“We should trust in our sensory perception”

When it comes to non-specific back pain, orthopedic specialist Susanne Gramatté recommends targeted multi-modal treatment. Here, supports and braces play a crucial role – as does active patient compliance.

“Nobody should be in pain.” This is how Susanne Gramatté describes what motivates her as an orthopedist. After all, she did specialize in pain therapy. She offers patients who suffer from back pain and come to see her in her practice at Sana Health Center in Berlin, Germany, a “cornucopia of treatment options,” that also includes supports and braces. The first step, however, has to be a thorough examination. And that starts on the way from the waiting room to the treatment room, where Susanne Gramatté closely watches all patient movements. “I first have to check for certain red flags,” the physician from Brandenburg explains. That means: is the pain limited to a specific area, does it radiate, is the intestine or the bladder affected, are there neurological impairments in the arms or legs? Has the patient been ill or suffered a fall? Then she performs function tests and examinations for which patients have to get undressed. “Initially, that’s more important to me than an MRI,” Susanne Gramatté emphasizes, even if many patients ask for it.

But the orthopedist trusts in her “miraculous tools of the trade”: looking closely at patients, touching them, finding the cause of the pain by feel if you will. “Sometimes it’s enough to put my hands on someone’s shoulders to feel the body tension.” And once she has found out about circumstances in the patient’s private or professional life, aspects related to activity and exercise, Susanne Gramatté is right in the middle of multi-modal treatment. “I also try to determine the patient’s mental state,” she explains. That is not the only area that has suffered from COVID-related restrictions. “I have noticed a significant increase in back pain since then.”

Supports and braces make exercise easier

If acute conditions have been excluded, the specialist discusses the individual path to pain reduction and freedom from pain with her patients. Sometimes, the cause cannot immediately be identified. But pain can quickly be reduced. Some prefer an injection, others decline it deliberately. According to Susanne Gramatté, the most important pillar of non-medication-based treatment is physical activity and, “not just once a week when instructed by the physical therapist, but every day at home.” All measures that enable an independent life are important. This is where supports and braces come in, which the physician has been using for more than ten years. For any pain in the lower lumbar area, not only in the sacroiliac joint, she recommends the SacroLoc for stabilization and has noticed excellent compliance: “98 percent of patients are happy with it and use it.” If the pain is higher up, Susanne Gramatté recommends the LumboTrain which many patients perceive as a stabilizing hand in their back because of its massaging nubs.

The LordoLoc is used less often. Susanne Gramatté prescribes it following a vertebral fracture or spine surgery. In these cases, the goal of treatment is mobilization while reducing certain movements. For braces to achieve optimum compliance – as well as effectiveness, the important thing is that they have to fit properly, don’t pinch and are worn regularly: during exercise, too, and even during physiotherapy as well as when returning into sports. Unfortunately, many people – even physical therapists – still think that a support inhibits muscle development, which the trained pain therapist laments. In fact, we know that the opposite is true: “Owing to the provided stabilization, it prevents patients from adopting movements to avoid the pain, thus reducing excessive one-sided strain. It promotes circulation, massages and activates the muscles.”

Less medication, more empowerment

Supports and braces provide older patients, who often have to take a lot of medication, with another advantage. Susanne Gramatté: “Exercise loosens tension that triggers pain. Supports encourage activity and make it easier. That’s quality of life!” After strengthening the lumbosacral area of the spine thanks to the SacroLoc or LumboTrain, patients can do their exercises and go shopping or for a walk with more ease. Fresh air is also good for mental health. “Supports and braces return a little bit of control and empowerment to patients,” summarizes Susanne Gramatté. “We should trust in our sensory perception more and rely on the self-healing powers of nature.”

Patient empowerment is also supported by Bauerfeind’s Training App, which features exercises to be performed at home, whenever it suits the patient best. “It’s important to make a note of the exercise times in the calendar,” recommends Susanne Gramatté, an active athlete herself in her leisure time. “Allocating this ’me-time’ just for oneself also has to do with mindfulness.” In addition to medication, physiotherapy and lifestyle changes, the active involvement of patients is also part of the multi-modal approach. If she is able to convince them, Susanne Gramatté’s motivation will have paid off.

Pain therapy with supports and braces

The LumboTrain support activates the torso muscles and alleviates low back pain. It stabilizes and straightens the lumbar spine. A massage pad provides targeted tension relief during movement.
The SacroLoc brace compresses the pelvis with two tensioning straps and reduces nutation movement in the sacroiliac joints (SI joints). This provides stabilization and relief. Two pads massage the back muscles, which has been proven to alleviate pain in the entire lower lumbar area. Studies conducted by Leipzig University and Chemnitz Technical University have confirmed the SacroLoc’s effectiveness. White papers with summaries of selected study results are available from medical.affairs@bauerfeind.com.

Images: Bauerfeind, Thomas Lebie