Pain relief and quality of life are primary concerns

Anyone who has suffered injury or disease will tell you that finding relief from pain and the restoration and preservation of their quality of life are their primary concerns.  However, making the right decision in achieving these goals is not always that simple.  For instance, if someone has suffered trauma or injury to the neck or the knee, or a condition such as osteoarthritis is diagnosed, wearing a brace may not only relieve pain and offer support to help strengthen the affected area, but evidence also points to the fact that doing so could, in many successful cases, prevent the need for surgery.  In this article, we will examine how wearing a device such as a cervical neck brace or offloader knee brace can, in many instances, provide an alternative to invasive surgery that most people simply would not want to have unless it is absolutely necessary.

Seek a second opinion – do you really need surgery?

Of course, there are situations whereby even if a doctor advises that surgery may be needed, a second opinion should be sought so that all possible angles can be explored to find ways to rule it out.  This is where wearing a brace comes into the picture.  Wearing a brace, in many cases, has proven to be effective enough to save many people from having to undergo unnecessary surgical procedures.  To avoid surgery is better for the body, emotions, mental stability of the patient and saves a tremendous amount of money. Ultimately, what counts here is the welfare of the patient.  Let us now examine the advantages and disadvantages of wearing a brace as an alternative to surgery.   

Advantages of wearing braces

In this article, we will examine the results of wearing braces as compared to opting outright for invasive surgery.  While much is determined by the nature of the disease/injury in question along with the guidance from the orthopaedic surgeon; the patient’s overall needs, budget and lifestyle issues need careful and critical examination and assessment prior to deciding what to do.

This piece focuses on the three main different types of braces worn in different parts of the body:

  • Knee braces
  • Neck braces
  • Back braces

Knee Braces

Since the knee can be considered as the largest joint in the human body it is prone to injury.  Even everyday activities such as walking can cause stress to the knee.  Wearing a knee brace can prevent further injuries by providing additional support to the knee.   Not only can wearing a brace obviate the need for surgery in certain cases, using a knee brace can help someone remain mobile and able to stay up and running while the injury heals and while they undergo other treatments such as physiotherapy.  Here are some of the main advantages to wearing a knee brace.

  • Prevention is better than cure

Injuries can occur to the knee when it is twisted or bent in an unnatural way.  This results in tearing of the ligaments that keep the knee in place.  A brace helps in the prevention of injury by holding the knee in place so that it doesn’t over-extend.  The brace also has the effect of compressing the tissue around the knee providing further stability.

Figure 1 Prophylactic knee brace for prevention and reduction of knee ligament damage

  • Knee braces for everyday activities versus sporting activities

For those engaged in everyday activities, a slip-on brace can be worn.  However, for those who take part in sporting activities a bulkier type of brace may be required.  

Figure 2 Functional knee brace provides support to injured knee

  • Post-surgery to prevent the need for more surgery

It is strongly recommended that a knee brace be worn post-surgery since, as knees tend to have a lengthy recovery period, wearing a brace:

  • Provides support to the knee
  • Helps to control movement of the knee joint
  • Promotes healing of the knee tissue
Figure 3 Rehabilitative or post op knee brace limits potentially harmful knee movements while the knee is healing
  • Unloads/offloads weight due to Osteoarthritis/arthritis/associated issues

Wearing a knee brace can alleviate the pain associated with osteoarthritis or arthritis along with any associated issues that may occur as a result of these types of diseases since wearing a brace:    

  • Unloads/offloads the weight from the knee
  • Transfers pressure to the thigh area, taking the pressure off the injured knee area
  • Provides better mobility of the knee
  • Reduces stiffness of the knee joint
Figure 4 Unloader/offloader knee brace provides pain relief from arthritis/osteoarthritis

Back Braces

Most people at some point in their lives will experience back pain.  There are many causes of back pain such as disease, injury and even bad posture or overstraining the back due to lifting heavy objects can cause back pain.  Wearing a back brace helps keep the back in the best possible position while preventing strain when you are standing or sitting.  Let’s take a look at some of the main advantages of wearing a back brace.

  • Keeping the back still – immobilisation

No matter the nature of the ailment, whether injury or previous surgery, wearing a back brace immobilises the back which not only relieves the pain but is critical to the healing process.  Wearing a back brace therefore:

  • Prevents unnecessary movement in the back including rotation, flexion and extension.
Figure 5 TLSO back brace prevents unnecessary movement of the back while the back heals
  • Back braces can be Custom-made 

Conditions such as spinal fractures require the back to be kept still to enable healing to take place.  As no two individuals are completely alike, braces such as the thoracic lumbar sacral brace can be custom-made to suit individual needs.

  • Thoracic Lumbar Sacral Brace can correct the spine without surgery

A thoracic lumbar sacral brace is often worn by those who suffer from scoliosis or those with spinal fracture damage.  However, this type of brace has been proven to be effective in correcting the spine without the need for surgery.  This is especially the case with those suffering from scoliosis.

Figure 6 Thoracic lumbar sacral brace worn by those with scoliosis and spinal fractures and effectively used to correct the spine without surgery 
  • Corrects posture

There is no doubt that bad posture can cause severe back pain.  Not only that but it can also cause spinal weakness which makes one prone to injury and even deformities.   Wearing a back brace:

  • Keeps the spine in a straight position, correcting posture and preventing injury and possible surgery.
  • Back braces treat multiple conditions

Many conditions can be treated by wearing a back brace including:

  • Osteoporosis
  • Spinal cord injuries
  • Muscle sprains in the back
  • Spinal fractures
  • Scoliosis
  • Whiplash

Neck Braces

A neck brace is typically worn following a spinal injury or spinal surgery.  Its main purpose is to provide pain relief by restricting movement in the neck area.  Especially following injury or after surgery, a neck brace is instrumental in keeping the neck still.  This is extremely important to the healing process in general as well as helping to prevent further injury and to avoid the need for more surgery.  Using a combination of medication and spinal block injections while wearing a brace have produced amazing results and saved many people from having to have unnecessary, invasive and costly surgical procedures.  There are two types of neck brace:  the soft cervical collar made of foam rubber and the rigid collar made of moulded plastic.  There are clear advantages to wearing a neck brace:

Rigid braces restrict neck movement during recovery from a fracture or surgery (e.g., fusion).

  • Aid recovery from fracture or previous surgery 

Rigid neck braces are used to aid recovery following an injury such as a fracture or following previous surgery.  Pain relief provided by the rigid brace that acts as an immobiliser for the neck can ward off the need for further invasive surgical procedures which are risky to say the least.

  • Aid recovery from minor injuries and prevent further injury occurrence

A soft cervical collar is used to support the neck following injuries such as whiplash and prevents the further occurrence of injury that could lead to greater pain and possible surgery.

Figure 7 Philadelphia collar – hard neck brace to stabilise the neck

Disadvantages of wearing all types of braces

While it is clear that wearing any form of brace provides many advantages where painful diseases are concerned, there are, even if few, certain common disadvantages where knee, back or neck braces are concerned.

  • Braces can be aesthetically unappealing
  • While a brace decreases the load on the injured area, it may increase the load elsewhere
  • A brace should only be worn for certain periods of time

Cost implications of wearing a brace versus surgery

Surgery is an expensive exercise, there is no doubt.  Even if funding can be obtained via a medical aid scheme the cost implications of any type of surgery starts at first procedure and can extend over long periods of time involving rehabilitation and recovery.  Such costs are comparable to ‘how long is a piece of string?’  Therefore, prices for surgical options are available upon consultation with the surgeon and other members of the medical team involved and dependent upon the unique circumstances of the patient.  On the other hand, as the table below indicates, wearing a brace versus opting for surgery can save a tremendous amount of money. 

Brace Average costs Surgery cost impact Rehabilitation
       
Knee  R200 – up to R20 000  Starting at R150 000 upwards Costs vary depending on rehabilitation time
       
Back  R650 – R1500 Starting at R150 000 upwards Costs vary depending on rehabilitation time
       
Neck  R650 – R1400 Starting at R150 000 upwards Costs vary depending on rehabilitation time

The orthotist and the surgeon – a symbiotic relationship

At this point it is worth mentioning that to enable the best possible outcomes, the importance of teamwork cannot be overemphasised.  In this manner, the surgeon and the orthotist need to work together in almost what can be considered as a symbiotic relationship.  This is a holistic approach that takes into account all possible angles to enable a better recovery.  Call Roger now on 011 640 7198.  Roger works hand in glove with the surgeon to achieve the best outcomes and can refer you to the best surgeon for your specific needs.  

Roger’s story – summing things up

In 2008, Roger Wolfson himself should have had knee replacement surgery.  However, he managed to avoid this by designing and developing his own knee brace called the JR OA Offloader Knee brace.  Click here to read the full article on how this was achieved.  

Roger has helped many patients to avoid surgery and minimise pain, which very often involves working hand in hand with various specialists:  e.g. neurosurgeons and orthopaedic surgeons and utilizing many different types of spinal orthoses depending on what type of device is prescribed by the surgeon.  Taking the approach of working as a team and pooling our best resources and solutions as a team of specialists has often resulted in a high success rate in being able to combat the need for surgery. 

Call Roger now on 011 640 7198 for a free first consultation and assessment and find out how you can brace yourself against pain and the risks and high costs of surgery.