Spine Anatomy

What is the structure of my spine?
The spine is composed of 33 bones called vertebrae (a single bone is called a vertebra).  Between every 2 vertebrae lies a gelentous body, referred to as a disc.  Together, vertebrae and discs protect the spinal cord, allow us to maintain an upright position, and allow for back movement.  A majority of the nerves in our bodies stem from our spinal cord, which is protected by vertebrae.  Injuries to vertebrae or discs can reduce the space available for nerves emanating from the spinal cord and in severe cases, may cause nerve Impingement.  Nerve impingement can be painful and may lead to surgery.

How is the spine anatomically divided?
The spine is divided into 5 main sections: cervical, thoracic, lumbar, sacrum, and coccyx.  The vertebrae in each section are numbered according to their location.  This system provides health care professionals with a standard for communicating the location of patient injuries.  The cervical region of the spine contains 7 vertebrae, the thoracic region contains 12 vertebrae, and the lumbar region contains 5 vertebrae.  The sacrum is comprised of 5 fused vertebrae and the coccyx is comprised of 4 fused vertebrae.  The structure of the vertebrae in each section of the spine is specific to the function those vertebrae perform.

Causes of Low Back Pain

What causes low back pain?
Back pain is oftentimes caused by muscle spasm, which can be the result of an underlying injury.  Some underlying injuries include vertebal fractures, disc injury or degeneration, and nerve impingement.  These Injuries can be aggravated by associated conditions, such as narrowing (stenosis) of the canal or shifting of the vertebra (spondylolisthesis), one upon the other.

Low back pain is sometimes caused by:

• Constant stress from slouching over a keyboard or steering wheel
• Excessive stress to the back, such as lifting something heavy
• Arthritis of the spine
• Problems with tendons or ligaments in and around the spine

Only your physician can determine the cause of your back pain.  You should expect your physician to conduct a battery of tests including a physical examination and diagnostic tests before diagnosing your condition.

What are the most common disc injuries?
The most common disc injuries are herniated discs and degenerated discs.

Herniated discs can be caused by trauma, but are oftentimes caused by repetitive stress.  Whether we are hunching over a computer keyboard or a steering wheel, many of us spend a majority of our life in such positions, which is called flexion.  As time progresses the repetitive stress can cause the outer layer of our discs (called the annulus) to weaken or crack.  When the outer layer is compromised, the inner gelentous mass (nucleus pulposis) can push outward, causing the disc to bulge.  Sometimes, the nucleus may protrude beyond the annulus.  This protrusion is a herniated disc.  This herniation can be painful, but can oftentimes be treated with bracing.  Surgical Intervention may be necessary in severe cases.

Disc degeneration occurs gradually as we age.  As discs degenerate they become shorter.  This reduces the space for the nerves emanating from the spinal cord and sometimes these nerves can become compressed.  Although nerve compression is painful, back bracing may reduce some of this compression.  Severe nerve compression may require surgical intervention.

What are the common vertebra injuries?
The most common vertebra injuries are vertebral body fractures caused by either a traumatic event, like a car accident, or osteoporosis.  Osteoporosis is a degenerative condition in which a depletion of calcium and bone protein causes a reduction in bone mass.  Vertebral fractures can be braced to provide support while bone heals.

Treating Back Pain

What are my treatment options?
Your treatment protocol will depend on your injury.  Only about 1 – 3 % of patients with lumbar conditions typically require surgery, and surgery is always a last resort to conservative care.  Most low back pain will resolve with conservative treatment, including rest, physical therapy, medications (including muscle relaxers and NSAIDS), injections, bracing, and chiropractic care.

How will physical therapy reduce my back pain?
Physical therapy decreases back pain and increases function through a variety of passive and active therapies.  Immediately after injury, therapists may focus on reducing pain with passive therapies including heat, ice, and ultrasound.  Active therapies that are commonly used to rehabilitate the spine include stretching and strengthening exercises as well as low-impact aerobic conditioning. 

What are NSAIDs?
NSAIDs, or Nonsteroidal anti-Inflammatory drugs, are used to treat inflammation.  NSAIDs offer pain relief by reducing swelling around the injury site.

How will my spine brace reduce my back pain?
When your back is injured, even small movements can cause pain.  All spine braces reduce back pain by supporting the spine and by minimizing spinal column movement.  Additionally, BREG's BOA spine braces minimize pain by providing maximum circumferential compression.  When the patient pulls the pull tab, tightening the BOA brace, pressure is increased in the abdominal cavity.  This increased pressure supports the spinal column and comfortably prevents motion that results in pain.

How do I know if I need surgery?
Only your doctor can determine if your condition requires surgical intervention.  His or her recommendation will be based upon numerous factors including injury, injury location, age, physical activity level, and pre-existing conditions or health risks.

Spine Bracing

When are spine braces used?
Spine braces are used for a variety of reasons including: controlling pain, lessening the chance of further injury, allowing healing to take place, compensating for muscle weakness, or preventing or correcting a deformity.  

What differentiates BREG spine braces from the other braces available?
BOA is designed to provide maximum patient comfort and ease of use.  BREG's unique patented teardrop Lacer Compression System provides even, progressive compression and prevents the brace from migrating up.   Additionally, most braces are lined with Airmesh, the same breathable premium material that BREG uses in its soft knee braces.  The single pull tab allows the patient to easily apply and tighten the BOA brace. 

What are the indications for BREG's BOA braces?
BREG carries a variety of braces to treat numerous conditions. 

BREG's BOA Low Profile is often used to treat low back pain, strains, sprains, spondylolisthesis (vertebra shifted forward), osteoporosis (bone mass reduction), and lumbar disc herniation (protrusion) or degeneration.  Additionally, the BOA Low Profile is used post lumbar discectomy, laminectomy, and fusion to provide support while patient's bones and ligaments heal.

BREG's BOA Low Profile with Chairback is used to treat more severe lumbar injuries as well as post-operative fusion and spinal stenosis (narrowing of spinal column) in the lumbar and lower thoracic region.

The BOA Duel TLSO (Thoracolumbosacral Orthosis) is used primarily to treat vertebral compression fractures and scoliosis and the SI Belt treats sacroiliac pain and dysfunction and sciatica.

What is BREG's most popular spine brace?
BREG's most popular spine brace is the BOA Low Profile.  This product provides comfortable support for low back pain, strains, sprains, spondylolisthesis (vertebra shifted forward), osteoporosis (bone mass reduction), and lumbar disc herniation (protrusion) or degeneration. 

The BOA Low Profile is easy for patients to apply and provides circumferential compression when tightened.

How often should I wear my new back brace?
You should speak with your doctor regarding frequency of use.  The length of time you are required to wear your new brace is dependent on your condition.   Patients experiencing low back pain, muscle sprains, or ligament strains may be required to wear a brace when walking or participating in activities that lead to pain.

Patients wearing a brace post-operatively will typically wear a brace for 2 to 8 weeks depending on the procedure and surgeon's treatment protocol.

Should I wear my new back brace under or above my clothing?
The back brace can be worn under clothing, but should be worn above a light T-shirt or undershirt.

Will my health insurance pay for my new brace?
Although insurance policies vary, Medicare and most private insurers will pay for your back brace if it is deemed medically necessary by the prescribing physician.