Low back pain relief, from DonJoy®

As one of the most common health problems, low back pain is a significant problem not just for individuals, but also their families and communities.1 The condition is defined as “activity-limiting low back pain (+/- pain referred into 1 or both lower limbs) that lasts for at least 1 day”.1

As the population ages, the number of people around the world suffering from low back pain is only going to increase.1 Thankfully, back supports such as Lumbostrap 35 and Dorsostrap 55 from DonJoy® can help relieve low back pain.

What are the causes of lower back pain?

There are many potential causes of low back pain:

  • Muscle or ligament strain from over-stretching (pulling), heavy lifting, twisting the spine while lifting, vigorous exercise at the gym, or a sudden awkward movement
  • Sciatica happens when a weakened and bulging disc is pressed against the sciatic nerve. This can cause intense pain which goes down one leg. This cause can be confirmed through imaging techniques
  • Spinal stenosis happens when the space around the spinal cord narrows and puts pressure on the spinal nerves
  • Prolonged periods of time incorrectly sitting at your desk (poor posture) can also cause lower back pain
  • A herniated disc occurs when an intervertebral disc slides out of position, and spondylolisthesis is when a vertebra slides out of position

Bracing for low back pain relief

A conservative treatment option for low back pain is to wear a back brace. As well as improving postural control,2 the support these devices provide can help to alleviate symptoms associated with low back pain through mechanisms such as activation of the trunk muscles and stabilizing the spine.3,4 They can also help to reduce the use of medication for the condition.5

In patients with low-back pain, walking with abdominal bracing activates the trunk muscles more than walking without an abdominal brace, particularly at slower speeds.3 This means patients incapable of walking faster might possibly benefit from abdominal bracing during walking exercise.3

Patients suffering from low back pain may find that the process of sitting down or standing up can be painful. A study by Im et al. (2021) found that wearing an extensible or a non-extensible lumbar brace has beneficial effects on the biomechanical factors of the sit-to-stand movement in office workers with low back pain.6 It also resulted in immediate reduction of pain intensity and pain-related anxiety.6

Do lumbar braces cause muscle weakness?

One concern about using bracing for low back pain is that it can weaken the trunk muscles. This comes from the assumption that the brace partly replaces the stabilizing function of the trunk muscles.

However, a number of contemporary studies show that back braces do not cause weakness in trunk muscles.7 There is no evidence to the contrary.7

Get low back pain relief with Lumbostrap 35 and Dorsostrap 55 back supports from DonJoy

Lumbostrap 35 and Dorsostrap 55 are two new back supports from DonJoy. These semi-rigid unisex corsets are designed for support and stabilization of the spine and relief of low back pain.

With a height of 35 cm, Lumbostrap 35 provides support and stability for the lumbar spine from S1-T10. At 55 cm high, Dorsostrap 55 covers the dorsal-lumbar spine from S1-T4.

Lumbostrap 35 is anatomically contoured to help provide a comfortable fit and improved patient compliance. Application is made easy through the use of a front closure with a hand loop.

The support’s double bilateral elastic straps are configured in a pulley system, providing independent superior and inferior adjustment of compression level. Conveniently placed within reach, they are easily affixed using hook-and-loop closures.

DonJoy Lumbostrap 35 and Dorsostrap 55
DonJoy Lumbostrap 35 (Left) and Dorsostrap 55 (Right)

And four semi-rigid pre-shaped dorsal stays help provide adjustable back support. Two of the stays can be removed and replaced with a more rigid pair for additional stability, and all of them can be reshaped by hand to achieve optimal comfort and fit.

Dorsostrap 55 includes all of the above features, as well as a pair of reverse shoulder straps. Using a traction pulley system, these straps provide adjustable tension to pull the shoulders back and straighten the back, thereby helping to improve kyphotic posture.

Both supports are lightweight, low profile, and breathable, allowing them to be worn comfortably for extended periods, and to fit more easily under clothing. To aid hygiene, they are made from odor-resistant materials which do not include natural rubber latex and are easy to clean.

Intended use and indications

DonJoy Lumbostrap 35 is designed for support and stabilization of the lumbar spine from S1-T10 and relief of low back pain.

  • Results of vertebral collapse (most common indication), that requires a very long usage (up to 12 months)
  • Outcomes of vertebral fractures of the lower dorso-lumbar tract
  • Post-operation period
  • Lumbalgia
  • Sciatic lumbalgia and lumbar cruralgia
  • Spondylarthrosis and lumbar discopathies
  • Slight traumas to the lumbosacral column and paravertebral lumbar contractures
  • Treatment of fracture of transverse processes
  • Degenerative lumbar scoliosis
  • Spondylosis with or without vertebral listhesis

DonJoy Dorsostrap 55 is designed for support and stabilization of the dorsal-lumbar spine from S1-T4 and relief of low back pain.

  • Outcomes of vertebral fractures of the dorso-lumbar tract
  • Dorsal vertebral collapses on an osteoporotic or metastatic basis (most common indication), that requires a very long usage (up to 12 months)
  • Post-operation period
  • Osteoporosis
  • Osteomalacia
  • Dorsal kyphosis
  • Osteolysis
  • Kyphosis with chronic back pain
  • Muscular insufficiency

To learn more about these products and others, visit enovis-medtech.eu

References

  1. Hoy, D., Bain, C., Williams, G., et al. (2012). A systematic review of the global prevalence of low back pain. Arthritis Rheum., 64(6): 2028-2037.
  2. Mi, J., Ye, J., Zhao, X., Zhao, J. (2018). Effects of lumbosacral orthoses on postural control in individuals with or without non-specific low back pain. Eur Spine J., 27(1): 180-186.
  3. Soo Choi, J., Kim, H., Lim, J., Seok Ryu, J. (2022). The facilitation of trunk muscles by abdominal bracing during walking in chronic low back pain patients. J Biomech, 143: 111299.
  4. Ludvig, D., Preuss, R., Larivière, C. (2019). The effect of extensible and non-extensible lumbar belts on trunk muscle activity and lumbar stiffness in subjects with and without low-back pain. Clin Biomech (Bristol, Avon), 67: 45-51.
  5. Calmels, P., Queneau, P., Hamonet, C., et al. (2009). Effectiveness of a lumbar belt in subacute low back pain: an open, multicentric, and randomized clinical study. Spine (Phila Pa 1976), 34(3): 215-220.
  6. Im, S.C., Cho, H.Y., Lee, J.H., Kim, K. (2021). Analysis of the Effect of Wearing Extensible and Non-Extensible Lumbar Belts on Biomechanical Factors of the Sit-to-Stand Movement and Pain-Related Psychological Factors Affecting Office Workers with Low Back Pain. Healthcare (Basel), 9(11) :1601. Published 2021 Nov 22.
  7. Anders, C., Hübner, A. (2019). Influence of elastic lumbar support belts on trunk muscle function in patients with non-specific acute lumbar back pain. PLoS One, 14(1): e0211042. Published 2019 Jan 24.

Does a back brace help with kyphosis?

In some people, kyphosis can be a debilitating spine condition that left untreated can have a severe impact on people’s lives. For older people in particular, if severe, the consequences can be life-threatening. However, evidence suggests that wearing a back brace can help address the symptoms of kyphosis.

What is kyphosis?

Kyphosis is defined as excessive curvature of the spine in the sagittal (front to back) plane. Normally there is 20° to 45° of curvature in the upper back, but anything in excess of 45° is called kyphosis (Website Source).

The condition gives the top of the back a more rounded appearance. The back may be painful, flexibility of the spine is reduced, and tiredness may also be experienced (Website Source).

What causes kyphosis?

In addition to spinal injuries, there are a number of different ways in which the upper back can become overly curved (Website Source):

  • Postural kyphosis—bad posture from slouching or carrying heavy bags can affect the muscles and ligaments supporting the spine and increase spinal curvature
  • Scheuermann’s kyphosis—vertebrae that do not develop properly can become abnormally shaped and out of position
  • Congenital kyphosis—when a child’s spine does not develop correctly in the womb, the vertebrae can become fused together
  • Age-related kyphosis—as people grow older, the spine can become increasingly curved
Kyphosis
Typical and kyphotic spines. Image credit: The Mayo Foundation.

Why is kyphosis a problem for older people?

Among the elderly population, the most commonly reported symptoms are weak back extensor muscle strength, loss of spinal mobility, and pain, along with the general degenerative components such as disc dehydration and changes in vertebral shape/wedging1.

For older people, kyphosis can have significant impact on function, quality of life, and mortality. Because it has a negative effect on gait and balance, older kyphosis sufferers are at increased risk of falls and fractures. Furthermore, severe kyphosis reduces the amount of space in the chest, mobility of the rib cage, and expansion of the lungs, which may lead to breathing problems, particularly in women2.

Older women with kyphosis are 70% more likely to suffer a fracture, regardless of age or prior fracture, and this risk increases as the condition progresses3.

How is kyphosis treated?

According to the NHS, it is usually only severe cases of kyphosis that require surgical treatment (Website Source). The condition can usually be improved by correcting posture through exercise and physiotherapy, while over-the-counter analgesics can be used to manage pain.

For children with mild to moderate kyphosis, bracing is recommended to minimize the progression of the curve whilst the spine is still growing (Website Source). In adolescents, bracing using an orthosis has been seen to reduce kyphosis ranging from 55 to 80°1.

In patients over the age of 60, bracing improves the balance score, and reduces spinal deformity and pain. If there is lumbar spine involvement, bracing and exercises should be prescribed for patients with kyphosis. Bracing becomes more of an attractive option for elderly patients when considering that the high risk of surgery for this age group means that surgical intervention is less likely to be recommended1.

What is a TLSO brace?

A thoracolumbosacral orthosis (TLSO) is a brace worn over the whole or part of the thoracic, lumbar, and sacral portions of the spinal column. TLSOs are prescribed to control motion, correct deformity, and/or compensate for weakness3.

Get customizable back support for kyphosis with IsoFORM™ TLSO

The IsoFORM™ TLSO back brace from DonJoy® is designed to provide motion restriction, creating a dynamic environment for healing within the thoracolumbar and lumbar spine.

It is intended for acute pain relief by thoracic postural extension alignment, compression fractures of the thoracic spine, osteoporosis, thoracic mechanical back pain, and kyphosis.

IsoFORM TLSO’s customizable lumbar belt encompasses the torso and restricts flexion and rotation, thereby providing stability for the trunk. Along with the posterior extending straps, this promotes postural correction for the upper spine, helping to relieve the symptoms of kyphosis.

The brace’s many customizable features allow it to be modified to suit the patient and achieve the optimum performance. The malleable telescoping sternal bar can be shaped for a custom fit, while the straps can be positioned in over-the-shoulder or underarm configurations to aid comfort.

Targeted compression and support are provided by a dual pulley system and an overlapping panel system consisting of anterior, posterior, and lateral extension panels.

Comfortable to wear and easy to don and doff, IsoFORM TLSO is available in two sizes (Small/medium and large/extra-large), and fits hips from 71 to 152 cm in circumference.

Supplemental aid is available in the form of a reusable hot/cold pack accessory sold separately for use with the brace. Simply warm up or freeze the pack before placing it into the brace’s purpose-built pocket to deliver heat or cooling therapy. It can be used for common aches, pains, swelling, and bruising, and provides fast relief for sore and stiff joints, muscle aches and pain, and muscle tension and cramps.

As well as kyphosis, IsoFORM TLSO is suitable for people with compression fractures of the thoracic spine, osteoporosis, and thoracic mechanical back pain.

You can learn more about IsoFORM TLSO by downloading our brochure

Or by visiting djoglobal.eu

References

  1. Bettany-Saltikov, J., Turnbull, D., Ng, S.Y., Webb, R. (2017). Management of Spinal Deformities and Evidence of Treatment Effectiveness. Open Orthop J. Dec 29(11), 1521-1547.
  2. Lorbergs, A. L., O’Connor, G. T., Zhou, Y., Travison, T. G., Kiel, D. P., Cupples, L. A., Rosen, H., & Samelson, E. J. (2017). Severity of Kyphosis and Decline in Lung Function: The Framingham Study. The journals of gerontology. Series A, Biological sciences and medical sciences, 72(5), 689–694.
  3. Huang, M. H., Barrett-Connor, E., Greendale, G. A., & Kado, D. M. (2006). Hyperkyphotic posture and risk of future osteoporotic fractures: the Rancho Bernardo study. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 21(3), 419–423.

Website

Kyphosis – Treatment – NHS (www.nhs.uk) accessed 07 May 2021

DonJoy® LadyStrap – back relief, precisely for women

When it comes to choosing a back support, one of the most important considerations is finding the best fit possible. Male and female spines are fundamentally different in shape; the female spine features a greater curvature, a caudally located lordotic peak, and greater cranial peak height.1

Many back supports are designed for unisex use, meaning they aren’t always made to accommodate the natural differences in shape between men and women.

DonJoy® LadyStrap is made specifically for the female body. Fitted at the waist, with a more pronounced lumbar curvature, it’s shaped to fit a woman’s natural curves. This means women can now get the same support and targeted pain relief they expect from a DonJoy back support, but with improved comfort. And with a host of adjustable features, DonJoy LadyStrap helps provide even more precise back support.

DonJoy LadyStrap’s features

The support’s height-adjustable back pad provides additional support and compression in the back area, and can be placed at different heights to help target low back pain.

A pair of bilateral straps enables the wearer to adjust the level of compression to suit their needs; increased for activity and reduced for periods of relaxation.

Its four semi-rigid dorsal stays are curved for optimal anatomical fit and improved comfort.

The ergonomic front closure with finger loop allows for fast and simple application and adjustment. And lace fabrics create a feminine look.

These features are in addition to those that come as standard with DonJoy back supports. A lightweight, low-profile design helps make extended periods of wear

comfortable, ideal during the acute phase. Optimal thermoregulation allows air circulation under the support for enhanced breathability. And soft and comfortable materials help prevent skin irritation.

Intended use and indications

DonJoy LadyStrap is designed to provide support and stabilization of the lumbar spine and relief of low back pain. It is indicated for:

  • Acute lower back pain
  • Back pain prevention, return to activities
  • Back sprain
  • Muscular weakness
  • Lumbar disc diseases (conservative treatment)

Available in two heights and five sizes, DonJoy LadyStrap fits waists from 56 to 136 cm.

References

  1. Hay, O., Dar, G., Abbas, J., Stein, D., May, H., Masharawi, Y., Peled, N., & Hershkovitz, I. (2015). The Lumbar Lordosis in Males and Females, Revisited. PloS one, 10(8), e0133685.

How a back brace can help patients with osteoporosis

Osteoporosis is a progressive condition that weakens bones, making them fragile and more likely to break.

As a result of this loss of bone, many osteoporosis patients will also suffer spinal compression fractures, with 1.4 million new clinical vertebral fractures reported in the year 2000.1 Such fractures can have a serious impact on a person’s ability to maintain an active lifestyle, with pain and a loss of confidence presenting two formidable challenges to overcome.

One therapeutic option available to osteoporotic patients is semi-rigid back bracing. These kinds of medical orthoses are designed to alleviate the symptoms of vertebral osteoporosis and help patients stay active, but what evidence is there that these products work?

What causes osteoporosis?

Bone naturally becomes thinner as a person ages, but women are especially vulnerable to osteoporosis after the menopause because their ovaries no longer produce oestrogen hormones which help maintain bone mass. Around 200 million women worldwide are estimated to be affected by osteoporosis.2

Other causes of osteoporosis are:

  • Removal of the ovaries
  • A diet lacking sufficient calcium
  • Certain hormonal disorders
  • Prolonged use of corticosteroid drugs
  • Prolonged immobility

Osteoporosis is also more common in heavy smokers and drinkers.

What are the symptoms and signs of osteoporosis?

The first sign of osteoporosis is often a fracture caused by a fall that would not result in a fracture in a young adult. Typical sites for such fractures are the wrist and the top of the femur.

Another type of fracture that occurs in osteoporosis is a spontaneous fracture of one or several vertebrae, which causes the bones to crumble, leading to a progressive loss of height or to pain due to compression of a spinal nerve.

What are spinal compression fractures, and how are they treated?

Spinal compression fractures occur when the combined axial and bending loads on the spine exceed the strength of the vertebral body, resulting in the collapse of the vertebrae.

These fractures are associated with back pain and disability, loss of height, and kyphosis – a spinal disorder in which excessive curving of the spine results in an exaggerated forward rounding of the upper back.3,4,5

Spinal compression fractures involving the anterior elements of the spinal column are considered stable fractures and most patients remain neurologically intact.5,6

Once a diagnosis is confirmed, the first line of treatment is typically conservative pain management, usually involving some form of bracing or physiotherapy.5,6

Some patients who fail conservative treatment may require hospitalization, long term care, and surgical interventions such as percutaneous vertebroplasty and balloon kyphoplasty.5,6

How can bracing help osteoporosis patients?

Orthopedic back braces designed for the management of osteoporosis symptoms should perform some or all of the following functions:

  • Control pain by limiting motion7
  • Stabilize injured structures by immobilizing the spine7
  • Provide pressure to promote correction and prevent deformity7
  • Reduce pain and fatigue8
  • Promote function or participation8

Of the different types, semi-rigid back braces seem to be the most effective, with good clinical evidence supporting their use for osteoporotic patients.

In 2011, Jacobs et al. demonstrated that using a semi-rigid thoracolumbar orthosis seems to have a positive effect on gait and stability in patients suffering from an osteoporotic spinal compression fracture.9  

In the same year, a study by Pfeifer et al. showed that the use of a semi-rigid orthosis increases trunk muscle strength and therefore improves posture in patients with vertebral fractures caused by osteoporosis.10

In Dionyssiotis et al.’s 2015 study, they showed that semi-rigid orthoses could be an effective intervention for improving back pain and muscle strength in osteoporotic women.11

And Meccariello et al. (2017) demonstrated that a semi-rigid orthosis proved to be safe and effective in the treatment of thoracolumbar osteoporotic vertebral fracture, with better functional outcome and less complications compared to a standard rigid 3-point orthosis.12

Introducing DonJoy® Osteostrap – a new back brace for osteoporosis

With its innovative modular design, DonJoy® Osteostrap utilizes a set of adjustable features to aid active relief and postural correction of the thoracic spine.

The brace’s reverse shoulder straps, semi-rigid dorsal frame, and lumbar belt combine to provide patient-specific support and correction of kyphotic posture through active relief and stabilization of the spine. The brace is easy to self-fit, and its intuitive fixtures remain within easy reach for hassle-free adjustment.

Comprised of two separate sections, the brace allows 15 combinations of different lumbar belt and dorsal frame sizes to accommodate spine lengths from C7-S1, as well as waist circumferences from 56 – 130 cm.

Soft, elastic, breathable materials help provide a comfortable fit, allowing extended periods of wear and encouraging patient compliance. Also, the brace’s low-profile shape allows the wearer to maintain freedom of movement while remaining supportive.

User-friendly, comfortable, and available in a wide range of sizes, DonJoy Osteostrap offers patients suffering from osteoporosis and other debilitating back conditions the support they need to help live a normal, active life.

References

  1. Johnell, O., & Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 17(12), 1726–1733.
  2. Reginster, J. Y., & Burlet, N. (2006). Osteoporosis: a still increasing prevalence. Bone, 38(2 Suppl 1), S4–S9.
  3. Mathis, J.M., Barr, J.D., Belkoff, S.M., Barr, M.S., Jensen, M.E. and Deramond, H., 2001. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. American journal of neuroradiology, 22(2), pp.373-381.
  4. Burge, R., Dawson-Hughes, B., Solomon, D.H., Wong, J.B., King, A. and Tosteson, A., 2007. Incidence and economic burden of osteoporosis‐related fractures in the United States, 2005–2025. Journal of bone and mineral research, 22(3), pp.465-475.
  5. Genant, H.K., Cooper, C., Poor, G., Reid, I., Ehrlich, G., Kanis, J., Nordin, B.C., Barrett-Connor, E., Black, D., Bonjour, J.P. and Dawson-Hughes, B., 1999. Interim report and recommendations of the World Health Organization task-force for osteoporosis. Osteoporosis international, 10(4), p.259.
  6. Kanis, J.A., 1999. The burden of osteoporosis. Journal of endocrinological investigation, 22(8), pp.583-588.
  7. Kato, T., Inose, H., Ichimura, S., Tokuhashi, Y., Nakamura, H., Hoshino, M., Togawa, D., Hirano, T., Haro, H., Ohba, T., Tsuji, T., Sato, K., Sasao, Y., Takahata, M., Otani, K., Momoshima, S., Tateishi, U., Tomita, M., Takemasa, R., Yuasa, M., … Okawa, A. (2019). Comparison of Rigid and Soft- Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. Journal of clinical medicine, 8(2), 198.
  8. Newman, M., Lowe, C.M. and Barker, K., 2016. Spinal orthoses for vertebral osteoporosis and osteoporotic vertebral fracture: a systematic review. Archives of physical medicine and rehabilitation, 97(6), pp.1013-1025.
  9. Jacobs, E., Senden, R., McCrum, C., van Rhijn, L. W., Meijer, K., & Willems, P. C. (2019). Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture. Clinical interventions in aging, 14, 671–680.
  10. Pfeifer, M., Kohlwey, L., Begerow, B., & Minne, H. W. (2011). Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. American journal of physical medicine & rehabilitation, 90(10), 805–815.
  11. Dionyssiotis, Y., Trovas, G., Thoma, S., Lyritis, G., & Papaioannou, N. (2015). Prospective study of spinal orthoses in women. Prosthetics and orthotics international, 39(6), 487–495.
  12. Meccariello, L., Muzii, V. F., Falzarano, G., Medici, A., Carta, S., Fortina, M., & Ferrata, P. (2017). Dynamic corset versus three-point brace in the treatment of osteoporotic compression fractures of the thoracic and lumbar spine: a prospective, comparative study. Aging clinical and experimental research, 29(3), 443–449.

Working from Home and the Potential Strain on our Bodies.

Treating low back pain with electrotherapy

Among the many impacts of the coronavirus pandemic, one of the least publicised is that of low back pain. Far more of us are currently working from home, often without the necessary ergonomic support of chairs and desks designed to prevent back problems, and as a result, physiotherapists are seeing a growing number of patients presenting with low back pain.

Among the many impacts of the coronavirus pandemic, one of the least publicised is that of low back pain. Far more of us are currently working from home, often without the necessary ergonomic support of chairs and desks designed to prevent back problems, and as a result, physiotherapists are seeing a growing number of patients presenting with low back pain.

One way of treating low back pain is with electrotherapy. The practice takes advantage of the high excitability of nerve fibres, stimulating them with electrical pulses to achieve a number of therapeutic effects. As well as pain relief, this includes stimulation to help strengthen muscles, meaning it can be used to address both the symptoms and causes of low back pain.

Treating the SYMPTOMS of low back pain with electrotherapy

Most acute low back pain is a result of injury to the muscles, ligaments, joints, or discs. The body’s reaction to injury is to instigate an inflammatory healing response, which can cause severe pain.

TENS (Transcutaneous Electrical Nerve Stimulation) uses electrical pulses to provide pain relief by blocking pain signals from reaching the brain. High frequency (HF) TENS, or sensory stimulation, uses pulses of 80-100 Hz and works via the gate control mechanism, inhibiting the transmission of pain signals to the brain while producing a pleasant tingling sensation. As a result, HF TENS is effective for providing patients with relief from the symptoms of lumbar pain.1

However, rather than just treat the cause of the pain, it’s important to also address the cause of the injury. Thankfully, electrostimulation also has an answer for this.

Treating the CAUSES of low back pain with electrotherapy

Sitting slumped over a desk while you work puts increased strain on the muscles and ligaments in your back, which can then lead to injury and low back pain. To address the cause of posture-related low back pain, we need to restore balance between the trunk flexors and extensors and strengthen our paraspinal and abdominal muscles to improve spinal stability and help us sit up straight. This is where NMES can help. 2,3

NMES (Neuro Muscular Electrical Stimulation) uses electrical pulses to produce muscle contractions, mirroring the impulse sent from the brain. NMES can be used as a standalone treatment, but is most effective when used in combination with voluntary exercise such as proprioceptive or functional rehabilitation.

By safely controlling the contractions, the muscles can be made to exert themselves much more than the patient would be capable of voluntarily, and without placing additional stress on joints. Additionally, NMES can help the patient to recruit the deep lumbar stabilizers.3,4 This allows patients to effectively and safely strengthen their trunk muscles during exercise, thereby helping to address the causes of low back pain.2,3

However, if symptoms remain, functional rehabilitation for low back pain can still be carried out by combining NMES and TENS in a single treatment. One device with this function is Chattanooga’s Intelect Mobile 2.

Intelect Mobile 2 – the next generation in electrotherapy

Intelect Mobile 2 is an innovative device designed to provide clinicians with everything they need for effective electrotherapy treatment, and comes in three different configurations, STIM, ULTRASOUND, and COMBO.

All three options include an intuitive touchscreen user interface, a library of suggested protocols, and Bluetooth connectivity for easy software updates. And as the name suggests, the device is truly mobile, enabling it to be easily carried or mounted on a wheeled cart.

Intelect Mobile 2 STIM and COMBO provide 2-channel electrotherapy with over 20 different waveforms, offering therapists multiple treatment options. For instance, when treating a patient with low back pain, Channel 1 can be used to deliver TENS treatment for pain relief, while Channel 2 provides muscle stimulation to support functional rehabilitation exercises. Or therapeutic ultrasound can be used as an adjunct pain-relieving modality. 5

Altogether, Intelect Mobile 2 is an excellent option for therapists interested in using electrostimulation for treating not only low back pain, but also a range of other neuromuscular conditions.

References

1 Jauregui JJ, Cherian JJ, Gwam CU, Chughtai M, Mistry JB, Elmallah RK, Harwin SF, Bhave A, Mont MA. A Meta-Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain. Surg Technol Int. 2016 Apr;28:296-302.

2 Durmus D, Akyol Y, Alayli G, Tander B, Zahiroglu Y, Canturk F. Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.

3 Baek SO, Cho HK, Kim SY, Jones R, Cho YW, Ahn SH. Changes in deep lumbar stabilizing muscle thickness by transcutaneous neuromuscular electrical stimulation in patients with low back pain. J Back Musculoskelet Rehabil. 2017;30(1):121-127.

4 Coghlan S, Crowe L, McCarthypersson U, Minogue C, Caulfield B. Neuromuscular electrical stimulation training results in enhanced activation of spinal stabilizing muscles during spinal loading and improvements in pain ratings. Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:7622-5.

5 Goren A, Yildiz N, Topuz O, Findikoglu G, Ardic F. Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial. Clin Rehabil. 2010 Jul;24(7):623-31.

How a Maternity Support Belt can Help Reduce Pregnancy Pain.

Pregnancy pain is a common experience for many women, but it can often have a negative impact on their work lives and quality of life. Remedies for pelvic pain and low back pain during pregnancy often focus on water exercise and physiotherapy, which are not always practical solutions, but a growing number of clinical studies also support the role maternity support belts can play in reducing this pain.

There are two common types of pain during pregnancy:

Pelvic girdle pain

Pelvic girdle pain is defined as pain in the symphysis and/or between the posterior iliac crest and the gluteal fold, particularly in the vicinity of the sacroiliac joint.

There are several causes for this, but they tend to stem from hormonal and mechanical changes in the body, as internal organs move and ligaments soften to make room for the birth of the baby. During pregnancy, an increase in the hormone relaxin can cause increased laxity of the ligaments of the pelvic girdle, with the resulting increase in range of movement in the pelvic joint causing pain.1

While typically mild to moderate, pelvic girdle pain is reported as the most common reason for pregnant women taking sick leave, with studies reporting a prevalence of 4%-76.4% in women during pregnancy

Low back pain

Often beginning in the second trimester, low back pain is defined as pain between the costal margins and the inferior gluteal folds, which may be associated with pain referred down to the leg. Usually accompanied by painful limitation of movement, low back pain often interferes with quality of life and daily living.

The cause of low back pain is related to additional stress placed on the back as a result of changes in the body during pregnancy. It is normal to gain 20-40 pounds in weight during pregnancy, and as the abdominal muscles stretch, they lose their ability to maintain posture, causing the lower back to support the increased weight of the torso. Increased axial loading results in increased spine compression, which leads to pain.

Low back pain is often considered “normal” in pregnancy, with studies reporting a prevalence of 50%- 71.3% in pregnant women.6 As with pelvic girdle pain, low back pain is another leading cause for pregnant women seeking sick leave.2

How a maternity support belt can help reduce pregnancy pain

A maternity belt is a supportive garment designed to be worn during pregnancy to provide support to the lumbar spine or pelvic regions, thereby helping to relieve pain.

The intended effects include:

  • Compressing the body to increase proprioception
  • Reducing mechanical loading of the localized weight
  • Stabilising the lumbar spine and pelvis
  • Stimulating the action of the muscles around the abdomen, spine and pelvic floor

A range of recent studies3,4,5 have demonstrated the effectiveness of maternity belts in reducing both pelvic girdle pain and low back pain, as well as providing improved stability and reducing the risk of falling during pregnancy.

Convenient, safe, low cost, and easily accessible for pregnant women, it is common for specialists to recommend maternity belts, especially alongside other therapies.

MyBabyStrap®

DonJoy’s MyBabyStrap® is a lumbar maternity belt designed to help reduce pain and discomfort during and after pregnancy. It is indicated for

  • Lower back pain
  • Pelvic pain
  • Sacroiliac pain
  • Postural instabilities
  • Discomfort due to stretching and expansion of the abdomen
  • Back support after birth

MyBabyStrap includes a number of features to help provide functional, easy-to-use support for pregnant women.

Thanks to itsmodular design, the support is easy to adjust, making it adaptable to all stages of pregnancy and also after birth. This includes an adjustable back pad and four rigid posterior stays to help provide extra support and compression in the lumbar area, and bilateral straps that can be tightened to help provide additional relief. It also comes with a removable elastic strap for lower abdominal support.

MyBabyStrap’s anatomical shapefollows the natural contours of a pregnant body for a comfortable fit, with no pressure on the abdomen. Its thin, soft, and breathable fabric and ergonomic front panel also help to provide comfort whether sitting or standing, while the design includes stylish details for a more fashionable and attractive appearance.

Finally, the belt is easy to fit, with a simple hook-loop closure that allows patients to quickly and simply adjust it to reach the desired level of comfort. It comes in one size that fits waist circumferences from 80 to 150 cm.


REFERENCES

1. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794-819.

2. Kristiansson P, Svärdsudd K, von Schoultz B. Back pain during pregnancy: a prospective study. Spine (Phila Pa 1976). 1996;21(6):702-709.

3. Kordi R, Abolhasani M, Rostami M, Hantoushzadeh S, Mansournia MA, Vasheghani-Farahani F. Comparison between the effect of lumbopelvic belt and home based pelvic stabilizing exercise on pregnant women with pelvic girdle pain; a randomized controlled trial. J Back Musculoskelet Rehabil. 2013;26(2):133-139.

4. Flack NA, Hay-Smith EJ, Stringer MD, Gray AR, Woodley SJ. Adherence, tolerance and effectiveness of two different pelvic support belts as a treatment for pregnancy-related symphyseal pain – a pilot randomized trial. BMC Pregnancy Childbirth. 2015;15:36.

5. Bertuit J, Van Lint CE, Rooze M, Feipel V. Pregnancy and pelvic girdle pain: Analysis of pelvic belt on pain. J Clin Nurs. 2018;27(1-2):e129-e137.

6. Kovacs FM, Garcia E, Royuela A, González L, Abraira V; Spanish Back Pain Research Network. Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy: a multicenter study conducted in the Spanish National Health Service. Spine (Phila Pa 1976). 2012;37(17):1516-1533.