Using Your Hyperextension Spinal Orthosis (Brace) at Home
Your CASH Hyperextension Spinal Orthosis
helps control and support your spinal
posture, helps reduce pain, prevents further
injury and promotes healing. It will remind
you to keep your back upright and straight.
It is often prescribed for the treatment of
compression fractures or fractures on the
front side of the spine.
Wearing your CASH Hyperextension
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
Preparing for your trip home
Arrange for someone to drive you home.
Bend at your hips and knees, but not your
back when getting into 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 CASH or sit in a
reclining chair. Do not loosen the brace’s
Taking off your 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
1. Roll to your back.
2. Undo Velcro on the right side, remove
from chafe and open brace like a book.
3. Have a helper slide the brace out from
Putting on your CASH Hyperextension
Always wear the orthosis 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
To close the straps, insert the right side
Velcro strap through the chafe opening, fold
over onto itself and pull to tighten. You do
not have 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 in
the proper manner, it must be worn very
If this method is difficult for you, try this:
1. Move to the side of your bed.
ξ Use your arms and legs to move your
hips over, or
ξ 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.
ξ Bend both legs by sliding your heels
toward your buttocks.
ξ Push with your heels and roll onto
your side. Do not twist! Roll like a
3. Your caregiver should 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.
4. Next, position the back of the brace
around to your back or slide it under the
side of your body.
5. Hold the pieces of your brace in place and
log roll onto your back.
6. Attach the front and back pieces of the
brace together as above using the Velcro
Check to see that the brace is aligned before
getting up. Adjust if needed.
If your doctor has told you to wear your
brace at all times when standing or sitting,
you can wear the brace in the shower or
have sponge baths 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 option 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 based on
changes in your condition. If you are
allowed to 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 CASH. Be sure to 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
Things to Remember
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
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.
What if the brace needs adjusting once I am
out of the hospital?
UW Health Orthotics Clinic:
(608) 263-0583 to schedule an appointment.
What should I do if my neurological
symptoms get worse?
If you have more numbness, tingling, pain
or are less able to move or do daily
Patients of the Neurosurgery Clinic:
Patients of the Orthopedic Rehabilitation
Spine Clinic: (608) 265-3207
After hours, nights, 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.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 2/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#7962.