Do lower-back (lumbar) supports and other devices help people with long-lasting (chronic) low back pain move around more easily?

Key messages

• In adults with long-lasting (chronic) low back pain, lower-back (lumbar) supports used on their own without additional treatment may not reduce pain or disability.

• In adults with chronic low back pain, pain may be slightly reduced when lumbar supports are used with pain medication compared to using the pain medication on its own. We do not know their effect on disability. We do not know if adding education and exercise to lumbar supports is any better than education and exercise on its own, or whether adding physiotherapy to lumbar supports has any benefit over physiotherapy on its own.

• More research is needed, particularly amongst older adults and people living in low-income and middle-income countries.

What is low back pain?

Low back pain is pain in the lower part of the back, which may also spread to one or both legs. When symptoms last longer than 12 weeks, it is considered long‐lasting and is referred to as chronic low back pain, which is a common cause of disability impacting people's quality of life across the world. It is estimated to be the leading cause of the need for rehabilitation, making it expensive in terms of healthcare costs and lost working hours.

What are lumbar supports and other assistive devices?

Lumbar supports include braces, belts, and general supports that help stabilise or support the lower back. Some are made of hard plastic to limit movement. Others are softer, allowing for some movement but still providing support during movement.

Other assistive devices are items that help people with disabilities move around more easily. They include wheelchairs, mobility scooters, tricycles, crutches, walking sticks/canes, and walking frames/walkers.

What did we want to find out?

We wanted to know whether lumbar supports and other assistive devices for adults with chronic low back pain help to reduce pain and disability, and improve health-related quality-of-life. We were also interested in the safety of the treatments, whether people receiving them felt they were helpful, whether they reduced painkiller use and falls, and their effects on anxiety, depression, and taking part in social activities.

What did we do?

We searched for studies where people with chronic low back pain received either a specific back pain treatment or 'usual care' (e.g. painkillers, general physiotherapy, education) or no treatment, and the results of the groups were compared with each other. We combined the results of similar studies and assessed how certain we were about the evidence.

What did we find?

We found eight studies with 501 men and women aged from 25 to 78 years. They had had chronic low back pain for between one and five years. All the studies investigated lumbar supports (for example, braces, corsets). Five of the studies took place in low- and middle-income countries (Bangladesh, Iran, Turkey) and three in high-income countries (Japan, USA).

Main results

• Lumbar supports alone, compared to getting no treatment, may have little to no effect on pain and disability after three months (1 study, 107 participants).

• Lumbar supports plus pain medication may result in a small reduction in pain intensity after three to four weeks compared with pain medication alone, but the evidence is very uncertain for disability (2 studies, 149 participants).

• We are very uncertain about the effect of adding lumbar supports to exercise and education (i.e. teaching about the structure and movement of the lower back, how it functions in daily activities, common conditions that can lead to low back pain, and different treatment options to help manage and relieve symptoms) on pain and disability after six weeks, when compared to exercise and education alone (1 study, 24 or 25 participants).

• We are very uncertain about the effect of combining lumbar supports with general physiotherapy (including ultrasound, low-intensity electrical current, heat, exercises to improve flexibility and increase strength) on pain and disability after four weeks, when compared to general physiotherapy alone (1 study, 41 participants).

What are the limitations of the evidence?

• Overall, we have limited confidence in the results, and our conclusions might change after further studies are done.

• The most important limitation was that study participants and healthcare providers knew what treatment they were getting. Even though this is impossible to prevent in these types of studies, it may have affected how participants felt about their pain or disability and how they rated it.

• None of the studies reported on the unwanted effects of the treatments.

• The characteristics of the study participants were not usually reported in detail. It is difficult to know how the results should be applied to the broader group of patients with chronic low back pain.

• No studies tested mobility devices like walking aids or wheelchairs, even though these treatments are often prescribed and could potentially affect pain and disability. This gap in the evidence is especially significant for older adults and individuals with disabilities.

How up to date is this evidence?

This evidence is current to January 2025.