Thursday 23 October 2008, 12:00AM
PEARLS 117, October 2008, written by Brian R
McAvoy
Clinical question
How effective are lumbar supports for prevention and treatment of
non-specific low back pain (LBP)?
Bottom line
There is moderate evidence that lumbar supports are no more
effective in preventing LBP than no intervention or training, and
conflicting evidence whether they are effective supplements to
other preventive interventions. It remains unclear whether lumbar
supports as a treatment for LBP are more effective than no or other
interventions.
Caveat
Assessment of clinical relevance found many of the trial
publications provided inadequate information, eg, in the
descrip•tion of the study population and reporting of both pain and
functional status. No trial specifically evaluated lumbar support
for acute LBP. Conclusions from this review should be viewed with
caution due to the low quality of many of the studies.
Context
LBP is a major health problem in western industrialised
countries. Seventy to 85% of the population has LBP at some time in
their life. Most patients recover quickly and without residual
functional loss - 60-70% recover within 6 weeks and 80-90% recover
within 3 months.1 Lumbar supports (braces or corsets) are used in
the treatment of patients with LBP, to prevent the onset of LBP
(primary prevention) or to prevent recurrences of a LBP episode
(secondary prevention).
Cochrane Systematic Review
van Duijvenbode ICD et al. Lumbar supports for prevention and
treatment of low back pain. Cochrane Reviews 2008, Issue 2. Article
No. CD001823. DOI: 10.1002/14651858.CD001823. pub3. This review
contains 7 preventive studies involving 14,437 participants and 8
treatment studies involving 1361 participants.
Further reference
1. Krismer M et al. Best Pract Res Clin Rheumatol
2007;21:79-91.