Lumbar support braces designed to provide relief from chronic low back pain may not be as effective as people have been led to believe, with scientists finding that recommendations are based on low-quality evidence.
A systematic review from the Cochrane Library has found that while these kinds of back braces are inexpensive tools commonly used to support the spine and in turn potentially help alleviate low back pain levels, scientists suggest there's no convincing studies that warrant them to be recommended. That said, there's also not a whole lot of reliable research that finds them useless.
Milan-based researchers analyzed eight randomized controlled trials that together involved more than 500 participants aged between 25 and 78 years. These studies compared back support braces either on their own, with no other interventions, or their use in conjunction with other pain management recommendations such as physical activity and/or medication.
Unfortunately, the results of their review are inconclusive.
Why this matters is that scientific evidence suggests lumbar supports won't make things worse, but may provide false hope given they're a commonly recommended intervention. It's important to note that some people may find these braces helpful.
The researchers found some nuances, however. There was some evidence that supported the idea that lumbar supports can help some people manage pain short-term, and they could also work in conjunction with common over-the-counter pain medications.
However, the scientists warn that their review produced no meaningful evidence of these methods working for enough people for it to be a reliable intervention.
“Lumbar supports are widely used in clinical practice despite the fact we know virtually nothing about their effectiveness,” says Dr Chiara Arienti, lead author from Humanitas University. “Drawing from a very thin research base, we still don’t have enough evidence to make broad recommendations for or against their use.”
The scientists did note that most studies on lumbar supports come from countries where access to healthcare is more difficult. This highlights the disparity in medical interventions that people suffering from chronic low back pain can access. In these populations, lumbar supports may actually be the most affordable and accessible tool for pain management.
"It's striking that most of the research on lumbar supports is coming from areas where active treatments are harder to access," says senior author Professor Stefano Negrini, from University of Milan. “There’s enough data now showing that active treatments have a clinical effect on low back pain, but these treatments can be very expensive because they require rehabilitation professionals' involvement.
“We have to ask ourselves whether we are looking at this problem only through the lens of the Global North, and whether that is the right perspective," he adds. "These devices may play a different and important role in contexts where the alternative simply isn't available."
Not surprisingly, the authors urge researchers to focus their work on populations where access to healthcare and general wealth plays a key role in medical treatment.
In the meantime, if you're using a lumbar support and it's helping, research hasn't found evidence it's harmful to continue doing so. But if it doesn't help relieve any low back pain, the science shows that this is just as likely.
We've covered low back pain extensively, and there are some exciting developments moving through the clinical trial pipeline. But even in the wealthiest countries, we're yet to find a way to effectively treat the condition beyond pain medication and lifestyle changes. Back pain in general is not caused by a single issue, which also makes treatment trickier, but an estimated 85% of US adults will experience some sort of spinal issue in their lifetimes, and chronic low back issues become increasingly common with age.
Source: Cochrane Library
