The Pros and Cons of Over-the-Counter Back Braces

Ouch! As many as 8 out of 10 people in the U.S. will experience back pain at least once in their lives, according to the National Institutes of Health. Back pain can range from acute (sudden pain) to chronic (a dull, constant ache). It is one of the most common complaints at doctor's offices.

While back pain usually resolves on its own, treatment options include oral and topical pain relievers, physical therapy, anti-inflammatory injections, and in some cases, surgery. But for some people, a back brace is their treatment of choice. But a back brace truly help back pain?

"Back braces are typically used following an acute injury or for preventative purposes." However, the efficacy [usefulness] of these devices for either of these intentions is not proven," says Chris Sebelski, PT, DPT, Ph.D., associate professor of physical therapy at Saint Louis University in MO.

It's important to note that back braces used for acute and chronic low back pain are different from those used after back surgery and to prevent the progression of adolescent scoliosis (curvature of the spine). These braces are typically custom-made devices; a surgeon or physical therapist orders the brace, which is made of heat-treated plastic and custom-made to the patient's measurements. "Typically, braces that are prescribed after surgery are intended to limit movements that are contraindicated [not recommended] for a short period of time following the surgical procedure," explains Sebelski.

But the types of back braces that most individuals with lower back pain use are different: They're made of neoprene (synthetic rubber, the kind used in wetsuits), don't require a custom fit, and are usually found at your local pharmacy or sporting goods store. These braces generally fasten with Velcro or clasps, and are worn over the lower back or entire torso. The jury's still out on their effectiveness at relieving back pain, but there have been reported benefits. Here’s what we found.

The Pros of Using a Back Brace

  1. Braces used immediately after surgery can promote spine stabilization during the healing process. "Post surgical braces are made of more durable material [heat-treated plastic] than over-the-counter options, and this material provides a more obvious restriction to certain movements," says Sebelski.
  2. Lumbar support belts (the back braces that you can buy at the pharmacy or sporting goods store) can be helpful after an initial lower back injury. They limit the movement of the spine in the lower back, which relieves excessive demand placed on nearby joints and can allow some back injuries to heal. Lumbar support belts also reduce pressure on the discs between the vertebrae (the bones that make up the backbone).
  3. Some users report that the braces support their abdomen, improve their posture, and take some of the load off of their lower back. In particular, many pregnant women wear so-called "belly bands" made of stretchy material; these support the belly and lower back, and can reduce pregnancy-related back pain.
  4. After a back injury, a brace can help people with labor-intensive jobs avoid too much strain on the spine when they return to work. However, the National Institute of Occupational Safety and Health (NIOSH) cautions that wearing such supports can provide a false sense of security, and encourage workers to lift more weight than they should—putting them at risk of further injury.

The Cons of Using a Back Brace

  1. Long-term use of a back brace may result in the loss of some muscles that support the spine. Since back braces provide the support usually given by muscles and ligaments, muscles can weaken due to lack of use. This puts the spine at risk of injury when the brace isn't being worn.
  2. It may be a waste of money. Despite the claims of back belt manufacturers, NIOSH says there's insufficient evidence to show that back braces can actually prevent workplace injuries.

Finally, "The greatest risk with wearing a back brace is an over-expectation of the results," says Sebelski.

Fortunately, "there are many types of interventions available with high quality evidence to support use for back pain," he continues. For those with low back pain, physical and exercise therapies are effective, according to a Center for Disease Control report on management of chronic pain. "A thorough consideration of all the treatment options available which will not only improve symptoms and provide benefit in the long run is the best treatment for those who have low back pain," Sebelski says.

This article was reviewed by Chris Sebelski, PT, DPT, Ph.D.

Sources

Chris Sebelski, PT, DPT, Ph.D. Email correspondence. March 28, 2016.

"Back Pain." National Institutes of Health U.S. National Library of Medicine. March 23, 2016.

"Help for Back Pain." Arthritis Foundation. Accessed March 27, 2016.

Mayo Clinic Staff. "Diseases and Conditions: Back Pain." Mayo Clinic. June 17, 2015.

Mayo Clinic Staff. "Diseases and Conditions: Back Pain Prevention." Mayo Clinic. June 17, 2015.

"Back Belts: Do They Prevent Injury?" The National Institute for Occupational Safety and Health. Updated June 6, 2014.

Dowell D, Haegerich TM, Chou R. "CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016." Morbidity and Mortality Weekly Report 2016;65:1–49.