Do back braces for lower back pain work?

Or do they actually make the problem worse?

By Coach E

back braces for lower back pain

Back braces are marketed to both gym junkies and sedentary sufferers of lower back pain as the best tool for spinal stabilization and getting out of pain. But, do back braces really work to cure, or even prevent spinal issues? Or do they actually make the problem worse?

The truth is, an over reliance on back braces for lower back pain can lead to decreased core activation and atrophy of the stabilizer muscles supporting your spine.

Think back to that time you had to wear a plaster cast because you’d broken your arm or your leg. The cast did well to protect your limb from further injury, but I bet your arm/leg ended up looking like a pool cue by the time the cast was removed.

Now, if you’re an elite competitive powerlifter, or any other kind of strength athlete regularly lifting 500lbs plus from the floor, then you know the answer to whether you should be wearing a back brace better than I do.

But, if you’re not lifting planets on a regular basis, and are training for more dynamic sports performance or just want to improve your general health and fitness, this article applies to you.

The Truth About Back Braces for Lower Back Pain

back braces for lower back pain

The truth is, when I first started lifting weights at 16, I wore a lifting belt. Little did I know it didn’t really do anything to improve the only three exercises I did back then, which were bench press, skull crushers and biceps curls.

Well, maybe wearing lifting a belt helped with my bicep curls a little bit.

I didn’t really know any better and I mainly wore the belt because, well, that’s what I thought you did when you lifted weights.

The bottom line is, back braces do serve a purpose in some situations, but they must only be used when absolutely necessary and should never be relied upon if you really don’t need them. Make sure you try these simple steps for minimizing pain and speeding recovery first, before spending your hard earned cash on expensive back braces.

Back braces CAN reduce pain by providing stability to an unstable lumbar area, and should only be used if there’s a risk of further injury from not using it, i.e. you’ve injured your back on the job and you’ve got to continue lifting things in order to earn a living. In this case, it would be a good idea to start using a back brace at work.

However, back braces are a Band-Aid solution and they don’t fix the actual problem causing the pain in the first place, which could be:

  1. Weak or poorly functioning core muscles
  2. Movement pattern dysfunctions i.e. a poor hip hinge
  3. Mobility restrictions (limited range in squat and hip hinge patterns)

Band-Aid solutions only mask the symptoms of dysfunction to a point before these symptoms start to intensify.

Over time, the unnecessary use of a back brace can weaken your core muscles, thus increasing the risk of injury and creating a vicious cycle where you may never be able to move without it.

The best alternative to wearing a back brace is to improve your movement and mobility and properly develop your core muscles to provide stability, creating your own ‘human back brace’.

The Anatomy of the Human ‘Back Brace’ AKA Your Core

To understand the root of poor core stability and how to fix it, you need to understand the different muscles in your core and how they work to create your very own natural back brace.

These important core muscles include:

  • The Multifidus
  • The Transverse Abdominis
  • The Internal and External Obliques
  • The Rectus Abdominis
  • The Latissimus Dorsi (The Lats)

The multifidus muscles are attached to the spinal column and relieve the pressure on the discs, spreading the weight of the body evenly along the v
ertebrae. These multifidus exercises will train these muscles to build and maintain strength in your spine to prevent lower back pain.

The multifidus can be broken down into two groups:

  1. The deep – responsible for stabilizing the spine.
  2. The superficial – responsible for straightening the spine.Multifidus - back braces for lower back pain

The multifidus is  extremely important for protecting the spinal column during everyday activity and are the first to be activated in many common movements. This is why dysfunction in this series of muscles is strongly correlated with lower back pain. [1]

The transverse abdominis is the flat layer of muscle deep within the core located under the internal obliques. This layer of deep muscle tissue plays a role in compressing the ribs and visceral organs, preventing the abdomen from ballooning outward and spilling your guts all over the floor.Back Braces for lower back pain - transverse abdominis

Studies have found that people suffering from chronic lower back pain have significantly thinner transverse abdominis tissue compared to non-sufferers. [2]

This correlation signifies how important a strong and healthy core is in the prevention of lower back pain and injury.

The internal obliques are located between the layers of the transverse abdominis and the external oblique muscles. The internal obliques play a role in supporting the abdomen and assist in functions such as breathing, side bending, rotational movements and compressing and bracing the core.

The external obliques are larger core muscles located on top of the internal obliques and run vertically from the lower half of the rib cage down to the pelvis. The external obliques play a role in rotation and aid in pulling the ribcage down and in posterior tilt, helping to compress and brace the core.

The rectus abdominis is better known by its street name – ‘abs’ or ‘six-pack’. This core muscle connects and runs from the sternum down to the pubic bone and is responsible for holding in the abdomen, pulling the ribs and the pelvis together in exercises like the sit up and also for sports specific movements like jumping or crunching when absorbing body shots in boxing.

The latissimus dorsi (or the lats) are not as well known for their role in core stabilization and preventing lower back pain, however, they are a huge contributor due to their connection to the lumbar spine via the thoracolumbar fascia. More on how to properly stretch your lats to improve mobility and posture in this article.

When the lats contract, they stabilize the posterior aspect of the core via the thoracolumbar fascia, doing the same job as a a typical lifting belt.

To sum up the muscles that make up your natural back brace:

Muscle Name Role
Multifidus Deep/Segmental Stabilization
Transverse Abdominis Compress Ribs and Abdomen
Internal and External Obliques Compress Abdomen and Rotational Stability
Rectus Abdominis Anterior Stabilization
Latissumus Dorsi Posterior Stabilization
 
To really protect your spine and eliminate the need for a back brace, you need to perform exercises that strengthen these muscles for these functions.

Reduce the Symptoms and Risks of Lower Back Pain Using the Damage Control Routine

Below you’ll find my popular Low Back Pain Damage Control Routine to help you in situations where you’ve tweaked your back moving the wrong way or bending over to pick up something light (we’ve all been there).

Outside of a serious muscle strain, tightness in your low back is related to an issue with your joint, ligament or disc. When your brain detects this issue, it goes into lockdown mode and tightens the muscles of the core in order to protect the spine.

If you feel that tweak or an uncomfortable sensation in your back, DO NOT try to stretch it out, this will only make it worse. Instead, the next time you feel a tweak simply run through the Damage Control Routine:

Sequence of Exercises and Technical Cues for the Damage Control Routine:

Press Ups: 10 Reps  (Do NOT perform this first exercise if your back pain is a result of some type of extension injury or you’ve been diagnosed with spondylolisthesis or stenosis)

Sequence from the Damage Control Routine - Press Ups - Back Braces for Lower Back Pain

  1. Lay face down on the floor resting with your forearms roughly under your collar bone
  2. Relax in this position for a minute or so and focus on your breathing
  3. Place your hands on the floor just outside of your shoulders
  4. Gently work on thoracic extension by pushing your hands into the ground to raise your shoulders – make sure you relax your back in this movement and let your arms do all the work
  5. Gently increase the range of motion as you go, exhaling with each extension

Hip Extensions: 5 Reps x 5 Second Holds

Sequence from the Damage Control Routine - Hip Extensions - Back Braces for Lower Back Pain

  1. Lay on your back with your feet flat on the floor, hip-width apart, and your legs bent at a 45-degree angle
  2. Alternate between squeezing and relaxing your butt to begin activating the glutes, and make sure you’re maintaining the natural curve to your lumbar spine. Do this couple of times until you feel comfortable
  3. Squeeze your glutes now and gently elevate your hips to the sky by driving your heels into the ground
  4. Try to keep your lumbar extensors as relaxed as possible
  5. Elevate your hips so that there is a straight line from the top of your chest all the way to the top of the knees and hold for five seconds
  6. Keep the glutes tight and make sure you’re breathing comfortably throughout the exercise

4-Point Opposites: 3 Reps Each Side x 10 Second Holds

Sequence from the Damage Control Routine - 4-Point Opposites - Back Braces for Lower Back Pain

  1. Taka a quadruped stance on the ground with your hands shoulder-width apart and your knees and feet at hip width
  2. Retract the shoulder blades back and down
  3. Rotate the elbows inwards to create stabilizing tension in the lats
  4. Maintain a neutral spine while keeping your chin tucked
  5. Slowly lift one leg and stretch it behind you making sure not to rotate at the hips
  6. Now, slowly raise your opposite arm, thumb up, at a 45-degree angle from your head and hold for 10 seconds
  7. Breathe naturally, making sure there is no rotation left or right of the hips, shoulders or the core
  8. Slowly return your hand and knee to floor

Side Bridge: 2 or 3 Reps Each Side x 10 Second Holds

Sequence from the Damage Control Routine - Side Bridges - Back Braces for Lower Back Pain

Level 1 – Beginner

  1. Start out laying on your side, stacking your knees on top of each other and your legs bent at a 90-degree angle
  2. Post your weight on your elbow so that your ribs are off the ground and your weight is supported by your elbow, hips, and legs
  3. Bridge up by lifting your hips off the ground and hold for 10 seconds supporting your weight now on your knees and your elbow
  4. Breathe naturally, shoulder blades back, chest tall with no rotation at the hips, shoulders or core

Sequence from the Damage Control Routine - Side Bridges - Back Braces for Lower Back Pain

Level 2 – Intermediate/Advanced

  1. Start out laying on your side with your legs extended so that your body is in a nice straight line
  2. Post your weight on your elbow so that your ribs are off the ground and your weight is supported by your elbow, hips, and legs
  3. Bridge up by lifting your hips, thighs, and knees off the ground and hold for 10 seconds supporting your weight now on the sides of your feet and your elbow
  4. Breathe naturally, shoulder blades back, chest tall with no rotation at the hips, shoulders or core

This routine has helped many people and hopefully, it can help you, too. But, if your lower back pain starts to get worse at any time during the routine, you need to stop it immediately.

If your pain doesn’t get worse, then using this routine will really help speed up your recovery and reduce the time you spend in pain and out of action.

To sum up, strengthening your core should be your first priority, and not ‘quick fix’ solutions that eventually weaken the muscles and cause you more pain in the long run. Back braces are NOT recommended for improving core stability, or posture, and are only to be used if absolutely necessary.

About the Author

Eric Wong (aka Coach E) is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.