A back support system that comprises a belt portion (101) being configured to provide back and abdominal support encircling a wearer&rsquos waist, a compression pants (103) portion and a hot or cold pack providing therapy to a wearer&rsquos lumbosacral region. The belt portion has a left and right portions and a rear portion that extends upwardly from a cutout of the rear portion of the compression pants and is attached fixedly thereto. The rear portion of the belt portion has a pack support structure for receiving a hot or cold pack so as to maintain hot or cold therapy on the wearer&rsquos back. Slots in the belt portion may accommodate vertically extending inserts of rigid plastic or spiral metallic to reinforce the belt portion over the lumbosacral region of the wearer. A front core support structure provides abdominal support in combination with the back support that supports the entire core of the wearer&rsquos body. The garment can be changed to an immobilizing brace device by inserting optional rigid inserts.
