Are there indications (other than scoliosis) for rigid orthopaedic brace treatment in chronic, mechanical low back pain?

OBJECTIVES

Mechanical low back pain (LBP) is a major public health problem. Today's standard care strategy involves a combination of drug-based and non-drug therapies. The use of conservative orthopaedic brace treatment is subject to debate. The lack of data and consensus in the literature on the value of this treatment in chronic LBP prompted to us to seek to estimate the modalities and indications for brace use in France.

MATERIALS AND METHOD

We performed a questionnaire-based survey of physician members of the French Society of Physical Medicine and Rehabilitation (SOFMER).

RESULTS

We received 55 completed questionnaires. Although the indications for this treatment were very heterogeneous (in both clinical and paraclinical terms), the prescribing behaviour was rather uniform. The brace is worn during the day for less than 3 months (with a progressive reduction in use over 1 to 2 months), together with physiotherapy before and after immobilization. The patient keeps the brace at the end of the treatment period. Orthopaedic treatment appears to be prescribed in many chronic LBP situations. Analysis of spinal posture and magnetic resonance imaging results (and Modic changes in particular) influence the therapeutic decisions.

CONCLUSION

Clinical and paraclinical indications of this treatment must be precisely defined and evaluated in prospective, multicenter studies with homogeneous cohorts.