Basis, indications and risk: Basis, indications and risk

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Neuroreflexotherapy (NRT) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

Corsets and lumbar belts

Objetive

To support the lumbar spine by decreasing the strain on the lumbar muscles.

Theoretical base

One of the functions of back muscles is to contribute to the maintenance of the normal spinal curves and the balance of the body in movement. To achieve this, muscles must contract. A corset allows the muscles to perform this function with less work. This can improve pain caused by muscle overload.

However, in cases of progressive scoliosis in children or adolescents who are still growing, a corset tends to hold the spine as straight as is possible, which may slow the progression of the deviation.

Evidence of efficacy

Some of the existing evidence based recommendations found no studies on the use of corsets or lumbar belts, but experts who participated in preparing the guidelines judged that they were not effective in the treatment of acute lower back pain.

Risks and warnings

The constant or prolonged use of corsets or lumbar belts is associated with muscular atrophy.

Recommendations

The existing evidence based recommendations do not advise the use of lumbar corsets or support belts for acute back pain.

Nevertheless, their use may be considered:

1. For healthy individuals and those patients who have had back pain when performing potentially taxing back efforts, such as weightlifting.
2. For acute patients whose pain and muscular contracture limit their activity significantly, in order to avoid bed rest and to help them return to their normal daily activities as soon as possible.
3. For older patients with acute or exacerbated chronic pain who, through lack of muscular fitness, may delay returning to normal daily activities.
4. For children or adolescents with progressive scoliosis who are still growing and for whom exercise is not sufficient to stop the progression of the curvature.

In adults, in order to minimize the risk of muscle atrophy or loss of muscular tone, corsets or support belts should be used only for a few days, avoiding constant use during this period of time. They should only be worn in instances of major back risk, such as when the patients must remain standing for prolonged periods or when they are subjected to vibrations (for example, in tractors or buses).

In children and adolescents who use a corset due to progressive scoliosis, it is also necessary to avoid the risk of muscular atrophy. Therefore, it is important to remove the corset periodically, in accordance with the physican's prescription for each individual case. Swimming, especially the backstroke or crawl, should be practiced at this time, or the recommended exercise program.