Treatments

Back and Neck Braces

What are back and neck braces?

The use of braces is widely accepted. They are effective tools in the treatment of spine disorders. In fact, more than 99% of orthopedic physicians advocate using them. There are more than 30 types of back supports available for spine disorders. This website will discuss several common types and why they are used.

Why are braces used?

Bracing is used for a variety of reasons such as to: control pain, lessen the chance of further injury, allow healing to take place, compensate for muscle weakness, or prevent or correct a deformity. More specifically, lumbar corsets and braces compress the abdomen, which increases the intra-abdominal pressure. This act allows pressure on the vertebral column to unload, providing some relief.

There are other reasons bracing is used. One is the theory that they insulate the skin, producing increased warmth that decreases the sensation of pain – much like a heating pad. Another reason is that the increase in abdominal pressure produces hydraulic support for the back. Finally, certain types of movement may cause stress to the pain generators in the back. The decrease in range of movement by using bracing may relieve this type of pain.

Who is a good candidate for back and neck braces?

If you are diagnosed with a spinal disorder, deformity, or potential problem that can be helped through the use of external structural support, your physician may recommend the use of a back or neck brace. Braces offer a safe, non-invasive way to prevent future problems or to help you heal from a current condition.

Conditions

Braces and supports are most frequently used to treat: low back pain, trauma, infections, muscular weakness, neck conditions, and osteoporosis.

The different types of back and neck braces

Neck Braces

Neck braces are used to provide stability of the cervical spine after neck surgery, a trauma to the neck, or as an alternative to surgery. They are probably the type of spinal brace you most commonly see people wearing. There are several types available, including: soft collar and philadelphia collar.

Soft Collar

This flexible brace is placed around the neck. It is typically used after a more rigid collar has been worn for the major healing. It is used as a transition to wearing no collar.

Philadelphia Collar

This is a more rigid/stiff collar that has a front and back piece that attaches with Velcro on the sides. It is usually worn 24 hours a day until your physician instructs you to remove it. This collar is used for conditions such as: a relatively stable cervical (upper spine) fracture, cervical fusion surgery, or a cervical strain.

Sterno-Occipital Mandibular Immobilization Device (SOMI)

A SOMI is a brace that holds your neck in a straight line that matches up with your spine. It offers rigid support to a damaged neck and prevents the head from moving around. With this brace, you are unable to bend or twist your neck. The restriction of motion helps the muscles and bones to heal from injury or surgery.

Trochanteric Belts

The trochanteric belt is usually prescribed for sacroiliac joint pain or pelvic fractures. The belt fits around the pelvis, between the trochanter (a bony portion below the neck of your thigh bone) and the iliac (pelvis) ridges/crests. It is about five to eight centimeters wide and it buckles in front, just like a regular belt.

Sacroiliac and Lumbosacral Belts

The lumbosacral belt helps to stabilize the lower back. These belts are usually made of heavy cotton reinforced by lightweight stays. The pressure can be adjusted through laces on the side or back of the belt. These belts range in widths between 10 to 15 centimeters, and 20 to 30 centimeters. The sacroiliac belt is used to prevent motion by putting a compressive force on the joints between the hipbone and sacrum (base of the spine).

Corsets

Corsets provide rigidity and support for the back. Corsets can vary in length. A shorter or longer corset will be prescribed, depending upon your condition. A short corset is typically used for low back pain, while a longer one is used for problems in the mid to lower thoracic spine. Corsets lace up from the back, side, or front. There are metal stays that provide the appropriate rigidity and support for the back.

Rigid Braces
These braces are typically prescribed for low back pain and instability. If greater rigidity is needed to support the spine than can be found in standard back supports, rigid frame spinal bracing is often prescribed. These are stiff braces. They usually consist of rear uprights that contour to the lumbar (lower) spine and pelvis, along with thoracic bands. There are also fabric straps on the braces that provide pressure in the front. Common types of rigid models are:

Williams Brace
This type of brace has no vertical uprights in the middle so that flexion/bending is allowed.

Chair-back Brace
This type immobilizes the lumbar spine in the neutral position. The chair-back is designed to reduce sideways and revolving movement of the lower spine.

Raney Flexion Jacket
This type reduces lumbar lordosis by holding the patient in a neutral tilt.

Hyperextension Braces

This brace is designed to prevent excessive bending, and it is often prescribed to treat frontal compression fractures that have occurred around the junction of the thoracic and lumbar spine. The brace can also be used for post surgery healing from a spinal fusion.
These braces offer support that allows anterior (front) pressure unloading of the thoracic vertebrae by restricting flexion (bending) of the thoracic and lumbar spine.

Molded Jackets

These jackets are designed to distribute pressure widely over a large area. By immobilizing the patient from the neck to the hips, pressure is distributed evenly, taking excess pressure off overloaded or unstable areas. These jackets were originally made of plaster of Paris, but now are typically made out of molded plastic.

Lifting Belts

These belts are designed to reduce low back strain and muscle fatigue that can occur when you are lifting heavy objects. The belt circles around the waist, covering the lumbar region of the spine, and closes in front. These belts are usually made of cloth or canvas and do not have stays. Some models also have lordosis pads.

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