Why are braces used as a treatment for osteoarthritis?
Osteoarthritis (OA) causes inflammation in your joints. This inflammation can restrict how much you move. Although knee arthritis is the most common type, joints such as the ankle, neck, shoulder, and wrist can also be affected.
When you’re first diagnosed with arthritis, your doctor will likely recommend nonsurgical treatments to relieve discomfort and disability. One such recommendation can be to wear a brace.
Some of the benefits of wearing a brace as a treatment for OA include:
Enhanced stability: Braces are intended to shift weight away from the damaged area of your joint, thus helping to reduce pain and discomfort.
Reduced swelling: Some braces provide compression, which can help to reduce swelling that occurs after activity for those with arthritis.
Reduced pressure: If your kneecap or ankle bone has weakening joints underneath, a brace that has a cutout area can help to reduce pressure and relieve discomfort while supporting the surrounding areas.
Increased confidence: Wearing a brace and knowing you have extra support can give you greater confidence when completing daily tasks.
What types of braces work for OA?
Braces for OA may be made from a combination of materials, such as plastic, metal, or other similar components. They may be padded with synthetic rubber, foam, or other soft materials.
Pharmacies, medical supply stores, and online stores are all good places to find braces for OA.
Several different types of braces exist, and not all are suitable for those with OA. Following are the four main types:
Prophylactic braces protect you from injury, usually when you play a sport.
Functional or supportive braces support you if you’ve already injured a joint.
Rehabilitative braces limit movement of a joint to allow time for healing. They are most often used after you’ve had surgery or a joint set in place.
Unloader or offloader braces are the most common type used by people who have arthritis of the knee because they reduce pressure on key areas.
The most common brace types used for OA are functional and unloader.
Braces also vary based on what part of the body needs support:
The American Academy of Orthopaedic Surgeons (AAOS) recommends a lace-up ankle brace to treat mild to moderate pain in your foot and ankle. However, if you have moderate to severe pain, the AAOS recommends a custom-made leather or plastic ankle brace.
Arthritis of the back and spinal disks can be reduced by using braces or corsets. Corsets are usually made of a stretchy fabric and adjustable. Braces tend to be more formed and have metal moldings. If you have a vertebral fracture due to OA, you may benefit more from a brace than a corset.
As knee OA is one of the most common types of arthritis, several brace types are available for this condition. Custom knee braces are also an option, although they cost more money.
Unloader brace: Unloader braces are made from molded plastic and foam padding. They typically have steel struts that keep your knee from wobbling. These are often custom knee braces that are adjustable to reduce pressure on the inner or outer portion of your knee. They can be bulky in size.
Hinged knee brace: A hinged knee brace often has a hole for your kneecap and straps above and below your knee for stability. They have a “hinge” portion on either side of your kneecap to support movement and walking. These braces are often sold over the counter and used for knee instability.
Drop-lock hinged brace: A drop-lock hinged brace is often used after an injury or surgery because it has an adjustable hinge. This hinge can “lock” and prevent your knee from overextending or excessively flexing.
Neoprene sleeve brace: This brace type can come with the kneecap area cut out. It’s often pulled up and over the knee. It has a low profile and can be worn under pants. However, it may not provide the same level of support as the previously mentioned braces.
Shoulder braces for OA can provide lightweight support but restrict movement. They often cross over your shoulder and compress the upper portion of your arm. Some shoulder braces are available that also provide support to your upper back, crisscrossing over your upper body.
Assistive devices for wrist arthritis include splints, braces, and gloves:
Splints immobilize your wrist, which can reduce arthritis pain.
Compression braces are similar to very tight gloves and can help reduce swelling.
Wrist wraps may have an open area for your thumb and sometimes a metal support for your hand. These can provide support for those who frequently type on computers, garden, or play tennis.
Arthritis gloves provide compression as well as create body heat, which can help to relieve inflammation.
What are the benefits and drawbacks of a custom-fit brace?
If you’ll be wearing a brace longer term (as is often the case for those with OA), you may wish to consider a custom-fit brace. Your doctor will write a prescription for a brace and refer you to an orthotist. These medical specialists will take many measurements of your joints, movement patterns, and more to build a custom-fit brace.
A custom-fit brace is ideally the most comfortable and effective brace you can wear because it’s made exactly for you. However, they can be very expensive, sometimes costing around $1,500. Some insurance policies may pay for all or a portion of the cost. Also, this type of brace can take time to create. Many people wear a temporary brace until their custom one is completed.
What are the limitations of using a brace for treatment?
Not all people with OA benefit from a brace. A brace’s effectiveness often depends on where OA has caused areas of instability and damage. For example, if you have damage to the medial compartment of your knee, a brace can help because it places more support on your outer knee. If you have a tear or injury to your anterior collateral ligament, you’ll likely needs surgery to stabilize your knee.
According to a research review, braces have limited effectiveness because people wouldn’t wear them. The reasons they stopped wearing the brace included:
Discomfort: It’s possible the added weight could feel bulky and heavy.
Skin breakdown: Adjusting to a brace can result in chafing of the skin. An improperly fitting brace can also cause redness and irritation.
Swelling: While braces can reduce swelling, some people may experience swelling as a side effect of wearing a brace.
In addition to these considerations, knee braces may not be as effective as other methods of relieving arthritis pain. This can include weight loss to reduce pressure on joints and exercise to reduce stiffness.
When should you call your doctor?
Even if a brace is custom-fitted for you, you shouldn’t wear it if it hurts you. While you can expect some skin soreness or scratching the first few times you wear a brace, always call your doctor if it hurts more to wear the brace than it does to not wear it.
You should also contact your doctor if your OA symptoms worsen to the point where you can no longer move easily or the pain is unmanageable.