Many people with chronic lower back pain use wide belts called lumbar supports when performing heavy lifting or other tasks that stress the back. Some workers also use the supports in the hopes of preventing on-the-job injuries.

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But in the new review, Dutch researchers found that across 15 clinical trials involving more than 15 000 people, there was no clear evidence that lumbar supports were effective.

Proper lifting technique just as good
When it came to preventing low back pain or reducing days off work, lumbar supports appeared no more effective than education on proper lifting technique, the review found. In fact, studies reached conflicting conclusions about whether lumbar supports were any better than doing nothing at all.

"We recommend the general population and workers not wear lumbar supports to prevent low back pain or for the management of low back pain," lead researcher Ingrid van Duijvenbode said in a statement.

"There is moderate evidence that lumbar supports do not prevent low back pain or sick leave more effectively than no intervention or education on lifting techniques," explained van Duijvenbode, an instructor in exercise therapy at the Amsterdam School for Health Professionals in the Netherlands.

She and her colleagues report the findings in the Cochrane Library, a publication of the Cochrane Collaboration, an international organisation that evaluates medical research.

More studies needed
It's hard to draw conclusions about the effectiveness of lumbar supports for back pain in general because the problem has so many different causes. The studies in the current review included adults aged 18 to 65 with "non-specific" lower back pain - not pain caused by conditions such as arthritis or osteoporosis.

And it is not clear whether using lumbar supports in addition to other therapies, such as muscle strengthening, might be more effective for treating existing back pain, van Duijvenbode and her colleagues note. Only one "low-quality" study in their review looked at this question, and found no benefit from adding supports to muscle training.

Future studies, the researchers suggest, should look at whether lumbar supports have different effects in people with new back pain and those with long-standing pain. - (Reuters Health)

SOURCE: Cochrane Library, online April 16, 2008.

Read more:
Managing back pain
Backache Centre

April 2008
 

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