For certain spinal problems, a lower back brace can be a useful part of a comprehensive therapy strategy, and it can provide support for the spine as it heals after back surgery.
A back brace, also known as a lumbosacral orthosis or LSO, can be prescribed by a doctor or acquired over the counter. Without a doctor's prescription, nonprescription braces are available, and it's critical to follow the manufacturer's directions to avoid further injury to the lower back. The focus of this page is on back braces that have been prescribed or recommended by a doctor.
Goals and Mechanisms
A back bracing prescription usually has several objectives:
- Muscle tightness and low back pain can be reduced.
- To redistribute weight in the spine, improve your posture.
- Ensure that the spinal structures have a good healing environment.
- Boost your performance during everyday activities.
The above goals are achieved by the basic mechanisms of the back brace during use. Mechanisms of pain relief vary somewhat by brace design, but in general, a brace is able to:
- Provide additional spinal support. A back brace can add stability when the low back is unstable due to injured or weakened spinal structures. By holding the torso in a safe, supportive posture, a back brace can help provide a healthy healing environment for the current injury and prevent additional injuries.
- Reduce pressure on the spinal structures. A back brace can help unload some of the weight normally placed on the lower back, in the process reducing pressure on the spine’s joints, discs, and muscles. By reducing spinal pressure, a back brace may lessen painful muscle tension which is a common protective reaction following an injury.
- Reduce range of motion during healing. A back brace is used to prevent or restrict painful movements, such as twisting the spine or bending forward, backward, or to the side. Limiting painful movements and postures can also help improve awareness of the body’s positioning (proprioception), which allows the wearer to consciously adjust posture for improved back health.
- Reduce micro-motion between vertebral segments. Braces also limit excess micro-movements at a particular spinal segment or vertebral fracture, thereby limiting pain from muscle tension and irritated joints or nerve roots.
Adding a back brace to a treatment regimen has been shown in some studies to improve mobility and pain scores better than only physical therapy and pain medication. However, more research is needed to confirm this finding.
Trusted, comprehensive information and resources for back pain.
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Almost everyone will experience low back pain at some point in their lives. This pain can vary from mild to severe. It can be short-lived or long-lasting. However it happens, low back pain can make many everyday activities difficult to do.
Anatomy
Your spine is made up of small bones, called vertebrae, which are stacked on top of one another. Muscles, ligaments, nerves, and intervertebral disks are additional parts of your spine. The muscles and ligaments help stabilize the bones while the intervertebral disks provide "cushioning" to the spine so it can tolerate various movements and stress you place on your spine. The nerves that allow communication between your brain and your body are located inside the spine. Understanding your spine and how it works can help you better understand low back pain.
Description
Back pain differs from one person to the next. The pain can have a slow onset or come on suddenly. The pain may be intermittent or constant. In most cases, back pain resolves on its own within a few weeks.
Causes
There are many causes of low back pain. It sometimes occurs after a specific movement such as lifting or bending. Just getting older also plays a role in many back conditions. As we age, our spines age with us. Aging causes degenerative changes in the spine. These changes can start in our 30s — or even younger — and can make us prone to back pain, especially if we overdo our activities. These aging-related changes do not keep most people from leading productive and generally pain-free lives. We have all seen the 70-year-old marathon runner who, without a doubt, has degenerative changes in her back.
Overactivity
One of the more common causes of low back pain is muscle soreness from overactivity. Muscles and ligament fibers can be overstretched or injured. This is often brought about by that first softball or golf game of the season, or too much yard work or snow shoveling in one day. We are all familiar with this stiffness and soreness in the low back and other areas of the body that usually goes away within a few days.
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Spinal Disc Injury
You may experience intense pain, similar to an electric shock, whether you stand, walk, or sit. Bending, lifting, twisting, and sitting can all increase the pain. Because it decreases downward pressure on the disc, lying flat on your back with a back brace, with your knees bent may be the most comfortable position. Disk tear. Small tears to the outer part of the disk (annulus) sometimes occur with aging. Some people with disk tears have no pain at all. Others can have pain that lasts for weeks, months, or even longer. A small number of people may develop constant pain that lasts for years and is quite disabling. Why some people have pain and others do is not well understood.
Herniated disk.A disk herniates when its jelly-like center (nucleus) pushes against its annulus. If the disc is very worn or injured, the nucleus may squeeze all the way through. When the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive spinal nerves, causing pain. A herniated disk often occurs with lifting, pulling, bending, or twisting movements. Because a herniated disk in the low back often puts pressure on the nerve root leading to the leg and foot, pain often occurs in the buttock and down the leg. This is called sciatica.
Disk Degeneration
Disk degeneration.With age, intervertebral disks begin to wear away and shrink. In some cases, they may collapse completely and cause the facet joints — the small joints located between each vertebra on the back of the spine — to rub against one another. Pain and stiffness result. Smoking has also been found to accelerate disk degeneration. This wear and tear on the facet joints are referred to as osteoarthritis, also known as spondylosis. It can lead to further back problems, including spinal stenosis.
Spinal Stenosis
Spinal Stenosis occurs when the space around the spinal cord narrows and puts pressure on the cord and spinal nerves. When intervertebral disks collapse and osteoarthritis develops, your body may respond by growing new bone (arthritis) in your facet joints to help support the vertebrae. Over time, this bone overgrowth (called spurs) can lead to a narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that connect vertebrae to thicken, which can narrow the spinal canal.
Scoliosis
Scoliosis is an abnormal curve of the spine that may develop in children, most often during their teenage years. It also may develop in older patients who have arthritis. This spinal deformity may cause back pain and possibly pain, weakness, or numbness in the legs if pressure on the nerves is involved.Compression Fracture
Vertebral compression fractures are a common cause of back pain in the elderly. As we get older, our bones become weaker and more likely to break, a condition called osteoporosis. In people with osteoporosis, minor trauma — such as sitting forcefully on a hard chair or toilet, or a ground-level fall — can cause bones in the spine to break, resulting in extreme back pain when moving.Additional Causes
There are other causes of back pain, some of which can be serious. If you have vascular or arterial disease, a history of cancer, or pain that is always present regardless of your activity level or position, you should consult your primary care doctor.