Back Braces - Are they a good idea?

I was doing some study recently and came across some interesting research and information on back braces.  I am often asked whether or not wearing back braces are a good idea, so I thought it would be a great topic to discuss here.  Back braces are often used when people are sore or to help protect their back from injury.  The information that I have learnt is that this may not actually be the case.  Continue reading to see what the research shows.

I was reading a book called low back disorders, written by Stuart McGill (one of the foremost researchers on lower back dysfunction).  In the book there was a section on back braces which discussed research that has been done to determine the effectiveness of wearing such braces.  I was actually surprised by some of the findings and it will definitely change the way I discuss the wearing of back braces with people I see.  Here is a summary of what the research shows:

• There is weak evidence to suggest that those already injured may benefit from belts with a reduced risk of injury recurrence.
• Evidence does not support uninjured workers wearing braces to reduce the risk of injury.  In fact, the risk of injury seems to increase following a trial of brace wearing.
• Those wearing a brace may be exposing themselves to the risk of a more severe injury if they were to become injured.
• You may be at more risk of an injury after wearing a belt for a period of time.
• Wearing back braces can increase blood pressure.  One study concluded that people who may have cardiovascular system compromise are probably at greater risk when undertaking exercise while wearing back supports than when not wearing them.
• Wearing a back brace can give people a false sense of security when lifting.  One study showed that subjects were willing to lift 19% more weight when wearing a brace.

Belt wearing guidelines by Stuart McGill
These are the guidelines that Stuart McGill suggests people follow if they are to wear a back brace.

1. Given the concern of increased blood pressure and heart rate when wearing a belt, everyone should be screened for cardiovascular risk by medical personnel.
2. Given the concern that belt wearing may provide a false sense of security, brace wearers must receive education on lifting mechanics.
3. Before wearing a belt, it is important to look into the ergonomics of how you are working, lifting etc to help find ways of reducing the load on the lower back. For example, if you change your workstation setup and procedures, the need for a belt may not be there.
4. Braces should not be considered for long-term use. You should have a program in place to help wean you off a belt.  These programs should include fitness programs and education on lifting mechanics, combined with work place ergonomic assessment.

What to make of this
For me there are two things to take from this information.

Firstly, prevention is better than cure.  If you can look at ways of preventing back injuries, there will be no need to wear a back brace.  Having a strong lower back and core is a key starting point, followed by making sure you are lifting correctly and your work place is set up properly in order to reduce load on your back and help prevent an injury.

Secondly, wearing a back brace will not stop you from getting injured.  In fact, wearing the brace may actually lead to a worse injury than if you were not wearing one.  This may be due to the fact that people often get a false sense of security from wearing one and will lift things they may not have lifted if they were not wearing the brace.

No matter what you are lifting, you still need to make sure your technique is good, get help if you need it and if you do feel a twinge or an ache stop and get it looked it.  If you do have a problem you want assessed, please contact me so we can arrange a time for an assessment. If you are currently wearing a brace at work for 'protection' or for an injury, hopefully this will give you something to think about. Once again, I am happy to discuss it with you if needed.  As always, if you follow this advice, your body will thank you for it.

References

• Stuart McGill, Low Back Disorders, 3rd edition, 2016