Chiropractors are healthcare professionals who focus on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and manipulation of the spine. As back pain is one of the most common reasons patients see a chiropractor, recommendations on back braces are a frequent topic of discussion.
In general, chiropractors take a nuanced view on back braces. On one hand, they can provide important back support and pain relief for certain back conditions and injuries. On the other hand, chiropractors tend to view back braces as more of a temporary treatment option rather than a permanent solution. The goal of chiropractic care is to address the underlying structural cause of back pain through spinal adjustments and other techniques to allow the back to properly heal over time.
When Chiropractors Recommend Back Braces
There are certain situations where a back brace can be a helpful recommendation from a chiropractor:
– Acute back injuries: For sudden injuries like fractures, herniated discs, or muscle strains, a back brace can immobilize the spine and limit movement while the injury heals. This prevents further damage and provides stabilizing support.
– Post-surgery recovery: After invasive back surgeries like spinal fusion, wearing a back brace helps reduce strain on the operated area during early healing stages. It allows the surgical site to properly fuse and scar.
– Spinal instability: For conditions like degenerative disc disease that cause abnormal spinal movement, a rigid back brace can help restrict and stabilize excessive motion. This provides pain relief.
– Osteoporosis: Compression fractures are common with osteoporosis. Bracing can help prevent exacerbating fragile vertebrae.
– Heavy lifting: Those whose jobs involve repetitive heavy lifting may benefit from industrial back belts to reduce the risk of recurrent injuries.
When Chiropractors Don’t Recommend Back Braces
While chiropractors see the value of back braces in certain situations, they also recognize that long-term use can lead to muscle weakness, loss of flexibility, and dependency:
– Chronic back pain: For nonspecific chronic back pain without an acute injury, braces tend to provide only temporary relief. They do not address the root cause which chiropractic seeks to fix through proper spinal alignment.
– Poor posture: Braces reinforce bad posture habits if worn constantly. Chiropractors instead focus on exercises and stretches to retrain posture.
– Overuse: Prolonged bracing can lead to deconditioning and weakening of the spinal muscles which provide crucial core stability.
– Unnecessary limitation: Rigid bracing limits range of motion which can allow the back to get tight and stiff if worn for too long.
For these reasons, chiropractors view back braces as more of a temporary treatment option rather than a long-term solution for chronic back problems. They prefer to use adjustments, stretching, strengthening exercises, and postural retraining to address underlying structural and biomechanical causes of back pain.
What Type of Back Braces May Be Recommended
If a chiropractor does recommend a back brace for certain conditions, they may suggest one of these common types:
Rigid braces
Rigid braces greatly restrict spinal movement through molded plastic or metal. They provide the most immobilization which helps stabilize injured areas. Rigid braces include:
– TLSO (thoracic-lumbar-sacral orthosis): Extends from below the chest down to the pelvis. Used for spinal fractures.
– LSO (lumbar-sacral orthosis): Covers only the lumbar and sacral regions. Often prescribed post-surgery.
– Corsets: Older style that laces up tightly over the lumbar area. Less commonly used today.
Flexible braces
Flexible braces allow for more movement and are made of stretchable fabrics like elastic or neoprene. They provide moderate support and reminders to maintain good posture. Types include:
– Elastic braces: Made of stretchable athletic-type material. Can be worn under clothes.
– SI belts: Support the sacroiliac joints of the pelvis. Help stabilize hypermobility.
– Maternity belts: Worn during pregnancy to support increased weight on the pelvis and spine.
Postural braces
Postural braces gently lift and realign the back into better posture. They train the back muscles to stay in proper alignment. Examples include:
– Posture pumps: Inflatable over-the-shoulders devices to straighten upper back rounding.
– Posture shirts: Compression garments to pull shoulders back and support the mid and lower spine.
– Clavicle braces: Wrap around the shoulders/chest to retract the shoulders.
How Long Are Back Braces Typically Worn?
Chiropractors recommend limiting the duration of back brace usage to avoid dependency and muscle atrophy. Some general timelines include:
| Condition | Recommended Bracing Duration |
|---|---|
| Acute injury (i.e. fracture) | 6 to 12 weeks |
| Post-surgery | 6 to 12 weeks |
| Severe spinal instability | 3 to 6 months, tapered use |
| Heavy lifting/high-risk job | Only during activity |
| Poor posture | 30 to 60 minutes per day |
The duration should be limited to the acute healing phase. For poor posture, intermittent bracing during exercise is preferred over constant wear. It is important wean off the brace through gradually increasing activity levels and core strength.
Risks and Downsides of Long-Term Back Brace Use
While back braces can provide symptom relief in the short-term, chiropractors caution against permanent use due to these disadvantages:
– Weakened muscles: The spine’s supporting muscles can become deconditioned and lose strength if immobilized long-term in a brace. This causes greater instability.
– Stiffness: Restricted movement from prolonged bracing reduces flexibility in the spine and surrounding muscles. This decreases range of motion.
– Bad posture: Constant external support from a brace can allow the postural muscles to relax rather than hold the spine aligned.
– Skin irritation: Excessive brace wear directly against the skin commonly leads to discomfort, rashes, or sores.
– Dependency: Patients may psychologically become “addicted” to brace support and feel they cannot function without wearing it.
– Avoiding activity: Braces may instill fear of movement and discourage patients from staying active, which prolongs recovery.
– Underlying cause unaddressed: Braces only treat symptoms but do not correct the root structural problem causing pain, such as a spinal misalignment.
How Chiropractors Complement Brace Use
Rather than permanent bracing, chiropractors focus on working hand-in-hand with patients to help wean off back braces through:
– Spinal adjustments: Gentle realignment of the vertebrae improves mobility and reduces pain. This helps patients become less reliant on the brace.
– Physical therapy: Stretches, exercises, and massage increase flexibility, strength, and range of motion to properly stabilize the spine.
– Postural retraining: Cueing proper posture through biofeedback helps retrain the neuromuscular system to support the back.
– Injury rehabilitation: Physically therapy modalities like ultrasound, electric stimulation, and cold laser therapy help accelerate healing.
– Lifestyle advice: Counseling patients on proper ergonomics, sleep positions, and activity pacing allows them to actively self-manage their condition.
The combination of chiropractic care plus temporary bracing when needed offers optimal short-term pain relief while working toward a long-term solution. This allows patients to move safely and confidently without a brace.
Conclusion
Chiropractors recognize that back braces can provide temporary assistance with pain relief and stabilization after an acute injury or surgery. However, their preference is to address the root cause of back pain through hands-on chiropractic techniques, exercise-based rehabilitation, and postural retraining. By working to strengthen the spine’s own stabilizing muscles and realigning improper spinal movement patterns, chiropractors aim to help patients regain function without permanent reliance on rigid bracing. They recommend a cautious approach to back braces by limiting wear to initial healing phases before transitioning focus to active self-care through exercise. With this multi-modal treatment approach, chiropractors give patients the tools to manage back pain safely and effectively while avoiding risks of prolonged bracing like muscle atrophy, joint stiffness, skin problems, and posture dependence.