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Activity May Be Better then Rest for Low Back Pain Recovery
Low back pain and its associated symptoms, like sciatica, are common problems in the United States. They lead to major medical and business costs and significantly impact quality of life. Your back is constantly at work providing posture, balance, and support, so when your back is injured, the pain can make it difficult to move. As a result, many assume that resting in bed is the best option when back pain strikes. However, research on recovery often finds that movement is key to a better, faster recovery.
Researchers from the Cochrane database conducted a review of several past studies to examine whether bed rest, activity, or exercise was the best recovery effort for short term low back pain. The summary, published in the Cochrane database, found that staying active was better at improving function and pain than bed rest.
About the Study
The systematic review included 10 randomized trials that compared patients advised to bed rest to patients advised to stay active for acute low back pain or sciatica. The trials included a total of 1,923 patients. Trials were matched by specific interventions, and researchers found that:
- In two trials with 401 patients with acute low back pain, staying active was associated with small but statistically significant improvement in pain and function.
- In three other trials with 250 patients, there was no significant difference between exercise and bed rest. These trials were low quality trials.
How Does This Affect You?
Although the level and type of activity may need further research, it appears that bed rest may not be the best option for recovery of back pain. A systematic review can increase the reliability of study outcomes by increasing the number of patients involved. However, the review is only as good as the trials that make it up. The low quality of some of the trials may mean that there may be differences between the two approaches that were not able to be detected.
These finding do not mean that you should do activities that can further injure your back. You may need to adjust or stop some of your normal activities. But for the most part, it appears that continuing to move some is better than not moving at all. The amount and intensity of your activities will need to be moderated by you and your doctor. You may have a base level of pain as you move, but it should not increase with your activity. Talk to your doctor about stretches or basic movements that may help. Follow other healthy back tips, including taking frequent breaks throughout the day to move and stretch your spine if you sit or stand for long periods of time.
Back pain can be caused by a wide range of injuries. Be sure you discuss your back pain with your doctor right away if any of the following apply to you:
- Back pain after trauma, such as a car accident
- Pain that is severe or that has gotten dramatically worse
- Progressive weakness in a leg or foot
- Difficulty walking, standing, or moving
- Numbness in the genital or rectal area
- Loss of bowel or bladder control
- Difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
- Pain that wakes you from sleep at night
- You have a history of IV drug use, cancer, steroid use, or a weak immune system
American Academy of Orthopaedic Surgeons
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.
- Reviewer: Brian P. Randall, MD
- Review Date: 11/2010