When you are experiencing low back pain, your first instinct may be to crawl into bed. Until a few decades ago, you doctor probably would have told you to do exactly that.
But the tide has turned on our understanding of what is best for tackling back pain, and now the consensus is this: When you have back pain, you should limit or avoid bed rest.
What research says about bed rest for low back pain
Clinical practice guidelines from the American College of Physicians (ACP) and the American Pain Society (APS) say that patients with low back pain should be advised to remain active. This is categorized by the ACP and APS as a “strong” recommendation.1
Research to support this recommendation exists, but it’s not very robust. One survey of 10 studies, all of which compared activity versus rest for low back pain patients, found moderate support for small pain decreases in those who remained active.2 Another study of Japanese workers with acute low back pain found that those assigned to the rest group were more likely to have recurring or chronic back pain, compared with the active group. 3 More research is needed to verify these results.
Why activity is better than rest
When you understand how the body works, it makes sense that activity would be better than inactivity to promote healing. From our bones to our soft tissues, our body needs movement and activity to stay in its best condition.
Lack of activity can have several negative effects:
- Muscles can grow stiff and weaken
- Soft tissues like ligaments and tendons can lose their flexibility and become more vulnerable to injury
- The intervertebral discs, which hold fluid like a sponge, can lose nutrients and become dried out and inflexible
Without exercise, back pain can be prolonged and even increase, which further discourages activity. In addition, bed rest can take a psychological toll on people, increasing the likelihood of depression and suffering.
Fortunately, all of this can be avoided by being active as soon as you’re able when back pain strikes. When pain in severe, your doctor may advise you to spend a day or two resting, but more than that should be avoided, if possible.
How to keep moving despite back pain
The best way to stay active even when back pain is present is this 3-prong approach:
- Activities that strengthen your core
- Stretches that maintain flexibility
- Low-impact aerobic exercise
It’s important 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.
- Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society.
- Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010 Jun 16;(6):CD007612. doi: 10.1002/14651858.CD007612.pub2.
- Comparison of physician's advice for non-specific acute low back pain in Japanese workers: advice to rest versus advice to stay active. Ind Health. 2011;49(2):203-8. Epub 2010 Dec 16.