Is Bed Rest or Staying Active Better for Low Back Pain Recovery?

Is Bed Rest or Staying Active Better for Low Back Pain Recovery?

When you are experiencing low back pain, your first instinct may be to crawl in bed. But after reviewing several studies, researchers confirmed that staying active is usually best to keep your back healthy.

Bed rest may not be your best option to help heal your low back pain.

The Norwegian Centre for Health Services reviewed studies on whether or not bed rest is best for low back pain patients, and their results were published in the Cochrane Library. The review was done in 2010, and since then, no new studies have been published. (At least not that I could find--please contact me if you know of one.)

Review details

The review combined evidence from 10 randomized trials that studied the effects of bed rest versus staying active. The data that was analyzed was divided into two patient groups: low back pain with and without sciatica.

The studies only included patients with acute low back pain, lasting less than 6 weeks, from unidentified sources (excluding patients with pain from fracture, inflammatory joint disease, osteoporosis, infection, etc.).

Pain levels and ability to function were compared 4 weeks and 12 weeks after the initial recommendation of either normal activity or bed rest.

Patients with back pain but no sciatica

This group of patients experienced less pain at 4 weeks and at 12 weeks, whether or not they were at bed rest or active.

The group of patients who stayed active showed a higher reduction of back pain. The difference in pain level between the two groups was not substantial. However, at both time points the ability to function was substantially greater in the group of patients who stayed active.

Patients with back pain and sciatica

From the group of patients with sciatica, there were little to no differences between the set of these patients that were put on bed rest and the set that remained active, in terms of pain reduction or ability to function after 4 or 12 weeks.

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      Author’s conclusion

      Though the evidence only slightly favors activity to bed rest for people with back pain and no sciatica, the lead author of the review, Kristin Thuve Dahm, noted, “The available evidence neither supports nor refutes that advice to stay active is better than resting in bed for people with sciatica. However, considering that bed rest is associated with potential harmful side effects, we think it is reasonable to advise people with sciatica to stay active.”

      Spine health and exercise

      Exercise increases blood flow to the spine. This is especially important for the intervertebral discs, which essentially act as sponges, to get their nutrition: The greater the blood flow to the sponges, the healthier they are.

      Exercise also increases the fluid exchange around the spine, which helps reduce swelling and inflammation that may occur as a result of an injury. Even if you can't participate in a formal exercise, just moving around through your daily activities will increase blood flow to your spine more than bed rest would.

      Until the 1990s, doctors commonly advised their spine patients to go home and rest. While this may be tempting to do, after a day or two, it’s time to get moving.

      Further reading:

      Reference:

      Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD007612. DOI: 10.1002/14651858.CD007612.pub2 - See more at: http://summaries.cochrane.org/CD007612/BACK_advice-to-rest-in-bed-versus...

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