This handout explains how to use your CASH hyperextension spinal orthosis. The brace helps control your posture, reduce pain, prevent injury, and support healing. Providers often order this brace for compression fractures or fractures on the front of the spine.
Wearing Your Brace
The brace limits motion. Do not expect to bend in all directions or sit in all chairs. The brace prevents you from bending forward. It may feel uncomfortable when you try to move in certain positions. You should be able to do many normal activities by yourself or with a little help. Talk to your care team about what to expect.
Going Home
Arrange for 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 straps on your brace.
Taking Off the Brace
Wear the brace as ordered by your doctor. Do not twist or bend your back. To remove the brace:
Lie flat on your bed.
Undo the Velcro strap on the right side.
Open the brace like a book.
Have a helper slide the brace out from under you.
Putting On the Brace
Wear the brace over a clean, dry T‑shirt. Put on the brace while lying down. Do not twist or bend your back. You may need help from a caregiver. To put on the brace:
Lie on your back on the bed.
Roll onto the back pad and strap.
Close the brace like a book over the front of your body.
Insert the right‑side Velcro strap through the opening.
Fold the strap back onto itself and pull snug.
If this doesn’t work:
Move to one side of the bed using your arms and legs.
Bend both legs and roll like a log onto your side without twisting.
Have your caregiver place the front pad while you lie on your side.
Make sure the top pad rests on your breastbone and the lower pad rests across the front of your lower trunk.
Slide or position the back pad behind you or have a helper slide the back pad under you while you lie on your back both parts in place.
Log roll onto your back.
Fasten the Velcro strap and check that the brace is straight before getting up.
Bathing
If your doctor tells you to wear the brace when sitting or standing, you may shower with the brace on. You may also take sponge baths in bed with the brace off.
If needed, lie down and remove the brace for a short time to clean and dry your skin. Do not twist or bend your back. After your skin and pads are dry, put on a T‑shirt and fasten the brace snug before sitting or standing. You may wear the brace with wet straps or dry them with a hair dryer set on low.
If your doctor allows you to shower without the brace, remove it just before showering and put it back on as soon as you are dry. This is only if your doctor allows it.
Sleeping
Your doctor will tell you if you should wear the brace while sleeping. These instructions may change during treatment. If you remove the brace at night, put it on before getting up. If you need to get up to use the bathroom, it may be easier to sleep with the brace on.
Cleaning the Brace
To clean the outside:
Wipe with a damp or soapy cloth or baby wipe.
Dry the brace well.
Let the straps air dry while you wear the brace.
Remove lint from the Velcro so it holds well.
To clean the inside:
Wipe with a damp cloth or baby wipe.
Use mild soap if needed.
Rinse and dry all surfaces before putting it back on.
Treatment Plan
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 to decide your care plan.
When to Call
Call if you have:
Skin redness that does not fade or causes pain.
Worsening numbness, tingling, or pain.
Trouble with bowel or bladder control.
Less ability to move or do daily tasks.
Who to Call
If you have questions, please contact your provider through MyChart or call your provider listed in your After Visit Summary or After Hospital Care Plan. For a list of UW Health Clinics, visit www.uwhealth.org/.