Evidence Shows Bed Rest May Make Low Back Pain Worse

By Erik Shaw, D.O.
Interventional Pain Management Specialist, Shepherd Pain Institute

“Ow! I hurt my back!” I imagine you have said this, out loud or to yourself, at some point in your life. During the course of their lives, at least 60 to 70 percent of people experience acute low back pain. This includes benign issues, such as muscle and ligament strains, and serious issues, such as herniated discs and pinched nerves. 

Most low back injuries involve lifting, bending or twisting in the wrong way.  There are many different little back muscles, all connected by tendons to the bones in your spine, called vertabrae. It is fairly easy to strain these muscles and tendons, leading to pain. Another common source of back pain involves the sacroiliac joint, a joint in the pelvis between your pelvic bone and the flat bone – just above the tailbone. Just as with a sprain in another part of your body (e.g., ankle), healing of these strains is expected in two to six weeks.

Muscle relaxers and anti-nflamatory medications typically help ease the discomfort of these types of back pain. Most studies demonstrate heat is better than ice because it helps improve blood flow and loosens tight muscles.

Although it may seem counterintuitive, the evidence is clear:  Bed rest is likely to make your pain worse and last longer than if you continued with light activity. While reduced lifting and bending is advised, light activity, such as walking and stretching, is encouraged because it allows the muscles to regain normal movement and reduces stiffness. A short course of physical therapy may also be helpful. Spinal manipulation, such as from an osteopath, chiropractor or well-trained physical therapist, can help short term, and some data suggest reduced chances of having more back pain later.

When to worry? 

Sometimes, low back pain can be more worrisome. Less than 0.2 percent of the time, an acute injury can be associated with a pinched nerve. Pain traveling all the way to your foot – with more severe pain, not just soreness – can be a sign of something that needs to be treated more aggressively. A herniated disc is uncommon. Degenerative or bulging discs, on the other hand, are very common and are not a sign that an MRI is needed. A thorough physical exam can determine whether the pain is the result of a sprain or something more serious.

To recap, acute low back pain is a common problem that most adults will experience in their lifetimes. Typically, heat, muscle relaxers and reduced activity will assist healing. Bed rest will make the pain and function worse. More serious conditions are sometimes present. A visit to a doctor for a checkup can help determine the best next step and get you feeling better in no time.

ERIK SHAW, D.O., is an interventional pain management specialist at the Shepherd Pain Institute. Dr. Shaw is board certified in physical medicine and rehabilitation, as well as pain medicine. For more about Dr. Shaw, click here. For more about Shepherd Pain Institute, visit www.shepherdpaininstitute.org.