Lumbar Supports Not Particularly Effective for Low Back Pain

A new systematic review published in the Cochrane Library proved what leading musculoskeletal experts have been saying all along that lumbar or lower back supports — those large belts that people wear around their waists when they lift or carry heavy objects — are not very useful for preventing low back pain,.

Readily available at pharmacies and other retail outlets, many people use lumbar supports to bolster the back muscles. However, the reviewers found that the supports are no more effective than lifting education — or no treatment whatsoever — in preventing related pain or reducing disability in those who suffer from the condition.

“We recommend the general population and workers not wear lumbar supports to prevent low back pain or for the management of low back pain,” said lead author Ingrid van Duijvenbode, a teacher and member of the research group at the Amsterdam School for Health Professionals in the Netherlands.

“Low back pain is very common and a major health problem in industrialized countries,” she said. “Prevention and treatment are important both to [sufferers] and to society, which bears the expense of sick leave due to low back pain treatment.”

She and her colleagues looked at 15 studies — seven prevention and eight treatment studies — that included more than 15,000 people. When measuring pain prevention or reduction in number of sick days used, the researchers found little or no difference between people who used supports and their peers who did not.

“There is moderate evidence that lumbar supports do not prevent low back pain or sick leave more effectively than no intervention or education on lifting techniques in preventing long-term low back pain,” van Duijvenbode said. “There is conflicting evidence on the effectiveness of lumbar supports as treatment compared to no intervention or other interventions.”
In an interview with Health Behavior News Service, Joel Press, M.D., associate professor of physical medicine and rehabilitation at Northwestern University’s Feinberg School of Medicine said, “This continues the line of research that shows lumbar supports make no difference in treating or preventing low back pain.” “Looking at the literature on lumbar supports, it is difficult to make any conclusions because these studies are using supports for many different causes of low back pain. It would be hard to prove any one treatment is effective for every type of back pain, just as it would be difficult to prove that any one heart medication would be good for every type of heart problem.”

Dr. Press said that lumbar supports are useful only as an additional treatment to exercise and other interventions. He said that the bracing makes it more comfortable for some people to move around.

“I usually tell my patients asking about lumbar supports that while there is not a lot of evidence that it is useful overall, there are still individuals who might benefit from their use,” Press said. “But it should be used as an adjunct treatment if it helps to activate patients to increase their activity and exercise.”

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Reference:

1. 1. van Duijvenbode ICD, et al. “Lumbar supports for prevention and treatment of low back pain (Review).” Cochrane Database of Systematic Reviews 2008, Issue 2.