Waist circumference occupies a relatively important position in the clinical practice of spinal surgery, and for most spinal diseases, one of the main ways to take conservative treatment is lumbar support. However, in clinical practice, we often encounter patients complaining of lumbar pain with a lumbar girth is useless, ask him what kind of lumbar girth he brought, take a closer look at the dismantled things, except for the shape can be called lumbar girth, the inner son of the pressure and lumbar girth on the edge. Many doctors also have limited knowledge of waist circumference, today we will talk about waist circumference. 1.What are the causes of low back pain? The causes of low back pain are very complex, so complex that a book could be written, which is obviously not the focus of this article. I personally summarize the mechanisms of pain into three categories: the first category of pain comes from bony structures, such as spinal instability and spinal fractures; the second category of pain comes from soft tissues, such as injury to paraspinal muscles; and the third category of pain comes from nerves, such as pain caused by herniated discs compressing nerves. In many cases the three categories of pain are not distinguished in such detail, and to a certain extent the three will also affect each other and be mutually causal. 2.What is the mechanism of action of lumbar circumference? The causes of low back pain are summarized above, and all conservative or surgical treatment options for low back pain at this stage are actually centered on these three aspects. The main function of the lumbar girth as an external similar to the existence of external fixed brace form of trauma orthopedics is to: 1. protect the lumbar muscles, so that the lumbar muscles are relaxed, when the human body stands daily, there is a certain tension in the paraspinal muscles of the lumbar back to maintain the upright posture of the human body, lumbar pain will make the spine fixed in a pain-free position, which eventually leads to spasm of the lumbar muscles, and spasm in turn will intensify Low back pain, forming a vicious circle, after wearing the waist circumference can partially replace the role of the lumbar back muscles to maintain the body’s posture, improve the force on the muscles of the lumbar back, so that the muscles are relaxed and slow down low back pain; 2, restrict the activities of the spine, the unstable activities of the spine is a major cause of low back pain, wearing the waist circumference to a large extent can limit the activities of the waist, the activities reduce the local repair of spinal injury can relieve pain. 3, waist circumference in the end there is no effect? Whether the waist circumference has any effect or not, many patients in the outpatient clinic will have questions about this issue. From the available literature, for patients with acute low back pain, the effect of wearing a waist brace for low back pain is relatively certain, as reported by Calmels, Pope and others; for patients with a previous history of low back pain, the effect of using a waist brace for low back pain prevention has also been confirmed, as reported by Roelofs, Jellema and others; but for patients with chronic low back pain, the effect of brace treatment is not clear. The effectiveness of brace therapy is unclear, and the literature does not currently support the application of lumbar aprons for this population. In personal analysis, acute low back pain is related to acute injury to the body structure, and wearing a lumbar brace provides a relatively good healing environment for the acute injury, and the low back pain is naturally relieved after the structure heals; while in chronic low back pain, the injured structure undergoes the process of injury-repair, and this process has become chronic, and short-term wearing of a lumbar brace does not fundamentally The dynamic evolution of the injury-repair process. 4.What kind of waist brace should be used? The theoretical basis (the mechanism of action of waist circumference) and clinical practice (whether waist circumference is effective) have proved the efficacy of waist circumference in the treatment of low back pain, so why do many patients still have the illusion that “waist circumference is useless”. In addition to the fact that no treatment can be guaranteed to be 100% effective, another very important reason is the incorrect choice of waist circumference. The quality of many patients’ waistbands is abysmal. There are many designs of waist circumference, different shapes, it is difficult to speak clearly at once, but based on the stretch performance of the waist circumference, broadly speaking, there are two types, including stretchable waist circumference (flexible) and rigid waist circumference (rigid), everyday we are using rigid waist circumference, personal summary rigid waist circumference should meet the following requirements: 1, the waist back should have sufficient strength, can complete the waist support function 1, good waist circumference in the waist are added with sufficient strength of metal material; 2, waist back support should have sufficient length and width, the length should be up to the lower edge of the ribs, down to the iliac spine below, the width should be appropriate to wrap around the entire waist back; 3, good waist circumference waist back support should have the shape of the waist physiological curvature; 4, waist circumference elastic combination of parts should have sufficient strength, in the bending waist circumference of the Diameter can not change too much, so too big or too small waist circumference is not suitable. Waist circumference that meets the above requirements can achieve the three points of support (3 points restraint principle, rib cage, pelvis, abdomen in front of the three points of support) to meet the waist circumference to limit the waist activities and relax the waist muscle effect. 5.How to bring the waist circumference? After choosing the right waist circumference, you also need to pay attention to wearing it correctly. I generally require patients to wear a waist brace when they get up and move around, but not when they are lying in bed. It is important to note that many patients with low back pain get up from bed to save time and wear a waist brace, which is not the most appropriate method. The correct way is to wear the waist brace in bed and then sit up in a side-lying position supported by one upper limb. The point that needs to be emphasized is that the waistband needs to be worn to ensure that it can complete the three points of support, too short waistband wear after the effect is not. 6.How long is it appropriate to wear a waist brace? There is no unified clinical opinion on the time to wear a lumbar girth, mainly based on the specific disease, different diseases have different requirements for wearing a lumbar girth, generally recommended to wear about 3 months, the longest time is not more than 6 months. As a therapeutic measure, it is not recommended to wear a waist brace as a long-term treatment option because of the possibility of weakening of the core muscles and restriction of spinal movement over a long period of time. In 2005, the North American Spine Society recommended that for patients with acute low back pain (less than 6 months), the use of a lumbar brace for a short period of time (1 to 3 weeks) is relatively effective.