September 8, 2026

@michaelokun

Could lumbar belts deserve a second look for low back pain? A lumbar belt is a soft support worn around the lower back that may improve postural control, proprioceptive feedback and reduce mechanical load. Laurent Grange and colleagues describe in a new randomized clinical trial in JAMA Network Open whether adding a nonrigid lumbar belt to usual care can improve nonspecific low back pain. The study included 168 adults whose back pain had lasted 1 to 6 months, so this is really a study of subacute, recently chronic and recurrent pain rather than longstanding chronic back pain. Key points: - After 12 weeks, disability improved more in the lumbar belt group, and pain at rest and during activity also improved more than w/ usual care alone. - 60.5% of folks using the belt achieved at least a 30% improvement in disability compared w/ 40.5% receiving usual care alone. - Folks using the belt were less likely to use pain medications, particularly NSAIDs, and there were no serious device-related adverse events. My take: For years many health care providers, including many of us in neurology, have discouraged lumbar belts because of concerns about dependence, deconditioning and weakening muscles. Interestingly, those concerns have not been consistently supported, and this randomized trial should make us more open-minded. I would be more enthusiastic about time-limited use during an acute-to-subacute flare than indefinite use for chronic low back pain, and importantly this study did not actually test very acute pain lasting only days or weeks. In Parkinson’s disease and other chronic neurological diseases, however, pain can shut down walking, exercise and independence. Could a belt used strategically during painful activities help some folks keep moving rather than retreating to the chair? That is a question worth asking. Here are 3 points that resonated w/ me: 1- Lumbar belts should perhaps not be dismissed simply because we were historically taught to avoid them. 2- The goal should be supporting movement, not replacing muscles or exercise. 3- Short-term targeted use may make more sense than wearing a belt indefinitely for chronic pain.