The use of a nonrigid lumbar belt, as an adjunct to usual care, significantly improves functional disability in individuals with nonspecific low back pain, as shown in a study.
Over a 12-week intervention, the primary outcome of mean Oswestry Disability Index (ODI) score decreased by 10 points for participants who wore the belt during daytime activities (belt group) vs 5.3 points for those who did not use the device (control group), with a between-group difference of −4.7 points (95 percent CI, −8.4 to −0.9; p=0.01). [JAMA Netw Open 2026;9:e2629793]
Significantly more participants in the belt group than in the control group achieved at least a 30-percent improvement in ODI (60.5 percent vs 40.5 percent), a threshold considered clinically meaningful at the individual level, according to the investigators.
Reductions in pain at rest and during activity were also markedly greater in the belt group than in the control group, with between-group differences of −8.7 points (95 percent CI, −16.1 to −1.3; p=0.02) and −10 points (95 percent CI, −18.3 to −1.6; p=0.02), respectively.
“The difference appeared particularly relevant for movement-related pain, as mean activity-related pain fell below 40 points in the belt group only from week 3 onward. These findings may suggest an early improvement in movement-related pain, which could help patients remain active and reduce fear of movement,” the investigators noted.
Nonpharmacologic option
Current evidence supports a biopsychosocial approach to low back pain management, as pain and disability are influenced by biological, psychological, social, and lifestyle factors, including physical inactivity, smoking, and obesity. [Lancet 2018;391:2356-2367; Lancet 2018;391:2368-2383; Hum Physiol 2022;48:968-974]
“Lumbar supports are often used as adjunctive nonpharmacologic options. Lumbar belts vary in extensibility or elasticity and can be rigid, semirigid, or nonrigid or soft,” the investigators said. These devices, they added, may help with low back pain by improving postural control, proprioceptive feedback, and reduced mechanical load. [Ann Phys Rehabil Med 2022;65:101406; Spine 2009;34:215-220; J Back Musculoskelet Rehabil 2023;36:1111-1125]
“Our results are consistent with previous studies on nonrigid lumbar belts” and support the consideration of lumbar belts as a nonpharmacological option for symptom management in nonspecific low back pain, the investigators said.
Study details
A total of 168 adults (mean age 49 years, 60.1 percent female) with nonspecific low back pain lasting 1–6 months participated in the trial. These participants were randomly allocated to either the belt group (n=86) or the control group (n=82).
Participants in the belt group were instructed to wear the belt during daytime activities for 4–8 h per day throughout the 12-week intervention period, adjust it for comfortable support without excessive tightness, and not wear it while sleeping. All participants were advised to remain physically active, use usual pain medication, and to avoid taking oral or epidural corticosteroids during the study.
Results for other secondary outcomes also favoured the belt vs the control group.
Finger-to-floor distance at 12 weeks decreased by 4.2 cm more in the belt group. On the Clinical Global Impression scale, physicians classified 71.8 percent of participants in the belt group vs 44.9 percent in the control group as improved (p<0.001). More participants in the belt vs control group indicated moderate-to-strong improvement on the Patient Global Impression of Change (56.3 percent vs 32.3 percent; p=0.02).
“Although no between-group difference was observed for the overall EuroQol index or current health visual analogue scale, several EQ-5D dimensions, including mobility, pain or discomfort, and usual activities, favoured the belt group, consistent with the observed improvements in ODI and pain,” the investigators said.
Over 12 weeks, fewer participants in the belt than in the control group used medications (50.6 percent vs 67.6 percent; p=0.03). None of the participants experienced serious device-related adverse events.
“The lower proportion of patients using low back pain-related medication in the belt group, particularly NSAIDs, further supports the potential analgesic benefit of lumbar belts as a nonpharmacological option,” the investigators said. This has important implications, “given the known adverse effects associated with NSAIDs,” they added.