Bed Rest Is Not the Best for Beating Back Pain

If you have lower back pain or sciatica, you probably want to know how to relieve your pain and prevent flareups or recurrences. Avoiding bed rest and staying active can help you do both. ¹ Fernandez M, Hartvigsen J, Ferreira ML, et al. Advice to Stay Active or Structured Exercise in the Management of Sciatica. Spine. 2015;40(18):1457-1466. PMID: 26165218 doi:10.1097/brs.0000000000001036 ^{, 2} Koes B. Moderate quality evidence that compared to advice to rest in bed, advice to remain active provides small improvements in pain and functional status in people with acute low back pain. Evidence-Based Medicine. 2010;15(6):171-172. PMID: 21106674 doi:10.1136/ebm1132 ^{, 3} Casser HR, Seddigh S, Rauschmann M. Acute Lumbar Back Pain. Dtsch Arztebl Int. 2016;113(13):223–234. PMID: 27120496 ^{, 4} Abdel Shaheed C, Maher CG, Williams KA, McLachlan AJ. Interventions Available Over the Counter and Advice for Acute Low Back Pain: Systematic Review and Meta-Analysis. The Journal of Pain. 2014;15(1):2-15. PMID: 24373568 doi:10.1016/j.jpain.2013.09.016

Staying active can include a combination of strategies, such as continuing your daily activities, adding a simple exercise, such as short walks, and/or following a structured and guided exercise program.

This blog explains the potential side effects of continued bed rest and the unique benefits of engaging in low-impact physical activities with back pain.

How prolonged bed rest may worsen your back pain

While you may want to lie down for a while if your back pain is severe, prolonged bed rest may not be a good option to treat your aching back. When you lie down for extended hours and minimize physical activity, the following changes may take place in your spine:

Deconditioning of muscles

The extensor and flexor muscles of your spine that aid in forward and backward bending movements become weak and reduce in mass (atrophy). These muscles, especially the erector spinae and multifidus are important stabilizers of your back and help withstand compressive loads. ⁵ Belavý DL, Armbrecht G, Richardson CA, Felsenberg D, Hides JA. Muscle Atrophy and Changes in Spinal Morphology. Spine. 2011;36(2):137-145. doi:10.1097/brs.0b013e3181cc93e8

See Back Muscles and Low Back Pain

Changes in disc size

When you lie down, the size of your intervertebral disc increases due to swelling by absorption of fluids. The risk of injury, such as herniation is high during this period, especially during bending movements. ⁵ Belavý DL, Armbrecht G, Richardson CA, Felsenberg D, Hides JA. Muscle Atrophy and Changes in Spinal Morphology. Spine. 2011;36(2):137-145. doi:10.1097/brs.0b013e3181cc93e8

Alteration in spinal biomechanics

Prolonged periods of lying down alter the normal lordotic (reverse-C shape) curve of your lower spine and makes it more flat, altering the normal mechanics of your spine. ⁵ Belavý DL, Armbrecht G, Richardson CA, Felsenberg D, Hides JA. Muscle Atrophy and Changes in Spinal Morphology. Spine. 2011;36(2):137-145. doi:10.1097/brs.0b013e3181cc93e8

Higher risk of injury

The above changes can make your back weak and worsen your pain. Additionally, these changes pose a higher risk of injury due to spinal instability and insufficient load-bearing capacity of the spine. ⁵ Belavý DL, Armbrecht G, Richardson CA, Felsenberg D, Hides JA. Muscle Atrophy and Changes in Spinal Morphology. Spine. 2011;36(2):137-145. doi:10.1097/brs.0b013e3181cc93e8

2 tips for staying active when you have back pain

Engaging in physical activities can help enhance blood flow to the tissues in your back, improve muscle strength and flexibility, nourish your spinal discs, and make your joints and bones stronger.

Here are 2 tips to help you get started:

1. Combat the immediate pain

If your pain is preventing you from being active, use these effective measures, which may provide immediate pain relief:

• Ice therapy
• Heat therapy
• Topical analgesics
• Massage

Once your pain level has reduced, you will be able to engage in more physical movements.

2. Engage in low-impact activities that help build strength

Staying active when you have back pain doesn’t necessarily include performing high impact pursuits. Start with low-impact activities, which can gradually build your strength and spinal stability with less exertion and fatigue, such as:

• Easy hamstring stretches
• Simple lower back exercises
• Beginner yoga poses for back pain
• Water Therapy Exercise Program

It’s advisable to talk with your doctor or physical therapist before starting a new exercise program, especially if you’re having an acute back pain episode. If you experience sharp or sudden pain while exercising, stop right away and consult your doctor. Be sure to use correct posture, form, and technique when you perform the suggested activities.

Following these tips may help in long-term relief and lesser recurrences of back pain compared to bed rest. Staying consistent with any of the suggested low-impact activities can make a difference in your overall wellbeing and may significantly enhance your spinal health.

Learn more:

Early Treatments for Lower Back Pain