Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers

BACKGROUND: Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP. OBJECTIVE: Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP. METHODS: A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias. RESULTS: Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P -value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P -value 0.004). CONCLUSION: Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.