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Bed Rest for Back Pain?

| Jeremy Kethley |

Article written by:  Erin Kethley, MPT

Many people who experience an acute onset of back pain might consider a couple of days of bed rest to be the first thing to try.  In fact, in the past, bed rest and medications were indeed considered to be the primary treatment for low back pain.  Actually, it wasn’t until the 1980’s that it’s efficacy in the treatment of back pain came into question.  The truth is that current research shows that it will not fix the problem and can actually make it worse.  Studies have shown that people who stay active during episodes of back pain do better than those that are sedentary.

Evidence not only shows that prolonged bed rest does not improve outcomes, but that it is strongly associated with negative outcomes such as more days off work, intensity of pain, and disability.  So, not only can bed rest make the pain worse, but it can also lead to other problems such as decreased strength/muscle atrophy, cardiovascular deconditioning, loss of bone density, depression, and blood clots.  Prolonged resting in bed means limited mobility.  Our spines need motion in order to move nutrients to the vertebral discs.  A lack of motion can cause a loss of strength and impair the spine’s ability to recover after injury.  Studies show that people lose 2-5% of their strength per day of complete bed rest.

Additionally, research has shown that light activities, such as walking, reduce the need for medications.

Although some people may need to temporarily modify their activities during an acute phase of back pain, most people should be encouraged to avoid bed rest and resume their normal activities as soon as possible.  In extreme cases, bed rest may be necessary, but it should be minimized to the shortest time possible. Also, a tailored exercise program appears to speed recovery and decrease future episodes of low back pain.  Active patients experience less pain and will avoid the side effects of immobility.  It is also important to note that you should always seek medical attention from your physician for severe pain or pain that lasts greater than one week.