The Physiologic brace® for thoracolumbar kyphosis

brace for flatback, thoracolumbar kyphosis

The physiologic brace® is a sagittal re-alignment brace. It addresses back pain and spinal instability for patients with thoracolumbar kyphosis (flatback) and lumbar kyphosis. The brace uses sagittal forces to attempt correction and reduce pain. In certain cases, it can also be used for treating chronic back pain in adult patients without scoliosis or with mild scoliosis (1).

Some adults who have previously worn scoliosis braces (not 3D style braces) have experienced flatback, and the problems associated with flatback. Those braces failed to address the sagittal plane and “reduced sagittal diameter” (2). This side effect may be the cause of lumbar back pain in formerly braced patients.

Physiologic brace® success story

We recently braced a young adult from California who was in significant pain due to a thoracolumbar kyphosis. His parents had taken him to see top spine doctors in New York and Los Angeles with no acceptable solutions offered. (Most people don’t consider the need for continual pain medication, or surgery, an acceptable solution to severe back pain–especially for a college student).

His mom found us online and called to inquire. We asked her to share his x-rays with us. After seeing them, Dr. Marc felt this young man might be a candidate for the Physiologic® brace but wanted to evaluate him to be sure. Fortunately, Dr. Marc was scheduled to be in California in late January. While there he evaluated the young man, determined the Physiologic brace® would indeed be appropriate, and measured him for the brace. A couple of weeks later, the young man and his mom made the trip to Boston so he could be fit. His pain reduced significantly in the brace, almost immediately. It’s been about a month now and he reports being mostly pain-free when he wears the brace. While here, he also participated in a few hours of scoliosis-specific exercise instruction to address the thoracolumbar kyphosis. The objective of the Schroth Best Practice® exercises are to improve lordosing of the spine in the thoracolumbar region.

Dr. Marc is looking forward to checking in with this young man again in April on his next visit to California.

The Physiologic Brace® is relatively small and compact. It is fairly easy to hide under clothing. It was developed in Germany in 2004 and in the US, it is only available at Scoliosis 3DC.


(1) Weiss HR, Dallmayer R, Stephan C. First results of pain treatment in scoliosis patients using a sagittal realignment brace. Stud Health Technol Inform 123: 582-585, 2006.

(2) Willers U, Normelli H, Aaron S, et al. Long-term results of Boston brace treatment on vertebral rotation in idiopathic scoliosis. Spine. 1993;18:432–5.