Question: I have Parkinson's disease, macular degeneration, and spinal stenosis with two bulging discs (L4 and L5) and pain 24/7. I am taking 1.5mg Mirapex three times daily, selegiline 5mg cap HCL twice a day, and 50/200 Sinemet CR three times a day. I take Loratab 7.5 for pain three times a day, and methocarbamol 750 mg tab as needed for muscle spasms in my back. The shaking is pretty much under control, but the "stooping" from Parkinson’s is aggravating my back. Do you think a back brace would help? I am disabled and go to the VA for health care.

The stooped posture so commonly associated with long term Parkinson's disease is best treated with aggressive physical therapy. While free-form fiberglass or plastic back braces may temporarily help with acute pain and fracture management, they limit movement, are bulky, and are used long-term only when all other measures have failed for pain management in non-surgical patients.

The best initial treatment involves management of your pain, aggressive physical therapy to recover lost range of movement, and adjustment of your meds so that you remain mobile and independent of braces and wheelchairs. Once you restrict your mobility, bones thin faster, degenerative changes from non-use occur in soft tissue and muscle, and discomfort is often amplified.

A back brace may be used for comfort while you begin toning, but it should be seen as only a temporary fix, not long-term. If your stooped posture is related to compressive changes or fractures of your vertebrae, or your pain is not responding well to medical treatment, ask your doctor for orthopedic and/or neurosurgical consultation. You may well be a candidate for kyphoplasty, a procedure where a balloon device helps restore height to collapsed vertebrae. You may also need evaluation for osteoporosis that may be arrested, or at least slowed, by additional intervention.