As soon as man could walk and then injured himself doing so, canes, crutches, and walkers have had a place in treating musculoskeletal pain. Sometimes referred to as “ambulatory assistive devices,” they offer support when a limb is painful, injured, or unable to bear weight. They may not change anatomy or speed up healing by themselves, but they are essential in cases where bones or soft tissues need to rest. And no one can deny the coolness of a stylish cane.

Braces are another question entirely, and it even depends on the question being asked. There are a multitude of braces for many conditions. For acute injuries, braces protect damaged structures so they can begin the healing process and avoid re-injury. They are meant to be used for a brief period and then removed after the body can safely support itself. For this, there is good evidence and common sense.

What about chronic conditions, such as osteoarthritis or loose ligaments? Bracing to replace tendon or ligament function or offload chronically painful joints has less clear evidence. Research regarding long-term benefit is mixed, with some studies showing osteoarthritis braces reduce the likelihood of joint replacement for years afterward. However, others report brace usage decreases over time. In my work, I have observed braces need to be replaced as they stretch out, and many people complain about brace slippage. As insurance coverage for braces decreases, purchasing new ones can become prohibitively expensive. Research and experience show bracing can be either a boon or a bother.

Two particular types of braces (tennis elbow straps and patellar tendon straps) have scientific evidence for benefit. If we think of our tendons as guitar strings, these implements act like moving up a fret; they take pressure off the tendon attachment point. Research reveals they decrease tendon pain and improve biomechanical alignment.  

A frequent question in my practice is whether a brace should have something additional in it, like copper or electromagnetism. Research on these special braces is very limited, and thus far, science shows no added benefit. Neverthless, as stated in a previous post, research studies look at how treatments impact a group of people, not an individual. Using a copper or electromagnetic brace is unlikely to be harmful, and it may bring a person relief. Ultimately, it is a matter of “try it and see.”

Given the enormous number of braces and their applications, a complete discussion is probably too ambitious for this post. I refer you to the excellent American Family Physician article in the References. Let’s identify some key points:

1. Bracing is useful for protecting and supporting fresh injuries.
2. Bracing is reasonable to try for chronic conditions like osteoarthritis.
3. Only wear your brace for as long as you need it. Ask the doctor when and for how long you should wear it.

Braces and assistive devices hold an important, practical place in the management of musculoskeletal pain. If we are interested in trying non-invasive treatments, they can be valuable assets. However, it is hard to predict how a person will respond to them for chronic conditions, and finances are sometimes a consideration. The decision to use these tools is based on individual factors, and the best approach may be to “brace yourself” and try them out.

References:

1. Sprouse RA, McLaughlin AM, Harris GD. Braces and Splints for Common Musculoskeletal Conditions. Am Fam Physician. 2018;98(10):570-576.
2. Choit EH, Kim KK, Jun AY, et al. Effects of the Off-loading Brace on the Activation of Femoral Muscles – a Preliminary Study. Ann Rehabil Med. 2011 Dec;35(6):887-96.
3. Marshall HW. Use and Abuse of Mechanical Supports in Orthopedic Conditions. Boston Med Surg J. 1920;182(20):497-502.