Sometimes rest is the most productive thing you can do for your body.
But when it comes to low back pain, resting, particularly prolonged bed rest and immobilization, runs counter to the direction you want to go to if you want your low back pain to go away sooner.
First, let us define the terms:
- Prolonged bed rest – For many years, people received the normal advice of getting bed rest when their back hurts. Some people choose to stay in bed for 48 hours or longer, or until their back pain goes away.
Understandably, it is often hard to stay active if you are in pain. Our natural inclination will be to stay still, or to stay in bed, not moving a limb, for fear that movement will aggravate the pain.
- Immobilization – For some, putting a back brace around their waist is the only way you can get them to move. They rely on a brace to make them feel that their back is stable and supported.
In this article, we will look into the research and evidence on the effect of bed rest and immobilization on low back pain.
Not moving, in order for your back pain to get better, is a myth!
Here’s what the evidence is telling us:
- Multiple research studies have shown that not moving enough can actually worsen your low back pain and not resolve the problem.
- A systematic review of studies for the management of back pain has recommendations for more, rather than less, activity in recovery.
- Long periods of inactivity or lack of movement will adversely affect your recovery from back pain.
- Finally, as you restrict the movement of your trunk, you further reduce the strength of your core and increase your lumbar instability, resulting in more back pain, not less.
Why prolonged bed rest and immobilization can slow down your recovery.
Staying in bed for extended periods of time can cause you to become stiff and exacerbate your pain. When you stay still and do not move your trunk, the strength and flexibility of your core and back muscles decrease.
Muscle strength is reduced by 1% each day while resting in bed. Take a week’s worth of bed rest and you could lose as much as 20 to 40% of muscle strength.
Also, remember that when you are always using a brace to support or stabilize your spine, the brace, and not your own muscle, is doing the work for you.
What happens when you take the brace off?
Your core and back muscles are weaker from not having the chance to do their job – that of actually supporting and stabilizing your spine!
As the days and weeks go by, your hips, pelvis, and spine become stiffer; making it harder to get back into the usual activities you’re used to doing before your initial experience of low back pain.
As your back muscles and core muscles grow weaker, and your joints become stiffer, your recovery takes longer.
The more you stay still, or sit around, or stay in bed, the worse your back pain gets.
What Sir Isaac Newton said about the first law of physics is just as true with the human body, “A body in motion stays in motion. A body at rest stays at rest.”
Who needs bed rest?
The only people who would require more time in bed and spinal immobilization are those with unstable fractures and who are awaiting surgery.
Unless you belong in the category stated above, taking prolonged bed rest or immobilizing your spine with a brace may make you feel better in the short term, but will hurt you in the long term.
What can you do for the pain?
An active approach, like walking, using a stationary bike, or light water aerobics if you have access to a heated pool, is usually the most effective.
In my book, Back Pain Unlocked, I provided unique position and movement patterns I developed to guide my patients on how to perform their daily activities without aggravating their back pain.
Some of the daily and usual activities I illustrated with pictures and step-by-step instructions include:
- How to get up and out of the bed without twisting your spine.
- How to get up from a low chair or toilet seat without putting a lot of pressure on your spine.
- How to pick up small objects from the ground. Hint: It is called a “golfer’s pick.”
- How to pick up heavy objects from the ground. Hint: It is called a “karate stance.”
- How to bend using your hips and not your back. Hint: It is called a “hip hinge technique.”
Conclusion
Bed rest and using back braces may sound like a good idea, but the truth is that there are very few people for whom it is recommended. In fact, bed rest can lead to slower recovery and increased pain because you lose muscle strength and flexibility while resting for an extended period of time.
Prolonged immobility is damaging, and rapid muscle loss, bone mineral density reduction, and other bodily functions impairment can be seen within the first week of bed rest or immobilization.
If you have low back pain or any other musculoskeletal problem, then talk to your health care provider about when it might be appropriate to use bed rest as part of a treatment plan.
Otherwise, avoid staying in bed too much – especially if you’re trying to recover from an injury. Instead, choose activities that will strengthen the muscles around the area where you feel pain or discomfort so they’ll start feeling better sooner rather than later!
Dr. Lex Gonzales, PT, DPT is an author and speaker who has been working as a licensed healthcare professional for over 24 years. On drlexgonzales.com he provides quality information and practical solutions you can use to achieve the best version of your healthy self.