Bed Rest vs. Active Rehabilitation

It is a popular myth that if you are experiencing back pain, you should take to your bed until the pain subsides. But very few studies have shown the advantage of bed rest. In fact recent studies have revealed the harm bed rest can cause, such as:

• Decreasing the muscle strength in your lower back
• Increasing muscle stiffness
• Decreasing bone mineralization
• Decreasing overall physical fitness

Unless you have a truly serious condition (like disc herniation) bed rest will stunt your recovery, and it is generally recommend that if you have an onset of pain, you should return to your normal activities as soon as possible. But if you do feel the need for rest, limit it to two days, and take two or three walks during the resting period.

Active rehabilitation means returning to normal or light activities and also exercising. Movement will not cause further deterioration or harm to your back muscles, and even if you experience some discomfort while performing normal duties, it does not mean you are hurting yourself. Active rehabilitation has many benefits, such as:

• Improving disc and cartilage nutrition
• Improving posture
• Increasing bone and muscle strength
• Increasing endorphins that reduce sensitivity to pain

Regular exercise (it does not have to be strenuous), is necessary for health and well-being while you battle low back pain. Exercise improves the condition of your back, your body, and how you feel about them. Knowing that you can move, that you are not impaired, and that this current condition is not long-lasting, is the first step to recovery.

Waddell probably summed up the situation the best: "There is strongly suggestive evidence that rest, particularly prolonged bed rest, may be the most harmful treatment ever devised and a potent cause of iatrogenic disability."

Agency for Health Care Policy and Research. "Understanding Acute Low Back Problems." AHCPR Publication Number 95-0644. December 1994.
Waddell G. A new clinical model for the treatment of low back pain. Spine 1987;12:632-644.
Deyo RA, Diehl AK, Rosenthal M. How many days of bed rest for acute low back pain? A randomized clinical study. New England Journal of Medicine 1986:315:1064-1070.
Bortz WM. The disuse syndrome. Western Journal of Medicine 1984:141:691-694.
Bijgos SJ and Battie MC. Acute care to prevent back disability. Clinical Orthopedics 1987;221:121-131.

 

 

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