HF 7962

Using Your CASH Hyperextension Spinal Orthosis (Brace) at Home


Your CASH hyperextension spinal orthosis helps to control and support your spinal posture, reduce pain, prevent further injury, and promote healing. It will remind you to keep your back upright and straight. It is often prescribed to treat compression fractures or fractures on the front side of the spine.


Wearing Your Brace

The brace will keep you from bending forward. It should be uncomfortable when you begin moving into positions you should avoid. You should be able to do many normal activities by yourself or with a little help from caregivers or special tools. Ask your doctor or occupational therapist for detailed guidelines.

Preparing for Your Trip Home

You will need someone to drive you home. Bend at your hips and knees, but not your back when getting in and out of a car, sitting, or standing. To relieve pressure from the front pads when sitting, try leaning back over a firm pillow, towel, or blanket behind the back pad of your brace. Sit in a reclining chair. Do not loosen the brace’s strap.

Taking off the Brace

You must wear your brace as ordered by your doctor. To remove it, lie down and open the straps. While the brace is open or off, be careful not to twist or bend your back.

Roll to your back.

  • Undo Velcro on the right side, remove from chafe and open brace like a book.

  • Have a helper slide the brace out from under you.

Putting on the Brace

Always wear the brace over a clean, dry T-shirt. Put on your brace while lying down. Roll onto the back pad and strap without twisting or bending your back (you may need help from a caregiver). You may also have a helper slide the back pad under you while you are lying on your back. Then close the brace like a book over the front of your body.

Insert the right-side Velcro strap through the chafe opening, fold over onto itself and pull to tighten. You do not need to adjust the strap each time. Close the strap snugly so the brace controls your back movement. If the brace “rides up” or twists out of position, it is too loose. For the brace to support and protect your spine, it must be worn very tightly.

If this is difficult for you try this:

  1. Move to one side of your bed by using your arms and legs to move your hips over. You can have a caregiver pull the sheet under you over to one side.

  2. Roll to the opposite side of the bed almost onto your stomach. To do this
    bend both legs by sliding your heels toward your buttocks.

  3. Push with your heels and roll onto your side. Do not twist. Roll like a log.

  4. Have your caregiver position the front half of the brace with you lying on your side. Make sure the upper pad is across your breastbone or sternum and the lower pad is across the front of your lower trunk or pubic bone.

  5. Next, position the back of the brace around to your back or slide it under the side of your body.

  6. Hold the pieces of your brace in place and log roll onto your back.

  7. Attach the front and back pieces of the brace together as above using the Velcro strap.

  8. Check to see that the brace is aligned before getting up. Adjust if needed.


If your doctor has ordered you to always wear your brace when standing or sitting, you can wear the brace in the shower. You can have a sponge bath while lying on your bed without the brace. If you cannot wash and dry under pads of the brace while wearing it, you will need to lie on your bed and remove the brace for a short time. Be careful not to twist or bend your back while it is off. After your skin and the pads are all dry, put on a T-shirt and apply the brace snugly before sitting or standing. The brace may be worn with wet straps, or you can dry the straps with a hair dryer set on low.

If your doctor allows you to shower without the brace, remove it just before starting the water and put it on again as soon as you dry off. While it is off, be careful not to twist or bend your back. This is only for patients who have their doctor’s permission.

Sleeping in the Brace

Your doctor will tell you if you should wear your brace while sleeping or lying down. Your doctor may change these instructions during your course of treatment. If you can remove the brace while sleeping, be sure to put it on before you get up. If you need to go to the bathroom during the night, it may be easier to keep the brace on.

Cleaning the Outside of Your Brace

Wipe off the outside with a damp or soapy cloth, or baby wipe and then dry. The straps can air dry while the brace is being worn. The Velcro hook fastener will hold best if all the lint is removed.

Cleaning the Inside of Your Brace

When your brace is removed for your bath, wipe the inside with a damp cloth or baby wipe. If you prefer, you may also use a mild soap that you would use on your skin. Rinse the soap from the brace and dry the entire inside before you put it on again.

How long do I need to wear the brace? Your doctor will decide how long you need to wear your brace. Follow your doctor’s advice, even if you feel better and would like to stop wearing it sooner. Your doctor will be checking your progress and will decide what is in your best long-term interest.

When to Call

Do not expect to be able to move in all directions or sit in all types of chairs. The brace is designed to limit certain motions and positions.

  • If you have redness in certain spots or around your brace, call your orthotist, the person who made or fit your brace. They can make changes to your brace so it will not rub.
    Redness over a large area of skin or pink skin is normal.

  • If your neurological symptoms get worse and you have more numbness, tingling, pain, loss of bowel or bladder function, are less able to move or do daily activities.

Who to Call

Patients of the Neurosurgery Clinic
(608) 263-1410

Patients of the Orthopedic Rehabilitation Spine Clinic
(608) 265-3207

After hours, weekends, and holidays, this will give you the paging operator. Ask for the resident on call for your clinic. Leave your name and phone number with the area code. The doctor will call you back.

If you live out of the area, please call 1-800-323-8942 and ask for your clinic.

If the brace needs adjusting after you leave the hospital, please call:
UW Health Orthotics Clinic
(608) 263-0583