FACT: LSO use leads to greater functional outcomes than medication and physical therapy alone.
An LSO is a conservative yet effective treatment option for low back pain and should always be considered as part of a comprehensive approach to low back pain and impaired function. This 2014 Spine study concluded that an LSO led to greater functional outcomes in comparison to standard care, which included only medication and physical therapy. Individuals wearing an Aspen QuikDraw Pro inextensible LSO had 4.7 times higher odds of achieving success [a reduction in ODI of ≥ 50% improvement] than those assigned to standard care alone.
Source: A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain.
MYTH: Back braces cause weakness.
The thought that back braces cause weakness is a misconception. Published in The Spine Journal in 2016, this systematic review found no conclusive evidence to suggest that an LSO causes trunk weakness. Of the 35 studies reviewed, multiple studies demonstrated an increase in muscle strength, others found no change in strength, and only one study suggested reduced strength. An LSO used properly can improve trunk strength by decreasing the pain levels which are impeding normal function. This promotes mobility within a safe range and can result in improved outcome measures for medical pain management and/or physical therapy plans of care.
Source: Can Lumbosacral Orthoses cause trunk muscle weakness? A systemic review of literature.
THE MULTIFIDUS and Back Pain
The stability of the spine depends on the complex interplay of three systems: the spinal column, the spinal muscles, and the neural control unit. Disturbances in the spinal column, the spinal muscles, or the neural control unit leads to spinal segments moving outside of their normal range, causing tissue injury and initiating LBP. The lumbar multifidus muscles provide 70% of the spine’s stability. Unfortunately, they are inhibited immediately by any type of back injury, with significant atrophy seen within 3 days. This compromises support to the spine and contributes to further injury. Spinal bracing protects the spine and improves patient rehabilitation outcomes.
Source: The role of the lumbar multifidus in chronic low back pain: a review.