You probably don’t think twice about putting on your socks – until your back makes it the hardest part of getting dressed.
When ordinary movements become painful, even a little relief can matter. A new clinical trial suggests some of that relief could come from a surprisingly old-fashioned source: a soft belt wrapped around the lower back.
In the French study, published in JAMA Network Open, adults who added a lumbar belt to their usual care reported less pain and greater improvements in their ability to manage daily activities than those receiving usual care alone.
Fewer belt-wearers also used back-pain medication during the 12-week trial.
For people who find movement painful, that support could help make staying active more manageable.
“A belt may help some patients stay active by reducing discomfort during movement and providing a subjective feeling of support or reassurance,” Grenoble Alpes University Hospital rheumatologist Laurent Grange told ScienceAlert.
The LOMBACT trial involved 168 adults at 17 French medical centers. Their current episode of nonspecific lower back pain had lasted between one and six months. “Nonspecific” means the pain cannot be attributed to a recognizable, specific underlying condition or injury.
Participants were randomly split into two groups. One group added a soft, adjustable belt to their usual care; the other continued with just their usual care, which may include physical and exercise therapy.
Both were advised to remain active and could use their usual pain medication.
Belt users were asked to wear the support during daytime activities for 4 to 8 hours and remove it for sleep. Heat sensors from some users showed that actual use averaged about 4 hours on days the belt was worn.
The researchers then asked a practical question: Was back pain interfering less with everyday life?
They measured this using the Oswestry Disability Index, a questionnaire assessing how much pain restricts daily activities. Scores improved in both groups, but more among people given a belt.
About 6 in 10 belt users reported at least a 30 percent reduction in daily limitations, compared with about 4 in 10 people receiving usual care alone. That level of improvement is commonly considered meaningful for an individual patient.
In other words, more people in the belt group experienced a noticeable improvement in how much their back pain limited them. It did not mean they were pain-free.
The medication findings offered another way to understand the possible benefit. Around half of belt users took pain medication during follow-up, compared with roughly two-thirds of the comparison group. This measured how many people used medication, not how many tablets they took or how often they needed pain relief.
Pain itself also eased more in the belt group, including pain during movement.
That could matter because staying active is a central part of managing lower back pain. Grange suggested that making movement more comfortable might help some patients keep going with daily activities.
The study did not establish how the belt produced its effects. Gentle support, feedback about body position, and greater confidence during activity are possible explanations, Grange said.
There are important limits to the findings, however.
The average extra improvement in daily functioning was modest, even though the difference between groups was statistically significant. Both groups improved, and receiving a belt did not guarantee relief.
Everyone knew who received a belt, and there was no sham belt for comparison. Expectations and reassurance could therefore have influenced the results.
Grange noted that even a convincing imitation might provide compression or a feeling of support, making those effects difficult to separate.
Pain and medication use were secondary outcomes, and the many additional comparisons were exploratory.
The trial also cannot show that benefits last after the belt comes off. Participants were not asked to assess their symptoms specifically without it, and follow-up ended after 12 weeks.
Six belt users reported mild device-related problems, including discomfort or skin irritation. Two serious adverse events occurred during the trial (an inguinal hernia in the belt group and positional vertigo in the control group), but doctors considered them unrelated to the study.
Thuasne, the belt manufacturer, funded the research and paid three authors for participating in a scientific committee for the study. The paper states that the funder had no role in study design, data analysis, interpretation, or the decision to publish.
Related: Here’s Why You Keep Being Told to Exercise if You Have Lower Back Pain
Earlier evidence has been mixed, and the World Health Organization’s 2023 guidance advises against routinely offering belts or lumbar braces for chronic primary lower back pain.
The LOMBACT trial does not establish benefits for every type or duration of back pain. Chronic back pain, which is generally defined as pain lasting more than 3 months, is a particularly complicated condition that scientists are still trying to understand.
“The main caution is that a lumbar belt should not replace active management,” Grange told ScienceAlert.
For some patients, the aim may be simple: a little support to help them keep moving.
The research was published in JAMA Network Open.
This article was fact-checked by Clare Watson and edited by Clare Watson. While we pride ourselves on our process, we are only human. If you spot a mistake, please let us know.
