metal bars or hard plastic that covers the outer surface of the brace. In addition, these types of stabilizing braces may contain a sacral pad that is positioned close to the bottom of the spine or a larger pad that covers the entire lumbar region. Back braces with pads offer relief for chronic recurrent lower back pain that is caused by weak or damaged muscles and lumbar instability. The pad helps restrict movement to promote healing. Additionally, the pad may offer massaging or warming effects that help relieve muscle tension. The general structure of a rigid brace is designed to immobilize vertebrae, discs, tendons, muscles, and ligaments in the back to ensure they heal properly.

Rigid back braces can be custom-made or assembled by a professional from pre-made parts. A healthcare professional such as a physical therapist who specializes in assembling and fitting back braces for lower back pain will measure and fit the brace to ensure it is comfortable, effective, and safe.

A rigid brace may be recommended after a traumatic spinal injury, severe spinal damage that requires surgical treatment, or a condition that necessitates spinal surgery. In such cases, the purpose of the brace is to promote post-operative healing through limited activity. More specifically, the main treatment goals involve reducing pressure on the spine, enhancing stability, substantially restricting movement, and significantly limiting micro-motions that can disrupt the healing process. The use of a back brace following surgery is generally recommended for a range of 3 to 8 weeks. However, the duration depends on each individual’s therapeutic needs.

When more moderate movement restriction is required, a semi-rigid brace may be recommended as this type of brace combines structural elements of flexible and rigid braces. For example, a flexible lumbar support belt may include molded plastic inserts and additional padding for extra stability. These added components would allow it to function as a semi-rigid brace.

Semi-rigid and rigid braces target lower back pain by:

• Gently compressing the lumbar region to maintain proper posture that keeps the spine in a neutral position and shifts weight from the spine to the abdomen.
• Offering extensive back support that takes excess pressure off injured or weakened spinal structures such as the nerve roots, muscles, joints, and discs.
• Significantly reducing mobility and range of motion in the back to prevent unnecessary movements that include bending forward or backward and rotating the trunk.
• Markedly restricting micro-motions at an affected fracture site or spinal segment. This improves positive outcomes (proper healing) by limiting spinal irritation that is linked to sudden movements.

Orthopaedic studies indicate that participants with severe cases of lower back pain (e.g., spinal fracture, spinal surgery) generally experience lower disability rates and pain levels when they use a rigid brace instead of a flexible back brace. However, a healthcare professional carefully evaluates each individual’s case to determine whether the temporary use of a semi-rigid or rigid back brace for lower back pain will support the desired physical outcome.

Semi-rigid or rigid braces may be recommended for:

• Osteoarthritis
• Spondylolysis
• Isthmic spondylolisthesis
• Lumbar herniated disc
• Degenerative disc disease
• Vertebral compression fractures

The use of a back brace for these types of conditions aims at limiting excess movement and micro-motions at affected spinal segments to help control pain and potentially prevent further damage of the vertebrae, discs, muscles, nerves, or joints. When used appropriately, a back brace for lower back pain can make simple movements such as transitioning from a seated position to standing much easier. Most individuals who combine the use of a back brace with physical therapy can experience a dramatic reduction in pain or complete pain relief when use of the back brace is discontinued.

In general, a healthcare professional (e.g., physical therapist) must carefully evaluate each individual’s body composition and spinal health to make an appropriate assessment regarding the use of a back brace. In particular, the potential efficacy of recommending a back brace must be evident before it is prescribed. This step is important because a proper evaluation helps lower the incidence of complications and treatment failure.  

It is also important to note that back braces are limited in their ability to control spinal movement through the deep and pliable soft tissue envelope for individuals who are obese. Furthermore, back braces must be modified periodically as individuals may experience body composition changes or become increasingly active as they start to recover from their lower back pain. In addition to the biomechanical advantages of wearing a back brace temporarily, a brace that is properly fitted promotes better compliance and comfort, thereby improving the chances of successful treatment.

Back Braces for Females

There are also back braces that are specifically designed to contour to the female body, including braces that can be worn during pregnancy. Women are more prone to lower back pain that is caused by compression fractures, osteoporosis, and spondylolisthesis than men. Compression fractures occur when vertebrae (spinal bones) break. Osteoporosis, which is characterized by weak, brittle bones, is one of the main causes of compression fractures.

Some women also experience lower back pain for other reasons, including herniated discs or pregnancy. Chronic lower back pain during pregnancy can also lead to issues such as sacroiliac joint pain. There are support belts specifically made for females to target sacroiliac joint dysfunction and pain. This condition develops when cartilage within the sacroiliac joints become damaged or gradually worn, allowing spinal bones to rub against each other. During pregnancy, hormones are released that cause the ligaments to relax. This relaxation of the ligaments allows for increased motion and stress on the joints. The pain in the sacroiliac joints may also persist after pregnancy. Overtime, osteoarthritis may develop as a result of the bones rubbing together.

Due to the position of support belts, they are an optimal form of treatment for women with lower back pain. In particular, the support belt reduces pain by stabilizing the sacroiliac joints. It easily wraps around a woman’s hips and pelvis, even during pregnancy, to provide gentle lumbar compression that helps relieve discomfort. Overall, back braces that are designed to accommodate the specific anatomy of the female body are beneficial toward reducing pain, preventing the progression of certain conditions, and promoting healing.

Summary

A back brace for lower back pain can provide support for the spine and lessen muscle-related pain. However, using a back brace for a prolonged period can gradually weaken muscle tissue in the back by deconditioning the muscles. According to orthopaedic research, wearing a back brace for extensive amounts of time may lead to muscle atrophy (shrinkage), which is a serious a problem that increases the risk of future back injuries. This also means that wearing a back brace for too long can make an individual become dependent upon it.

The therapeutic use of back braces warrants that an individual only receives as much spinal support as is required through a back brace. Furthermore, during the course of treatment, the amount of stabilization an individual needs can be efficiently enhanced through concurrent physical therapy as well as additional therapeutic measures, as deemed necessary.

To enhance the natural healing process, the back brace that is recommended for therapy should also be adjustable to accommodate the individual’s gradually improving degree of body stabilization. In addition, the brace should be periodically removed to provide off-training periods that allow the back muscles to strengthen and rebuild their own support.

If you would like to talk to a physical therapist about whether a back brace may benefit you, please contact FYZICAL today. We would love to help you eliminate your lower back pain.

FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!

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