Regarding the controversy of lumbosacral supports and braces - an update

Many health care practitioners believe lumbosacral supports and braces can be used effectively in treatment and prevention of musculoskeletal disorders of the lumbar spine.Ninety-nine percent of 3,410 orthopedic surgeons surveyed in the United States reported prescribing spinal orthoses.1 While there is no hard scientific evidence of the clinical effectiveness of lumbosacral supports and braces as a group, there are retrospective studies that have documented acceptance by patients and improvement of symptoms in from 30% to 80% of the cases.2-4The lower lumbar region is of particular interest because most disorders occur in one or both of the lower two segments. The use of supports and braces in the management of many common disorders will be discussed. Disorders of the sacroiliac joints, spinal fractures, postsurgical management, and corrective braces used in the treatment of disorders such as scoliosis and kyphosis are not within the scope of this article.Medical as well as industrial health and safety literature is filled with the pros and cons of using lumbar supports and braces. Certain factual information concerning the effects of back supports and braces has been known fix many years, while certain other effects remain unclear. While it is true that we have not made many recent discoveries concerning the effects of back supports, we have seen a renewed interest in their use. This renewed interest seems to focus on prevention as well as treatment, as is especially evident in business and industry.There also seems to be increased awareness and evidence of back injuries in sports. This has created interest in and use of back supports, and has led to development of new concepts and designs of back supports.Perhaps another reason for the renewed interest in back supports and braces has to do with the recent changes in attitudes toward the treatment of back disorders in general. Most experts now agree that almost all back disorders can be treated most effectively with early intervention of exercise and patient education. We no longer tell the patient to rest, take it easy, and wait until he or she is completely free of pain before starting exercises and activities. Many practitioners are recognizing that placing a back support on a patient often assists him or her in returning to full function sooner, avoiding the well-documented harmfi.il effects of prolonged immobilization and inactivity.