A back brace includes an inner frame member having an interior surface, an exterior surface, a plurality of recesses formed in the interior surface, and a clamshell shape configured to wrap around a portion of a torso of a user. Each of a plurality of inserts is positioned in one of the recesses. An inflatable bladder is positioned on the exterior surface of the inner frame member, and an exterior shell member is wrapped about the bladder and the inner frame member.