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Lumbar Bracing for Chronic Low Back Pain: A Randomized Controlled Trial
Thiru M Annaswamy1, Kegan J Cunniff, Mitchell Kroll
1From the Physical Medicine & Rehabilitation Service, VA North Texas Health Care System, Dallas, Texas (TMA); Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center at Dallas, Dallas, Texas (TMA, KJC); Edward Via College of Osteopathic Medicine-Louisiana Campus, Monroe, Louisiana (MK); Physical Medicine & Rehabilitation Service, VA North Texas Health Care System, Fort Worth, Texas (LY); Infirmary Medical Clinics, Mobile, Alabama (MH); Riverside Community Hospital, Riverside, California (C-KL); and Star Orthopedics and Sports Medicine, Coppell, Texas (JP).
Back bracing did not improve pain or function for chronic low back pain patients. Adding a back brace to education and exercise did not offer benefits over education and exercise alone.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Pain Management
Background:
- Chronic low back pain (CLBP) affects millions globally, with varied treatment approaches.
- Back bracing is a common intervention, but its efficacy in conjunction with conservative care requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of a semirigid back brace as an adjunct to education and exercise for patients with CLBP.
Main Methods:
- A prospective, unblinded, randomized controlled trial involving 61 adults with CLBP and degenerative spondylosis.
- Participants received back school instruction; the treatment group also used a lumbar orthosis as needed.
- Outcomes measured included pain intensity (Numerical Rating Scale), disability (Pain Disability Questionnaire), function, and quality of life (PROMIS, EQ-5D) at multiple time points.
Main Results:
- Interim analysis showed worse scores in the treatment group for disability, function, and quality of life (PDQ, PROMIS, EQ-5D) compared to controls.
- No significant difference in pain intensity (NRS) was observed between groups.
- The study was halted due to unlikely significant changes in results upon completion.
Conclusions:
- In patients with uncomplicated CLBP, a back brace combined with education and exercise did not provide additional pain relief compared to education and exercise alone.
- The use of lumbar orthoses in this context may not be beneficial and could potentially worsen outcomes.
