| One-Minute Clinician

An Effective Alternative: Spinal Bracing

“Spinal bracing” is using braces to help give people stability and pain relief in their spine, particularly in the neck and then the low back. Braces help people move. We want to change people from a focus on pain to a focus on function, and spinal bracing helps us to do that. In the old days, people were concerned about muscle atrophy with bracing, but it’s a myth. A study published in 2016, looking at 35 different reviews, showed no scientific evidence of atrophy or weakness due to bracing. Geriatric patients want to maintain as much independence as possible. Spinal bracing gives people immediate relief and allows them to do some activities of daily living. Many general practitioners are very fearful about the opioid crisis and don’t want to write pain medicines. Spinal bracing will give them another tool that they can use to decrease pain and increase the function. Patients can get immediate relief, and that’s when you know it’s going to work. It’s going to be like the light bulb went off. If it doesn’t do that, then that is not an appropriate patient for a brace. There are different braces. There are special braces for scoliosis, for people who have kyphosis, the hump back, the mid back that’s kind of exaggerated from osteoporosis. They come in various sizes to fit the patient. Sometimes the brace looks a little bulky to a patient, so I tell them to get over how the brace looks and get in to how it feels. Then I let them put it on, and then they’d say, “You’re right. It feels good.” I tell them they need to wear it when they’re doing their activities of daily living. I don’t want them wearing it when they’re sitting around being a couch potato. It’s to enhance movement. If you need it for washing dishes or cleaning your home, working in a yard, going to the grocery store, you can use it then. Studies have shown that people who use the brace in conjunction with physical therapy have had an improved disability index.