Back bracing may be a cost-effective means of providing immediate relief from low back pain, and can act as an effective bridge to other interventions.
Low back pain (LBP) is a frequent problem in industrialized countries and is the second most common reason for visits to physicians.1,2 Approximately 70% to 85% of adults have suffered or currently suffer from LBP, and its prevalence continues to rise.1 In any given year, 15% to 45% of the population will experience an episode of LBP, with the incidence increasing in older adults up to age 65.1
Although the duration of most LBP episodes is usually brief (1-2 weeks), recurrent symptoms are common.3 Among patients who report recurring problems, symptoms often resolve spontaneously, many times without any intervention. However, many patients suffer from prolonged symptoms that do not resolve quickly. Some authors have reported that between 10% and 33% of patients report persistent pain after 1 year.3 Within this group, recovery is often protracted, and their treatment accounts for a majority of the spending on the problem. This segment of patients makes up a large portion of individuals on work disability.
Lumbar supports have been used in the workplace to treat LBP and to prevent strains. They also are used in primary care to reduce pain and improve mobility.1 Although interventional pain physicians routinely see patients with LBP, lumbar supports are not a common part of most of their treatment plans. This may be due to the widely held notion that a lumbar support might result in atrophy of already weakened core muscles. Research does not definitively support this position.4-6 One study even reported an increase in muscle strength after the brace was worn for 6 weeks.6 The authors acknowledged that the brace itself likely did not affect muscle fiber size, but rather that the patients’ reduced pain allowed greater mobility, thereby encouraging increased strength and flexibility.
Previous studies demonstrate that use of a lumbar support can be a viable and helpful method of improving back pain symptoms. One recent multicenter, randomized controlled trial measured three outcome measures for patients wearing an elastic lumbar support: pain level, function, and medication use. Patients in the treatment group showed improvement in all three areas, and the authors concluded that back bracing is an effective treatment option for LBP.2
Bridge to Pain Relief
Most patients seeking treatment from a pain management specialist have experienced pain for upwards of 1 year. By the time they present to a pain clinic, their pain has generally caused them significant distress, and they are seeking rapid intervention to alleviate their symptoms. However, fully understanding each patient’s unique situation with diagnostic tools such as injections and planning the appropriate course of treatment to produce long-lasting, definitive results can take several weeks. Even after treatment is performed, patients may not benefit for several weeks. For example, a physician may perform one or two medial branch nerve blocks prior to proceeding with radiofrequency (RF) nerve ablation. However, the patient may not experience the full benefit of the RF procedure for up to 4 weeks. Opiates are an option for providing relief during this period, but they come with certain risks, and many patients are already using them with unsatisfactory outcomes or with side effects. For this purpose, we undertook a study to determine if back bracing was a reliable means of providing immediate relief from LBP.
Read the full article in its entirety: http://www.practicalpainmanagement.com/treatments/bracing/prospective-study-lumbar-back-brace-interventional-pain-practice