The Milwaukee brace is a type of back brace which is worn to correct curves in the mid back, also known as the high thoracic spine. This type of brace is among the most restrictive of back braces, because it runs from the pelvis all the way to the neck, and for this reason, it is only prescribed when it is the most suitable option for a patient. Patients with lower spinal curves may wear a Boston brace or another type of brace which is less restrictive.
This spinal brace was introduced in the 1940s for the purpose of slowing the progression of spinal curvatures like scoliosis. The Milwaukee brace became the standard of care until other, less restrictive braces were introduced, and it continues to be used today for correction and control of curvature in the high spine.
This brace is introduced in childhood, and worn through adolescence as the body grows to control the curvature of the spine. The brace consists of a pelvic girdle attached to a series of rods and pads which connect with a neck ring. While the brace is worn, it holds the back in place. To be effective, a Milwaukee brace usually needs to be worn 23 hours a day for several years. While wearing the brace, the patient should be able to engage in normal physical activity, and in fact, this is encouraged to promote health.
For patients, wearing a Milwaukee brace can be very frustrating. The brace can feel restrictive, if it is not fitted properly it can chafe the skin, and it can damage clothing and make it difficult to wear fashionable clothes. Some of these problems can be addressed by wearing a brace which is properly fitted and getting a doctor to confirm that the brace is properly fitted. Observing a proper skin care regimen to protect the skin is also important, as is putting the brace on correctly so that it does not twist on the body. Fashionwise, the patient will need to wear loose clothing, but some loose styles can be worn fashionably, and some charitable organizations provide patients in braces with fashion consultants to help them dress more confidently.
Also known as a cervico-thoraco-lumbo-sacral orthosis, the Milwaukee brace can be custom made, using a mold of the patient's body, or put together with prefabricated parts which are adjusted by a doctor. Patients need to periodically see their doctors to monitor the progress with the brace, and so that the doctor can make adjustments as needed, including fitting new braces as the patient grows older. Although the brace is not exactly pleasant to wear, the alternatives are worse; the patient may require surgery to rod and fuse the spine, for example, or the patient may be left with severe spinal curvature which impedes quality of life.