Back belts and neck collars: when they help and when they slow recovery

Some braces are part of medical treatment and must be worn exactly as your surgeon or doctor says: after spine surgery when one is prescribed, after a neck injury or fracture, for a spinal compression fracture, or for a child's scoliosis brace. Never take off a collar or brace that was put on after an accident, a fall or surgery without your doctor's say-so.

This guide is about the other, much more common situation: ordinary back or neck pain, where a belt or collar is bought for support or comfort.

For common low back pain, clinical guidelines such as those from NICE in the UK advise against belts and corsets as a treatment, because studies have not shown that they improve recovery. Research on belts for preventing back pain in workers who lift has also not shown a clear benefit.

A belt can make you feel more secure for a few days when pain is severe, and some people find it helps them get through a journey or a necessary task. That is reasonable. The problem is wearing it all day, every day, for weeks. Your back is supported by your own muscles, and they work best when they are used.

People who rely on a belt also tend to start believing their back is fragile and must be protected. That belief, more than the belt itself, often keeps people moving stiffly and avoiding activity, which can make pain last longer.

Soft cervical collars are often advised for neck pain and "cervical spondylosis" seen on an X-ray. For ordinary neck pain, keeping the neck moving gently tends to lead to a better recovery than holding it still in a collar. Studies of neck strain after road accidents, for example, have found that early movement does better than immobilising the neck.

Brief use, such as on a long bus journey in the first days of a painful neck, is reasonable if it makes you more comfortable. Long-term daily use is not advised for ordinary neck pain.

If you have been wearing one for weeks, you do not need to throw it away today. Start by taking it off at home and while sitting, then for short walks, and keep it only for the activity you find hardest. Over a week or two, most people find they no longer reach for it.

At the same time, start gentle exercises for the back or neck and build them up. A physiotherapist can show you which ones suit you and check that you are doing them correctly, so that your own muscles take over the job.