A good support system keeps spines in line.

As doctors of chiropractic, by far our most common and most difficult cases deal with chronic low back pain. As spine specialists, we should always investigate new and improved techniques to help our patients achieve their goals of a pain-free life. One of the easiest and most overlooked solutions to chronic low back pain is a proper lumbar support. Unfortunately, many Americans spend the majority of their day sitting at a desk, in a car, or in front of the television or computer.

The Truth About Sitting

Our bodies are not designed to sit for periods of time. When a person sits, the lumbar spine flexes, which significantly changes the mechanics of the low back. The weight of the torso is transferred from the facet joints to almost completely on the intervertebral disks. This compression causes rapid dehydration and tremendous internal pressure within the disks, leading to more long-term problems.

Short-term problems also can occur. When the lumbar spine flexes in an unsupported seated position, the low back muscles are under increased tension. Blood flow to and from the muscles is decreased, and normal metabolic waste will accumulate. This becomes a chemical irritant and is felt as pain or stiffness in the low back.

Lumbar Support to the Rescue

An effective lumbar support is the solution to this problem. With a proper lumbar support, the low back should retain a normal lordotic curve. This allows for proper weight distribution between the disks and the facet joints, decreasing the rate of disc dehydration and reducing internal disk pressure. Low back muscles may also relax, allowing for more normal blood flow to and from the muscles, reducing metabolic waste buildup.

This radiograph demonstrates the effect of no back support on the lumbar spine.

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Clearly, one can see the difference a good seat support can make.

The concept and physiology behind lumbar supports are relatively basic. Unfortunately, lumbar supports are seriously underutilized.

Most new patients that enter my office with chronic low back pain usually have sought care in the past and still have no idea what a lumbar support even is. Explaining to the patient what a support is designed to do and how it may positively affect their low back discomfort makes the patient more educated and a better patient. I have found low back patients that begin using a prescribed lumbar support generally feel better, understand the concept of prevention, and refer more patients to the practice.

A Personal Experience

Most of my professional career has been spent researching lumbar supports. After suffering a severe lumbar and pelvic injury, I spent years rehabilitating my body and studying proper biomechanics and ergonomics. I realized early in my rehabilitation the importance and effectiveness of proper lumbar support. After all, most of my time was spent sitting, reading, and traveling to doctors across the country.

Through my experience, I have discovered there are several aspects of lumbar support that must be considered. Most importantly, the shape of the device must reinforce proper ergonomics and mechanics within the low back. I have found many of the lumbar supports on the market are not as effective as they could be. Quite often, the apex of the curve does not match the proper lumbar lordosis. Many of the devices offer only generalized low back support.

Key Features to Look Out For

To have a truly effective lumbar support, it must be customizable. This is such an important factor when considering which lumbar support to prescribe for a patient. How many patients in your office are the same height, weight, and body frame, or have the same tolerance to lumbar support? A customizable support is so much more practical. If a patient has never used a lumbar support before, they can gradually increase the level of support over time. This can only add to the patient's compliance.

Customizable applies not only to different body shapes, but also to different seat types. The amount of added support needed can vary dramatically from seat to seat. Imagine a compliant patient using a lumbar support in their car and transporting it to a couch. The level of support must be adaptable in order to remain effective.

Portability is another key feature. If a support can easily be transported, the patient compliance and use increase significantly. Who would want to carry a large foam support on a plane or into a movie theater? If a lumbar support can be discrete and take up very little space when not in use, it can easily go from the car, to the office, to dinner, or anywhere a patient is going to sit.

A New Concept in Lumbar Support

Find out more about seat supports by visiting the November 2007 archive.

Through my own experience with low back pain, I have learned to look for the key features noted above in a lumbar support. However, when I was in need, there was no such product on the market that encompassed these traits. It was out of personal necessity that the Back Booster was developed. I, along with Daniel Greenberg, DC, spent many years researching and developing a new concept in lumbar support. We designed an extremely ergonomic back support, customizable for a wide range of people and portable enough to fit in a pocket, purse, or briefcase.

I know that after my back injury, I would have never been totally pain-free without the use of lumbar support. I make sure my patients understand the importance of proper lumbar support. It is an important recommendation to help our patients achieve their goals of a pain-free life.

Jonathan Greenberg, DC, CCEP, practices in Margate, NJ, where he specializes in sports chiropractic and treats many professional athletes from the NFL, MLB, and NHL, as well as Olympic athletes. Greenberg may be reached via e-mail at or via phone at (609) 823-9300. For more information about the Back Booster, visit www.BackBooster.com.