Effectiveness of Extension-Controlled Lumbar Support and Elastic Lumbar Support in Chronic Low Back Pain in Short-Term Follow-Up and the Factors Affecting the Compliance: A Randomized Controlled Clinical Study

Objective: It still remains unclear if lumbar supports are effective in the treatment of chronic low back pain. The objective of the present study was to assess and compare the short-term effect of extension-controlled lumbar support and elastic lumbar support on low back pain, lumbar flexibility and back-specific disability in chronic low back pain patients. We also investigated the factors affecting the lumbar support compliance. Materials and Methods: One hundred and eighteen chronic low back pain patients were randomly allocated into three groups. Group 1 (n=39) was prescribed traditional, extension-controlled lumbar support; group 2 (n=40) was prescribed elastic lumbar support; both for six hours a day for three weeks. Lumbar support was not prescribed for group 3 (n=39). All patients used 1000 mg/day naproxen sodium. Pain severity was evaluated with numeric rating scale (NRS), back flexibility was evaluated with the Schober test and back-specific disability was evaluated with the Roland-Morris Disability Questionnaire (RMDQ). A 30% improvement was considered as threshold for identifying clinically meaningful improvement on NRS and RMDQ. Results: Clinically meaningful improvement was detected on NRS (45%) and RMDQ (35%) in group 1; on NRS (37%) in group 2. No meaningful clinical improvement was detected in group 3 on NRS and RMDQ. Lumbar support compliance was 52.1% in groups 1 and 2. Compliancewas positively correlated with patients' pre-treatment positive beliefs about the lumbar support and negatively side effects of lumbar support. Conclusion: In chronic low back pain patients, extension-controlled lumbar support or elastic lumbar support usage in addition to classical medical treatment is better than classical medical treatment alone in terms of pain intensity in short term. Extension-controlled lumbar support improves back-specific disability. Compliance with the lumbar support was increased with the patients' pre-treatment positive beliefs about lumbar support and decreased with the side effects of lumbar support.