Lower Back Pain: Can Devices Help?

You may have seen an aisle at your neighborhood drug store labeled “waist belts” or “back supports.” There are dozens of options for back braces – also called support belts, waist belts, back supports, lumbar supports, and support braces – available over-the-counter or online. And, if none of the over-the-counter options work for you, an orthotist can tailor a prescription brace for your back.‍

Who Do Back Braces Help?

Back braces are likely helpful for reducing curvature due to scoliosis, but it’s not clear whether they’re particularly useful for non-specific low back pain (1). However, some people experiencing low back pain have reported pain relief the use of a back support, so it may be worth speaking to your doctor about back braces (2).

Specifically, back braces may benefit patients with:

• Spinal stenosis 
• Spinal osteoarthritis 
• Scoliosis 
• Herniated disc 
• Fractured vertebrae 
• Isthmic spondylolisthesis

How Do Back Braces Work?

Back braces come in rigid, semi-rigid, and flexible consistencies. Typically, rigid and semi-rigid braces are prescribed by a doctor. Rigid braces are typically prescribed for problems with stability or lower back pain (3). Semi-rigid back braces may be recommended as a post-operative support after spinal fusion (4).

Flexible back braces are available over-the-counter and online. Their pliability allows for greater range of motion than rigid and semi-rigid back braces. Flexible back braces tend to have a few various components:

• Adjustment tabs: Typically, adjustment tabs (or pull-tabs) are Velcro tabs that help brace wearers fit braces to their torsos in order to attain the optimal level of comfort and support.
• Adjustment cords: Also called cables, these cords are similar to adjustment tabs. Tweaking them will increase the quality of fit, support, and comfort.  
• Wings: These side panels wrap around the torso to provide back support.
• Panels: Often detachable, these panels can be used in the front, back, or both, according to the wearer’s support and comfort needs.

Take your time in adjusting these components of your back brace in order to achieve maximal support and pain management. You may want to schedule a visit with a healthcare provider to determine the proper back brace adjustments.‍

What Are the Risks and Side Effects of Back Braces?

Overuse of back braces can lead to muscle weakness. Talk to a healthcare provider about how and when to wear your back brace. You may also want to discuss the activities you should or shouldn’t perform during or immediately after your use of a brace.

TENS (Transcutaneous Electrical Nerve Stimulator) machines, also known as TENS units, send low-level electrical impulses to the painful area. “These currents stimulate your peripheral nerves to induce pain relief” (5). Some studies show that TENS units offer significant benefits in cases of lower back pain, while others do not. They may be beneficial in cases of fibromyalgia and neuropathic pain, which is pain arising from a nerve-related origin (6).

The University of Iowa states that TENS units may be helpful for:

• Arthritis or other joint pain 
• Back and neck pain 
• Fibromyalgia 
• Muscle pain 
• Neuropathic pain‍

How Do I Use a TENS Machine?

If you decide to try a TENS unit, you can purchase a machine at a pharmacy or online. Clean and dry the skin around the painful area and refrain from using any lotion or moisturizer on that part of your skin. Check the instruction manual for advice on where to place the patches. In the case of low back pain, you’ll likely place the patches near your tailbone.

Place the patches on your clean, dry skin – ensure that they do not have contact with clothing or jewelry – while the unit is off. Turn it on and increase the intensity to the point of noticeable strength but not of pain. As your body adapts to the intensity, increase the intensity for optimal effects.

Turn off the TENS unit before removing the lead wires and then the patches. Store everything in a dry, sanitary place (7).‍

Do TENS Machines Work?

TENS units may be a useful form of non-drug pain control. For example, the Emory Pain Center offers TENS Unit therapy alongside other alternative pain control options such as massage therapy, acupuncture, spinal cord stimulation, and behavioral therapy (8).

Further work is needed to determine the nuances of how TENS machines provide pain relief. A University of Florida study found that TENS dosage needs to be modulated according to age and that it may need to be administered at higher amplitudes than it had been for previous scientific studies. The UF study used individualized doses that participants suffering from low back pain “found to be strong, but tolerable, and not painful.” Participants reported that, while wearing the TENS devices equipped with the proper dosages, they experienced 48% improvement in resting pain and 34% improvement in pain during movement across all age groups.

Available online at Amazon and in-store at large retailers like Walmart and Target, foam rollers enable self-administered myofascial release. This can improve range of motion in people suffering from lower back pain, which researchers hypothesize results from the lengthening of fascicles (muscle fibers) induced by the release (9). More work is needed to assess the effect of foam rollers on pain relief.

If you’d like to try a foam roller for lower back discomfort, Harvard Health recommends you try one of the following two exercises:

• Lie on the floor with your knees bent and the foam roller under your lower back. You may want to support your neck with a rolled-up towel or pillow. Gently slide your torso so the roller moves up and down your back.
• Wedge the roller between your back and a wall then move up-and-down as though you’re performing wall squats (10).

With both of these exercises, make sure you stop if you experience an increase in pain. You may feel soreness or stretching in your affected muscles, but acute pain that makes you feel like you’re pushing yourself too much is a sign that you should stop, rest, and consider speaking to a healthcare provider.

One approach to relieving back pain is to counterbalance effect of gravity on your spine. This form of therapy is known as inversion therapy. Inversion tables, which can be ordered online and purchased at some sporting goods stores, stretch the spine by enabling the user to hang upside down.

Inversion tables can potentially help with cases of non-specific back pain, but they’re primarily useful for treating back pain due to spinal disc-related issue. They tend to be more helpful when combined with other therapies. For example, patients with sciatica resulting from disc herniation may find pain relief by combining ice and heat therapy with inversion therapy (11). Similarly, inversion table therapy has been shown to reduce radiating pain from degenerative disc disease in patients who combine inversion therapy with physical therapy (12).‍

What Are the Components of Inversion Tables?

Many inversion tables come with various settings so that you can find the best angle and balance point for relieving your pain. They’re generally equipped with ankle locks, a headrest, and a padded backrest. Some inversion tables feature tracking handles that help you push downward while using the table in order to enhance the traction you’re experiencing.

Some inversion tables use technology to other forms of therapy. For example, they may feature a heat and massage pad that can vibrate and provide heat therapy during treatment. Possible upgrades include tethers for amplifying the degree of inversion, additional handles for people with limited mobility, and storage caddies.‍

Risks and Side Effects

Hanging upside-down will cause your heartbeat to slow down and blood pressure to increase after just a few minutes. The pressure in your eyeballs will increase, which can lead to headaches and vision issues. If you suffer from high blood pressure, heart disease, or glaucoma, you should not use an inversion table (13, 14).

Did you know that ultrasound isn’t just a diagnostic tool, but a therapeutic one as well? Some healthcare providers use the technology to manage pain and to treat soft-tissue inflammation and muscle spasms. The sound waves produced by ultrasound machines can increase blood flow and promote healing for people with chronic pain (15, 16). Continuous ultrasound cycle should heat soft-tissue, which some physical therapists believe reduces pain. Pulsed ultrasound waves may also relieve pain, as well as stiffness (17).

If your healthcare provider prescribes an ultrasound machine as a form of back pain treatment, ask them to walk you through how to use it. They can show you what to do using a machine in their office, or they can recommend that you schedule an appointment so that you can come in once you get your own machine. If you’re feeling nervous about how to use an ultrasound machine on your own, don’t hesitate to ask a healthcare provider for guidance. Your ability to relax and release stress as you conduct ultrasound therapy may impact the quality of your experience, as well as reduce the likelihood of errors.

In general, the literature suggests that ultrasound machines are not very useful on their own. This is the case when it comes to chronic back pain (18). However, ultrasound machines can amplify pain relief when used as a complement to other treatments like physical therapy (19). Ultrasound machines can be purchased online with a prescription.

Risks and Side Effects

Some patients have experienced burns or skin irritations, though this risk is quite low when ultrasound is used properly. Ultrasound therapy can cause internal bleeding, however, so talk to a trusted healthcare provider about the potential effects of ultrasound therapy (20).

Device-related treatments are generally safe, but their effects are limited when used on their own to treat low back pain. They shouldn’t form the cornerstone of a treatment program. Instead, they should supplement other treatments such as physical therapy and medication.

Device-based treatment shows particular promise as a supplementary approach in cases of chronic pain from fibromyalgia and disc-related back pain. Talk to a healthcare provider about the potential benefits of device-related treatment options for your specific situation.