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.