Boston Brace: Mechanism, Indications, Cost and Complications

Amongst all the different types of back braces, the Boston brace is the one usually used for the treatment of kids and teens. 
It’s the most widely used thoraco-lumbo-sacral- orthosis or full back brace in the United States.  You need a doctors’ or an Orthotists’ prescription to wear one because it has to be specific to your case. 
This article will help you understand how the Boston brace works, what the indications for use are and how much it costs. If you’re suffering from a condition for which you need a Boston brace, then this post will help answer many of the questions you might have.  
Overview of the Boston Brace 
The Boston brace is made of rigid polypropylene material and you wear it by wrapping it around your chest, ribs, back and hips.  There’s padding inside the brace for comfort since patients have to wear it for many hours at a time. 
The main purpose of the Boston brace is to keep the spinal deformities from getting any worse. 
Recently, there’ve been advances in treatment technology and the most prominent one’s the Boston brace 3D. It’s a customized orthosis that provides corrective forces in all three planes and has room for rotational movements.
Although it’s a full-back brace, your Orthotist can prescribe you a region-specific brace such as the Boston Lumbar Brace or Boston Thoracic Brace based on your condition. 
Working Mechanism of the Boston Brace 
Just like any other spinal brace or spine alignment brace, the Boston brace works by applying steady pressure on the spine to force it back into alignment. 
The Boston brace has pads on either side that are the main areas for providing a medially directed force. The location of these pressure points is decided based on the kind of spinal deformity your Orthotist wants to treat and varies from case to case. 
The pads are placed in a zigzag shape (push-relief principle). If one of your pads is on the left side of the lower back, then the next pad will be on the right side and slightly above that level. 
This brace is prescribed for teens, and the way a Boston brace works is that when the pads apply force to centralize the spine, the developing spine of an adolescent starts to grow towards the midline. 
Your Orthotist will regularly reassess your scoliosis and measure the spinal deviations to determine if you need a better fitting Boston brace. 
The Boston brace is highly effective in fixing spinal deformities. But it takes four to five years of wearing the brace to have a full recovery. 
Indications of the Boston Brace
The primary indication of prescribing a Boston brace is Idiopathic Scoliosis. That’s the condition where the spine is curved sideways early on in life. It’s due to genetic factors and not the result of a bad posture or injury. 
The Boston brace is indicated to correct the spinal alignment of the growing spine. 
It’s used when your doctors determine that the conservative approaches will not be effective and a brace is necessary to stop the progression of the curve. 
The exact size of the brace depends on your Cobb’s angle, which is in most simple terms, the level of lateral spinal deviation from the neutral position. 
There’re also some contraindications to using the Boston brace. Obesity and psychological conditions such as claustrophobia are at the top of the list. There can be other factors as well which your Orthotist will tell you about after your physical examination. 
Boston Brace Cost
The cost of a Boston brace varies in different areas of the United States, but the average cost is around $2,600 to $3,000. The actual price can be higher depending on which design you use such as Boston brace 3D, Jacket, Night Shift etc. 
Since this treatment is a medical necessity, most insurance plans cover the cost of a Boston brace. 
Complications of Using the Boston Brace Although one of the best solutions for treating Idiopathic Scoliosis, the Boston brace has several side effects which cannot be ignored. 
Since it restricts the spine, there’re limitations to what kind of physical activity you can do and how much forward or backward bending is permitted while wearing the Boston brace. 
Here’re some more complications to watch out for when using a Boston brace: 1. It Restricts Your Breathing
Since the Boston brace demands a snug fit around your chest and ribs, you’ll find it hard to take deep breaths. Your Orthotist might refer you to a pulmonary physical therapist for breathing exercises to counter any long-term effects. 
But the restricted breathing will remain a complication as long as you’re wearing the Boston brace. It also affects the amount of physical activity you can do. 2. Effects on the Abdomen 
Weak muscles, increased abdominal pressure and bowel issues are some of the complications of using the Boston brace. 
A good Orthotist will provide you with ample instructions on how to use the brace and effective home exercise programs to reduce these problems. 3. Skin Issues and Perspiration
Hot and humid climates are a major issue for those who wear the Boston brace. 
Proper cleaning methods and safety guidelines are helpful. But since you’re required to wear the brace for 15+ hours a day, you’ll still suffer from skin rashes, pimples, and raw skin at some point.
That complication is avoidable by staying cool, using antiperspirant creams, taking care of the skin and most importantly by understanding the warning signs.  
Final Thoughts
The Boston brace is a great device to treat spinal issues in adolescents. The success rate is high and there’s evidence supporting its use for Idiopathic Scoliosis. 
If the complications become too much to handle then there’re other options you can consider. 
If you’re dealing with a new Boston brace or looking for alternative therapies, then reach out to us online or visit any one of our locations for an expert consultation with our Orthotists. 
Our multidisciplinary teams will guide you on how to properly use a Boston brace and help you with all your queries.  

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