Braces don't make you worse

[ampaphb]

A non-randomized clinical trial on the impact of non-rigid, inelastic corsets on spine function in low back pain participants and asymptomatic controls.
Spine J. 2015 Jun 19. [Epub ahead of print]
Kawchuk GN, Edgecombe T, Wong A, Cojocaru A, Prasad N.

Abstract
BACKGROUND CONTEXT:
While previous studies suggest braces/corsets can reduce acute pain, no prior study has assessed back function following bracing with both self-reported and objective measures. Use of both self-reported and objective measures of spine function together may be important given evidence they assess unique aspects of function.

PURPOSE:
To assess both self-reported and objective measures of spinal function before, and after, use of a non-rigid, inelastic lumbar brace.

STUDY DESIGN / SETTING:
Non-randomized clinical trial PARTICIPANT SAMPLE: Acute low back pain participants and asymptomatic controls.

OUTCOME MEASURES:
Oswestry Disability Index, spinal stiffness and muscle endurance.

METHODS:
Three groups were studied: -LBP/-Brace (n = 19), -LBP/+Brace (n = 18) +LBP/+Brace (n = 17). Both groups of braced participants were instructed to wear the brace continually for 2 weeks with the exception of bedroom & bathroom activities. Before and after the 2 week period, 3 measures of spinal function were performed: spinal stiffness via motorized indentation of the L3 spinous process, a modified Sorensen test (timed lumbar extension against gravity), and the Oswestry Disability Index (ODI). Repeated measures analyses of variance were conducted for all three outcomes. Braces were provided at no cost by Aspen Medical Products as were funds to support data collection (∼ $29,000 CDN).

RESULTS:
Between groups, ODI scores decreased significantly for the +LBP/+Brace group (p < 0.001) compared to the other two groups. The +LBP/+Brace mean ODI score decreased 3.71 points (95%CI 2.01 - 5.40) compared to the -LBP/-Brace group and decreased 3.48 points (95% CI 1.77 - 5.20) compared to the -LBP/+Brace group. Change scores for Sorenson's test were significantly increased in the +LBP/+Brace group (p = 0.037) compared to the -LBP/-Brace group (22.47s 95%CI 8.14-36.80). Spinal stiffness did not change significantly between groups.

CONCLUSIONS:
This study demonstrates that lumbar function assessed by self-reported and objective measures do not worsen when non-rigid, in-elastic bracing is used for short periods of time for those with, or without, back pain. These data add to the existing literature that suggests short-term use of non-rigid, inelastic bracing for acute LBP does not decease spinal function when measured separately with subjective or objective tools.

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[SSdoc33]

nice to see that they used the ultra-specific diagnosis of "low back pain"

 

[geauxg8rs]

Shocking result considering aspen gave the braces

 

[Stim4me]

N=54, tx group N= 17... That's a silly study... Not much to see here, move it along...

 

[emd123]

I agree that this is not a profound study. I also agree that the dogma that a non-rigid brace worn on an as needed basis hurts anyone, is ridiculous. It sounds good in theory, and is precious held dogma by some, but it's downright ridiculous.

What I'd like to see is the piles and piles of case reports of people rushing to emergency departments because they were maimed by a non-rigid back brace. The streams of people in tears over the evil effects of back braces. Hell, if you can even get Binder & Binder and the rest of the lawyers to take up your case that "you've been harmed" by a medical treatment, in this case a brace, then you really have nothing.

Now if you said "non-rigid elastic corset braces" do nothing, I may listen. But cause harm?

Meh....

 

[101N]

The braces being advertised for free in the newspapers and on TV for Medicare patients are being billed to Medicare for $800 to $1,300 ea.

Braces for spondylosis in the elderly are essentially fraud.

 

[lobelsteve]

The braces being advertised for free in the newspapers and on TV for Medicare patients are being billed to Medicare for $800 to $1,300 ea.

Braces for spondylosis in the elderly are essentially fraud.

I throw away 2-3 requests per day for this, knee braces, and 5 different creams all for the same patient.

 

[emd123]

Braces for spondylosis in the elderly are essentially fraud.

A back brace is "fraud," yet, the "holistic" medicine you now tout, isn't. You criticize opioids and injections on the grounds "they can't cure all pain," yet you propose nothing than can "cure all pain."

You'd be more likely to win me over if you said we should just leave chronic pain patients alone and do nothing. But you incessantly criticize every treatment option except equally unproven, if not more flawed approaches such as "holistic" medicine and hopeless and utopian money-pit treatments such as massive cost and resource-intensive psychology programs no patients want part of, and no budget can withstand.

You're throwing around buzzwords and phrases like "fraud," "holistic," "IPM is laughed at," "you can't cure all pain, therefore..." Generally I do respect the viewpoints you post on this forum, but honestly, it's all starting to sound a lot like regurgitated politically-correct group-think.

 

[101N]

Ok

Guess you aren't willing to actually answer his question. Shame you are only capable of being a condescending smarta$$, and not able to engage in a reasonable conversation.

 

[Papa Lou]

101N how on earth do you practice pain management? Who goes to you? WHAT DO YOU DO? I mean in detail not some abstract or smart ass answer. I really want to know what you do with each of your 15-40 patients a day.

Psychological "work" would help most patients I agree. So would the recommendation to "eat a healthier diet, just lower your carbs and fats, and try to eat less animal protein" but REAL people, that vast majority of them, don't just up and follow these recommendations. That style of advice gets no results. You're not going to get a good return on "increase strength and mobility" in most cases. Hence we study alternatives, and an entire field of interventional pain management has bloomed. It may not be perfect, but the results compared to the advice quoted above is good/better in many real world scenarios. And even if we're imperfect, these attempts and these struggles for advancement drive innovation.

Please educate me on what you do day to day. I believe in keeping it basic and simple also. I think it's an important component but I recognize the limitations. I want to know what and how you do things in detail please....

 

[lobelsteve]

Easy on 101. His idea of a brace might be a really long, firm hug.

 

[PainDrain]

If back braces are fraud, what is spinal fusion?

 

[Ducttape]

fraud in a box?