Clinical effectiveness of lumbosacral orthoses in chronic non-specific low back pain: a systematic review.

Introduction: Chronic non-specific low back pain (CLBP) is a common and disabling condition. Lumbosacral orthoses are used in conservative care, but their clinical benefit remains unclear. This systematic review evaluated the clinical effectiveness of lumbosacral orthoses in adults with CLBP. Methods: A search was conducted in PubMed, Scopus, Ovid, PEDro, and Web of Science up to July 2025. Randomized controlled trials (RCTs) investigating lumbar or lumbosacral orthoses in adults with CLBP were included. Methodological quality was assessed using the PEDro scale, and the level of evidence was classified descriptively using the Oxford Centre for Evidence-Based Medicine framework. The review followed the PRISMA 2020 guidelines. Results: Eleven RCTs involving 691 participants were included. The studies used different types of lumbosacral orthoses, including rigid, semi-rigid, soft, extensible, and inextensible designs. Intervention duration ranged from a single session to 12 months. Several studies reported improvements in pain or disability after lumbosacral orthosis use, especially in short-term intervention periods. The findings were not consistent across studies, and meta-analysis was not possible because of methodological heterogeneity. No study reported orthosis-induced muscle atrophy, but adverse effects, adherence, and patient tolerance were not consistently assessed. Objective neuromuscular outcomes and psychosocial measures were also limited. Discussion: Current evidence suggests that lumbosacral orthoses may be helpful for selected individuals with CLBP, especially when used as part of multimodal rehabilitation. Further high-quality RCTs with standardized protocols and longer follow-up are needed.