It just doesn’t work. We can say definitively that lower back pain and sciatica are not improved, even in the short term, by bed rest. A review of several clinical trials, where patients were advised to take bed rest as a treatment for lower back pain, published in 2010 (Hagen, Hilde, Jamtvedt, Winnem) concluded that there was high quality evidence to suggest that patients suffering with back pain who had been advised to rest in bed experienced “a little more pain” and “a little less functional recovery” than patients whom were advised to remain active.
So why do people still do it? For years, particularly in the case of sciatica, since some patients gain immediate relief from lying down it became the treatment of choice and the advice given by GPs and physiotherapists. In recent years a move towards evidence based medicine has lead to investigation of our management of common conditions, including the medications, interventions and advice that we provide. Bed rest seemed well and good to recommend as patient’s felt they were resting their backs and it wouldn’t get damaged further. Now we know that this was the wrong advice. Bed rest prolongs both the pain and disability associated with lower back pain and sciatica. Several clinical trials and reviews now substantiate this modern held belief.
It seems counterintuitive that you would continue to exercise and remain active while suffering with back pain but that’s only because we’ve delivered the message for too long that you must rest when you’ve got a back injury. Well thankfully that’s all changing.
So remain active in the knowledge that you’re doing the right thing and don’t be tempted to take to the bed. It’ll speed up your recovery.
Hagen KB, Hilde G, Jamtvedt G, Winnem M. Bed rest for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD001254. DOI: 10.1002/14651858.CD001254.pub2