Low back pain (LBP) is a very common condition that many attempt to self-manage prior to seeking treatment at their local chiropractic office. One approach that an individual with LBP may reach for, especially if it helps keep them working, is a low back belt or brace. A 2008 systematic review concluded that lumbar belt use is not likely to prevent back pain, but what about the patient who already has LBP? Can a low back belt/brace benefit the LBP patient or does it unnecessarily prolong the patient’s pain and disability?
In a 2021 study, researchers asked 30 office workers (15 with LBP and 15 without LBP) to perform sit-to-stand movements while wearing either an extensible lumbar belt, a non-extensible lumbar belt, and no lumbar belt at all. With the aid of 3D motion analysis and a force plate, the research team observed that lumbar belt use provided benefits with respect to lumbar lordosis and total trunk range of motion in all participants. With respect to those with LBP, belt use reduced pain intensity, pain-related anxiety, and fear or movement. Interestingly, the results did not favor one type of lumbar belt over another.
It’s important to note that prolonged use of a lumbar belt may not benefit the patient in the long-term. This is because bracing can restrict normal movement and weaken the deep muscles that help to stabilize the spine. This is similar to the reasoning in treatment guidelines for back pain that encourage movement and discourage prolonged bed rest and inactivity.
The authors of the study note that the average person performs sit-to-stand movements over 60 times a day, which accounts for 56-64% of total lumbar sagittal mobility. Because a low back condition can make sitting and standing painful and/or difficult, the temporary use of a lumbar belt may benefit the LBP patient while they’re under care to address their musculoskeletal disorder (of which chiropractic care is a great choice).
While additional studies are needed before firm conclusions can be made and treatment guidelines can be adjusted with respect to lumbar belt use for the patient with LPB, it’s worth noting that treatment guidelines also recommend that providers assess each patient individually and apply treatment strategies they feel will benefit the patient. Doctors of chiropractic will often tailor a patient’s treatment recommendations based on examination findings, the patient’s history, and other factors unique to the patient. This may include the use of a lumbar belt if it may help a patient return to their normal activities.