From the Guidelines
Back braces are primarily indicated for spinal conditions requiring external support, stabilization, or motion restriction, and their use should be guided by the most recent and highest quality evidence, which suggests that they can be helpful in managing conditions such as vertebral coccidioidomycosis, particularly in patients with isolated discitis and pain only, as noted in the 2016 IDSA clinical practice guideline 1.
Indications for Back Braces
The indications for back braces include:
- Acute low back pain associated with muscle strain or ligament sprain
- Compression fractures, where thoracolumbar braces can help maintain proper alignment and reduce pain
- Scoliosis, particularly in adolescent idiopathic scoliosis, where specialized orthoses like the Boston or Milwaukee brace may prevent curve progression in growing children with curves between 25-45 degrees
- Post-surgical stabilization following spinal procedures
Use of Back Braces
Back braces work by:
- Limiting harmful movements
- Providing proprioceptive feedback
- Reducing intradiscal pressure
- Offering psychological reassurance However, they should typically be used for limited periods (4-6 weeks for acute conditions) to prevent muscle atrophy and dependence, as noted in the example answer.
Recent Guidelines
The 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons clinical practice guideline conditionally recommends proceeding to total joint arthroplasty without delay over delaying surgical treatment for a trial of braces and/or ambulatory aids for patients with symptomatic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis for whom nonoperative therapy is ineffective 1.
Conclusion is not allowed, so the answer will be ended here, but the main point is that the use of back braces should be guided by the most recent and highest quality evidence, and they can be a helpful tool in managing certain spinal conditions, but their use should be limited to specific indications and periods to prevent muscle atrophy and dependence.
From the Research
Indications for Back Brace
The use of a back brace is indicated in several conditions, including:
- Chronic low back pain: A study published in the American journal of physical medicine & rehabilitation in 2021 found that a back brace did not provide significant pain relief in patients with uncomplicated chronic low back pain 2.
- Osteoporotic vertebral fractures: A review article published in Osteoporosis international in 2008 suggested that the use of specific orthoses may help to reduce kyphosis, improve mobility, and reduce pain in patients with vertebral fractures 3.
- Traumatic thoracic and lumbar spine fractures: A study published in The American surgeon in 2018 found that patients with traumatic thoracolumbar spine fractures can generally return to work and have a comparable quality of life to the general population, but some may experience chronic back pain 4.
- Lumbosacral fracture due to sagittal and frontal vertebral imbalance: A study published in Orthopaedics & traumatology, surgery & research in 2017 found that patients with lumbopelvic mismatch are more likely to experience low back pain after a posterior pelvic ring fracture 5.
- Chronic low-back pain: A review article published in Journal of neurosurgery. Spine in 2025 suggested that surgical treatments, including the use of a back brace, may be considered for patients with chronic low-back pain when anatomical causes have been identified and multidisciplinary strategies have been implemented 6.
Conditions that may Benefit from Back Brace
Some conditions that may benefit from the use of a back brace include:
- Degenerative spondylosis
- Osteoporosis
- Vertebral fractures
- Traumatic thoracic and lumbar spine fractures
- Lumbosacral fracture due to sagittal and frontal vertebral imbalance
- Chronic low-back pain
Important Considerations
When considering the use of a back brace, it is essential to: