An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

Abstract

Background: The current literature is not conclusive for spinal orthosis treatment in low back pain. Therefore, two questions have to be answered: Does the current literature support the indication of spinal orthosis treatment in low back pain? Which treatment concept can be derived from the result? Method: The 30 highest-rated literature citations (PubMed: best match, 30 December 2021) dealing with low back pain and spine orthosis were included in the study. Excluded were all articles related to Kinesio Taping, scoliosis, physical exercise, or dealing with side effects and unrelated to treatment effect. Thus, the literature list refers only to “low back pain and spine orthoses”. These articles were analyzed according to the PRISMA criteria and divided according to “specific diagnosis”, when the cause of pain was explained (group A), or when “specific diagnosis is not given” (group B). The articles were also distinguished by the information about the orthosis. Articles with biomechanical information about the function of the orthoses were called “diagnosis-based orthosis” (group C). All other articles were part of the group “unspecific orthotic treatment” (group D). The results were compared to each other in terms of effectiveness. According to anatomical causes, a concept of orthosis selection depending on diagnosis of low back pain for clinical practice was developed. The risk of bias lies in the choice of the MESH terms. The synthesis of the results was a clinical treatment concept based on findings from the current literature. Results: The literature citations with 1749 patients and 2160 citations of literature were processed; 21 prospective clinical or biomechanical studies and 9 review articles were included. The combination of literature citations according to “specific diagnosis” (group A) and “diagnosis based orthosis” (group C) was very likely to lead to a therapeutic effect (seven articles). No positive effect could be found in four articles, all dealing with postoperative treatment. When “specific diagnosis is not given” (group B) and combined with “unspecific orthotic treatment” (group D), therapy remained without measurable effect (15 articles). An effect was described in four articles (three biomechanical studies and one postoperative study). In review articles, according to specific diagnosis, only one article dealt with fractures and another with stenosis. In all review articles where specific diagnosis was not given, no effect with spine orthoses could be found. Using this knowledge, we created a clinical treatment concept. The structure was based on diagnosis and standardized orthoses. According to pain location and pathology (muscle, intervertebral disc, bone, statics, postoperative) the orthoses were classified to anatomical extent and the mechanical limitation (bandage, bodice, corset, orthosis with shoulder straps and erecting orthosis). Conclusion: The effectiveness of spinal orthoses could not be deduced from the current literature. The most serious limitation was the inconsistency of the complaint and the imprecise designation of the orthoses. Interpretation: Articles with a precise allocation of the complaint and a description of the orthosis showed a positive effect. The treatment concept presented here is intended to provide a basis for answering the question concerning the effectiveness of spinal orthoses as an accompanying treatment option in low back pain.

Pengaruh Penggunaan Elastic Lumbar Corset Terhadap Nyeri Punggung Bawah Pada Penjahit Rumahan

“…Banyak faktor yang dapat menyebabkan LBP seperti usia, jenis kelamin, lama bekerja, dan posisi kerja (Nurzannah et al, 2015). Beberapa penanganan dapat dilakukan untuk mengurangi low back pain seperti menggunakan tapping kinestologi ataupun treatment dengan manual therapy (Abbasi et al, 2020;Schmidt et al, 2021) Alat bantu yang digunakan untuk penanganan nyeri pinggang yakni orthosis, dapat berupa lumbosakral orthosis, spinal orthosis atau yang hanya mencakup bagian lumbar saja (Azadinia et al, 2019;Landauer & Trieb, 2022).…”

Effect of external lumbar supports on joint position sense, postural control, and postural adjustment: a systematic review

“…These inconsistent findings justify the need for a systematic review to synthesize the current evidence and to explain the variation between studies. Some previous reviews examined the efficacy of external lumbar supports [18][19][20][21]; however, none of them have specifically focused on sensorimotor function. The core outcome measures in these reviews were pain and disability.…”