Lumbar Pillows and Supports Do Not Worsen Back Problems
Based on the highest quality evidence, lumbar supports do not make back problems worse and appear safe to use, though their effectiveness for treating or preventing low back pain is limited. 1
Safety Profile
No evidence exists that lumbar supports exacerbate back pain or cause harm. The American College of Physicians guidelines found low-quality evidence showing no reported serious adverse events associated with lumbar support use. 1
Lumbar supports have been studied extensively in both preventive and therapeutic contexts without any documented cases of worsening back problems. 1
The primary concern with lumbar supports is not harm, but rather lack of proven benefit and poor compliance (only 43% of users wear them consistently). 2
Effectiveness Evidence
For Acute/Subacute Low Back Pain
Low-quality evidence shows no difference in pain or function when lumbar supports are added to education programs compared to education alone. 1
There is insufficient evidence to determine if lumbar supports are more effective than other active interventions for acute or subacute pain. 1
For Chronic Low Back Pain
Evidence remains insufficient to support lumbar support use over no treatment. 1
One higher-quality trial found lumbar support superior to superficial massage for functional scores (RDQ) but not for pain relief or disability scores (ODI). 1
No clear differences exist between lumbar supports and other active treatments like spinal manipulation, exercise, or TENS. 1
For Prevention
Moderate evidence indicates lumbar supports are not more effective than no intervention or training for preventing low back pain in workers. 3
For workers with previous low back pain history, lumbar supports may reduce the number of days with pain (52.7 fewer days over 12 months) but do not reduce overall sick leave. 4
Clinical Recommendations
Short-Term Use (1-3 Weeks)
Rigid lumbar supports are recommended for low back pain of relatively short duration (<6 months). 1
This recommendation is based on potential short-term symptomatic relief without risk of harm. 1
Long-Term Use (>6 Months)
Lumbar braces are NOT recommended for chronic low back pain (>6 months) due to lack of evidence for long-term benefit, not because they cause harm. 1
The concern is ineffectiveness rather than worsening of symptoms. 1
Common Misconceptions
The myth that lumbar supports cause muscle wasting or dependency is not supported by evidence. While critics have argued that braces might allow muscles to waste or provide false security, no studies have documented these effects actually occurring or leading to increased injury rates. 1
Lumbar supports do not eliminate spinal motion, which has led some to question their utility, but this mechanical limitation does not translate to harm. 1
Practical Considerations
If a patient finds comfort using a lumbar pillow or chair support, there is no evidence-based reason to discourage its use. 1
The decision to use lumbar supports should be based entirely on patient comfort and preference, not fear of worsening back problems. 5
For workers with previous back injuries, lumbar supports may be considered as part of a return-to-work strategy, though they should not be relied upon as the sole intervention. 4, 2