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When muscles weaken, people living with ALS may find it harder to hold their head up, raise their arms, or lift their feet. Without additional support, muscles can stiffen and daily activities can become more difficult and painful.
Braces, also known as orthoses, can help you stay safe, have more energy, and experience less pain and discomfort. Getting the brace you need—sooner rather than later—can help you remain more independent and improve your overall quality of life. |
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If you notice that it is getting more challenging, or taking more effort, to walk or do other daily activities, contact your ALS clinic or neurologist to ask about braces and other interventions.
Neck Braces
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If you find that your neck muscles are getting weaker and it is more challenging to hold your head up, a neck brace, often called a cervical brace or collar, can support the weight of your head and take the strain off your neck muscles.
A cervical collar can help you look straight ahead and engage more easily in daily activities like socializing, using the computer, and watching TV. It can also reduce your neck and shoulder pain, save you energy, improve your posture, and help with balance. |
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There are many different types of neck braces. Your physical therapist or orthotist can assess your individual needs and recommend the best one for you. These premade neck braces come in different sizes and can be adjusted.
The two most common styles for people living with ALS are:
The two most common styles for people living with ALS are:
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Headmaster Collars
This type of neck brace has an open design with a padded metal frame. You can bend the frame to adjust it. If your head falls to the side, you may need a more supportive neck brace. |
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Cervical Neck Collars
This stronger, more supportive neck collar has a rigid plastic structure, foam padding, and a greater surface area to support your head. This type of cervical collar will prevent your head from dropping or falling to the side. |
Wrist braces and hand splints
If you are noticing that it is getting more challenging to do daily activities with your hands, such as eating, picking things up, or holding a brush, a brace or splint may help you regain function and remain more independent.
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Functional Wrist Brace
If the muscles in your wrist are weak but you can still use your fingers, a functional wrist brace, also called a cock-up wrist splint, can help stabilize your wrist so you can use your fingers to do things like type, text, write, eat, and grasp. |
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Resting Hand Splint
If your hands and fingers tighten or curl, a resting hand splint can help provide a prolonged stretch to the wrist and fingers, which may reduce stiffness and pain. The resting hand splint holds your wrist, hand, and fingers in a neutral position to prevent them from contracting. |
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Finger Splint
If your fingers are curling so much that it’s preventing you from doing daily activities, finger splints can help align and stabilize the middle joints of your fingers. You can wear these splints during the day and/or at night. |
Ankle Foot Orthoses (AFOs)
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If you are having difficulty walking because your foot is dragging or catching on the ground, an ankle foot brace, usually referred to as an AFO (ankle foot orthosis), can make a big difference. Foot drop is common with ALS, and AFOs can help stabilize your foot to create a safer and more efficient gait.
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AFOs have thin footplates that insert into your shoes and connect with support struts that wrap around your calf and/or shin. When you step with an AFO, it helps lift your foot to clear the ground and land back on your heel. These braces support your gait and can allow you to stay safe, conserve energy, and continue to walk independently.
These are the three designs most commonly used by people living with ALS:
These are the three designs most commonly used by people living with ALS:
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Standard AFO
This premade brace, sometimes called a posterior leaf spring AFO, wraps around the back of your calf and helps if you have foot drop but no knee or hip issues. |
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AFO with Knee Support
This premade carbon fiber brace, also referred to as a ground reaction AFO, provides knee support as well as foot and ankle support. |
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Custom AFO for Additional Support
If you need more support than the off-the-shelf options above, your occupational therapist or orthotist can fabricate a custom AFO that covers your foot, prevents ankle movement, and provides greater overall support and stability. |
Can stretching help?
As ALS progresses, you may experience stiff and tight muscles due to your body moving less on a daily basis. When the muscles around your joints tighten and contract, this can cause stiffness and pain, which can reduce your mobility, flexibility, and ability to complete daily tasks. You can alleviate joint pain and maintain greater flexibility by doing range of motion (ROM) exercises.
Where can I get braces?
You can find many braces online and in stores, and there is a chance you will find one that works well for you. However, we recommend starting with your ALS clinic or local medical team. There is no substitute for experienced professionals who can assess your individual needs, prescribe the right style of brace for you, and answer your questions.
If you get a prescription from your doctor, Medicare should cover 80% of the cost of your braces. Medicaid, supplemental plans, and secondary private insurance should pay for the remaining 20%. If you have Medicare but do not have Medicaid, a supplemental plan, or secondary private insurance, you will likely have to pay the remaining 20% out of your own pocket.
If you are facing out-of-pocket expenses that you cannot afford, ask your local ALS organization if they can lend you a brace from their loan closet. If not, talk with your durable medical equipment (DME) provider and/or local ALS organization about financial assistance options.
Military veterans: Your coverage for equipment, including braces, is different than what is listed here. Learn more.
If you get a prescription from your doctor, Medicare should cover 80% of the cost of your braces. Medicaid, supplemental plans, and secondary private insurance should pay for the remaining 20%. If you have Medicare but do not have Medicaid, a supplemental plan, or secondary private insurance, you will likely have to pay the remaining 20% out of your own pocket.
If you are facing out-of-pocket expenses that you cannot afford, ask your local ALS organization if they can lend you a brace from their loan closet. If not, talk with your durable medical equipment (DME) provider and/or local ALS organization about financial assistance options.
Military veterans: Your coverage for equipment, including braces, is different than what is listed here. Learn more.
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Coming Soon!
Stay tuned for our comprehensive ALS Braces Guide, which will include more videos and in-depth information on braces and splints for people living with ALS. |
Your ALS Guide developed this page in collaboration with orthotist Reese Evans from Hanger Clinic and occupational therapist Melissa Werz and physical therapist Laura Good from the Duke ALS Clinic.
