In the history of back treatments, one very used has been bed rest. Studies in lumbar pain have shown that people who are treated with bed rest have more pain and a slower recovery than those who remain active. Let’s analyze why this is so and at what times rest is advisable and how it should be done.
Bed rest and the interruption of our daily activities have two effects:
– Physical decomposition. Many years ago absolute bed rest was considered as a method to discharge the discs and joints of the lumbar spine with the intention of allowing the body to recover from the lumbar injury. As an idea had its foundation but time has shown us that it is not right. The lumbar lesions themselves cause a loss of the faculties of the lumbar extensor muscles. These muscles are responsible for stabilizing the spine and allow harmonious mobility between the different vertebral segments. If in addition to the deleterious effect of the injury itself on these muscles we add absolute rest, the muscles are in a very precarious situation. In order to function without pain we need this extensor muscle, with the multifidus muscle at the head. The stronger these muscles are, the longer we stand our assets without pain. People who spend a lot of time in bed feel that they are able to stand for less time standing or walking without the disabling pain. The situation will be less pain with rest but we will each notice less able to be active. In addition, the more muscles we lose, the longer the recovery time and the risk of chronifying the pain.
– Loss of elasticity. Besides the damage to the muscles, the tissues lose elasticity. The ligaments and muscles adapt quickly in length to the path in which we use them. If we maintain the same position for a long time these tissues are shortened and adapted to this degree of mobility. When we later want to be more active, we find limitations of mobility and lack of elasticity.
– Psychological effects. One of the important risks of ending chronic back problems has to do with our perceptions and attitudes towards pain and injury. Promoting bed rest can have negative effects in this regard by promoting greater apprehension of pain and feeling of illness. So bad is to get ourselves to lift excessive weights with a back injury without recovering as not to make any kind of physical effort and feed our brain with the idea that we are not able and that our injury is worse than it is. It is a complex subject but it is well known the component that our psychology has in diseases and specifically in back injuries.
Having said all this, how do we do the rest? And how much rest is reasonable?
The stance that decreases intradiscal pressure most is described in the post titled “the best posture for the back .” The demonstration of this fact contributed to the prescriptions of absolute repose that were done in the past. If we need to rest in bed because the intensity of the pains advises, we will try to do it in this posture. Another option is also to lie on the side with the hips and knees at 90 degrees as in the fetal position. In the moments that we get out of bed it is important to do it right. In the post about how to get out of bed you can find a video that clarifies it in a simple way.
Absolute rest should not last more than two days in a row. The exception could be severe sciatic pain from involvement of the nerve roots. In this case you could extend more days but more than 10-14 days will end up giving more problems than the benefits that can contribute. In any case, absolute rest is not advisable and we must maintain a certain activity with the help of the appropriate medication prescribed by our doctor.