Taking Action

Once upon a time, bed rest was the rule for recovery from musculoskeletal disorders, especially back pain. Over time, however, research and recovery outcomes have given us new knowledge and advice. Authorities like the International Paris Task Force on Back Pain now advise against rest for acute and chronic lower back pain, suggesting that those in need of rest should see a specialist within 10 days if they haven’t resumed regular daily activity. The Cleveland Clinic's Center for Continuing Education on musculoskeletal disorders also recommends that bed rest for acute nonspecific low back pain is not helpful and tends to delay recovery.

These changes are rooted in findings that show that bed rest doesn’t just lead to poorer clinical outcomes; it can aggravate related conditions. Studies found that unused “resting” muscles tend to become weak while their supporting joints stiffen. Over extended periods of time, the muscles can become permanently shortened, and joints can bend permanently in a condition called contracture. Healing contracted parts of the body and strengthening weakened muscles is possible but very challenging and time-consuming — and it is unnecessary if you avoid prolonged bed rest in the first place.

Bed rest — even reduced activity — also can lead to problems with digestion. Constipation becomes a more likely issue, especially if you are using pain-relieving medications. And your original pain can be made worse by straining at the toilet, creating a cycle of pain and constipation that slows recovery.

Bed Rest Blues

Staying home in bed, isolated by your pain, can also negatively affect mood. Studies have shown that chronic back pain and depression are tightly linked. Resuming activity and moving your body helps bring back a sense of power and control—a better state for healing mind, body, and spirit. Endorphins released by activity also help elevate a depressed mood. Early studies show beta-endorphin and beta-lipotrophin release in exercise can lead to significant mood boosts.

A proviso: Always pursue the path of resuming activity under the guidance of a healthcare professional and please keep in mind that action does not need to be strenuous to be effective. Try an easy walk, gentle stretching, or even a restorative yoga session. If you’re recovering from surgery or have a flare of lower back pain, you don't need to try and quickly resume your pre-injury activity level. The idea is simple: rest as little as possible and get active and mobilized — within your ability — as soon as you can.