How Back Braces Help Spinal Stenosis
Back braces in the Middle Ages involved rudimentary metal and leather contraptions but, thankfully, modern lumbar back supports are fashioned using lightweight thermoplastics that can be comfortable, inconspicuous, and breathable. The main idea behind a back brace for spinal stenosis is to limit motion and take pressure off the spinal discs, vertebrae, and ligaments in the spine to allow them time to heal without further trauma. A corset for back pain is effective due to compression of the abdomen and transfer of weight-bearing from the back to the core muscles. Stabilizing the spine in this way can help apply a three-point system to correct abnormal posture and degenerative spine disease. Where a pronounced deformity of the spine already exists it is unlikely that a back brace will be able to correct it alone.
What is a Back Brace?
Spinal stenosis treatment using back braces involves a little complex terminology which can make it confusing when buying back pain relief products. Firstly, the area of the spine being managed by the back brace forms part of the devices’ name. Starting at the very bottom of the spine back braces (or orthoses) are referred to by the following terms: Sacroiliac (SIO), lumbosacral (LSO), thoracolumbosacral (TLSO), cervicothoracolumbosacral (CTLSO), cervical (CO), and cervicothoracic (CTO). Back pain orthotic devices are then classified in regards to the type of control they exert on movement, including spinal flexion, rotation, extension, and sideways movement (lateral bending), The degree of control puts orthoses into either flexible, rigid, or semi-rigid categories. Hopefully, this brief guidance on back braces means that you’re better able to make a choice when faced with a semi-rigid, flexion-limiting, TLSO or a rigid, extension-limiting CTLSO.
Do I Need a Rigid Back Brace for Spinal Stenosis?
Patients with severe back pain and spinal stenosis are most likely to have a rigid orthosis that is custom made to support the back and control movement as needed. Velcro straps are commonly used on these body jackets or TLSOs with a two piece front and back design often used after back surgery to make it easier to get on and off and a single piece design more common for other patients not undergoing surgery, such as those suffering from scoliosis that may be corrected non-surgically.
How Back Braces Work
Flexible back braces can help provide relief from back pain from lumbar spinal stenosis and degenerative disc disease. They are also helpful in cases of trauma to the spine or where postural deformities have developed. The application of pressure to the abdomen takes weight off the spine’s discs, vertebrae, and ligaments and these back corsets can often be made more or less rigid through the use of inserts (stays). Some people use these types of back braces for spinal stenosis as a prompt to control posture or as a way of restricting motion.
Choosing Your Back Brace for Spinal Stenosis
Buying a back brace for spinal stenosis usually involves a discussion with a spine care expert who can tailor a pre-fabricated device to meet the patient’s needs. An orthotist or prosthetist is the type of specialist able to provide such guidance and these healthcare experts should be ABC certified and use a CO (certified orthotist) or CPO (certified prosthetist/orthotist) to display their expertise.
Evidence Supporting Back Braces
Back braces can be very effective in managing symptomatic degenerative lumbar spinal stenosis, with studies by Prateepavanich (et al, 2001), and reviews by Katz and Harris (2008), amongst others, highlighting their use. A lumbosacral corset for neurogenic claudication from spinal stenosis led to significant improvements in back pain and ability to carry out daily activities in the study carried out by Prateepavanich, et al. This study was not long-term, unfortunately, but the participants were certainly much better able to cope with their degenerative lumbar spinal stenosis symptoms when using the back brace.
Lumbar Spinal Stenosis Relief
Back braces mimic the effects of having stronger abdominal muscles and create a slight lumbar flexion. This subtle change in posture, and postural support, can open up the spaces in the spinal canal and reduce nerve compression and lumbar spinal stenosis pain. Patients with degenerative lumbar spinal stenosis may wish to use the theory behind the effectiveness of back braces to inform their physical therapy. This means that strengthening the abdominal muscles could help prevent excessive lumbar extension and, thereby, reduce symptoms of low back pain from lumbar spinal stenosis.
Back Brace Risks
Katz and Harris note that the use of back braces for spinal stenosis can be helpful but that they should only be worn for a limited number of hours each day so as to prevent the paraspinal muscles from atrophying. Using any back pain relief products for too long and without having talked to your physician is generally inadvisable as it may be that you become reliant on aback brace for lumbar spinal stenosis symptom relief and that overuse actually exacerbates your condition long-term.
Prateepavanich P, Thanapipatsiri S, Santisatisakul P, Somshevita P, Charoensak T., The effectiveness of lumbosacral corset in symptomatic degenerative lumbar spinal stenosis. J Med Assoc Thai. 2001 Apr;84(4):572-6.
Katz, J.N., Harris, M.B., CLINICAL PRACTICE: Lumbar Spinal Stenosis, N Engl J Med 2008; 358:818-825, February 21, 2008.