Should I use a Back Brace?

“Should I use a back brace?” This is a common question that we get asked and one that does not have a simple "yes" or “no" answer.

As a Chiropractor,  the most important question is: ”why do you want to use a back brace?” It is important to know what your expectations are,  when considering wearing a back brace. Do you want to wear it to help ease your back pain? Do you think it will improve your posture? Or do you think it will support your back while doing exercises? These questions will help you to decide if a back brace is what you need and if it will work for you.

Let's start by looking at some of the back brackets. The most common types of back braces are: rigid, semi rigid and flexible.

Rigid and Semi-Rigid Braces
Rigid braces are commonly used for the management of severe and moderate back pain. They are normally recommended in cases where there is a lot of instability, such as in a spinal fracture or when support and stability is required after back surgery. Rigid braces are made from a sturdy canvas or cotton, which wrap around the torso, and are supported in the front, back and sometimes the sides by a sturdy plastic frame or metal bars. Just by looking at the design of the brace, you can see that it is designed for structural support and stability. 
Semi-rigid braces usually have a flexible cotton or neoprene belt that wraps around the lumber spine and has some added padding or moulded plastic inserts for added support and stability.
 
Based on their design and structure, rigid and semi-rigid braces help to support the spine by transferring the weight from the spine to the abdomen, by placing pressure on the front and back of the torso. The brace itself will help to keep you in an upright posture by removing pressure off of the injured area. These types of braces do not allow for much movement, which is why they are designed more for stability and structural support. These types of braces help with shock absorption and limits any jarring forces to be transmitted to the spine, protecting it from any irritation and preventing any further damage. These types of braces are usually custom made or fitted by an orthopedic surgeon or a neurosurgeon.

Flexible  Braces 
Flexible braces include corsets, sacroiliac belts and lumbar belts. They are usually made from soft materials such as cotton or elastic blends, canvas or neoprene. Corsets usually have vertical metal or plastic inserts on the front, back or sides of the brace. These structural supports limit movement and provide some structural support, depending on the location of the inserts.

The sacroiliac and lumbar belts are sturdier and are made of a tougher fabric. They don't have the metal or plastic support frames but their design limits the degree of movement in the spine, compared to the corset brace.
 
Flexible braces apply a light pressure to the torso, helps to shift the weight off the spine and helps you maintain an upright posture. They allow you to move, but it is limited. So for example,  you may be able to bend forward when you wear the brace, but you wouldn’t be able to touch your toes, as the brace doesn't allow you to go further than your knees. Since the brace applies pressure around the torso and spine, it prevents small movement in the spinal joints, which protects the injured area from irritation. Wearing the brace also warms the area, which may help with tight and spasmodic muscles.

Recently, we have been seeing advertisements for shoulder braces which are recommended for helping improve posture. These are known as posture correctors and should not be confused with the back braces. Their function, purpose and design are different to back braces.
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Before wearing a brace, it is always advisable to speak to your doctor or Chiropractor first. Finding the right brace, to suit your specific needs is important, but finding the right size and fit is vital. If it doesn't fit properly, it won't work correctly.
 
This article was referenced from the following journal article:
Morrisette D, Cholewicki J, Logan S, Seif G, McGowan S. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain. Spine (Phila Pa 1976). 2014 October 1; 39(21):1733-
 
The image was courtesy of Amazon:
https://www.amazon.com/Comfortable-Posture-Corrector-Adjustable-Provides/dp/B07K5VSR9Q
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