The variable lumbar orthosis: fabrication and guidelines for use

When treating the patient complaining of low back pain, the physical therapist may decide to support the lumbar spine through the temporary use of a lumbar orthosis. In severe cases (generally involving fracture or instability) the goal of orthosis application may be immobilization or significant limitation of movement. In less severe cases the goal is generally the reduction of spinal stress by the application of supportive pressure to the abdomen and by supporting a flexed, neutral, or extended position of the lumbar spine. A variety of orthoses is commercially available. These include rigid orthotics and body casts, various types of corsets, elastic binders with molded plastic inserts, and all-elastic binders. To date, however, we have not encountered a commercially available orthosis which provides abdominal support and lumbar positional support which can be varied by the patient in order to meet his changing biomechanical needs as he changes body position. This report describes a variable lumbar orthosis that we have fabricated and utilized in our clinic with favorable results. J Orthop Sports Phys Ther 1982;3(4):206-208.