In back circles over the past few years, there has been much discussion about the therapeutic value of bed rest for back pain. Some years ago ‘The Clinical Standards Advisory Group’ in the UK made light of the value of spinal mobilisation/manipulation and trunk control exercise (without specifying which exercises!). Equally, The CSAG discussion paper also concluded that bed rest was not good for ailing spines. The best way forward, it seemed, was simply to keep on keeping on.
Is this really the best advice we, in the vanguard of spinal learning, can give?
For a malady reaching pandemic proportions worldwide - affecting all ethnic groups, all ages, all societies and every range of sub-groups in those societies – is the sum total of our learning that we should tell our patients to just 'keep going'?
Bed rest for a bad back is sometimes the only way to go. If the irritability of the spinal segment is severe, it may only make matters worse trying to keep going. At all times it is important to remember the dictum: pain makes pain. If you are in pain - and you cannot control it (and this is the important proviso) – you simply worsen the picture by battling on through it. You start running into the secondary complications of the body’s muscles reacting to the pain, which simply 'wraps in' the underlying problem more and makes everything harder to unravel.
See Sarah's new Chapter 7 'Dealing With Acute Pain' in the third edition of the book ‘Back Sufferers’ Bible’ about the body's reaction to severe pain, both physically and mentally.
If you are caught in the web of pain, you do not know the cause of that pain, and you can't see your way out of it, it's easy to live life in a state of permanent low-grade panic. This alone, is a potent source of making matters worse
Keeping going when you are in acute crisis often causes the body’s defence mechanisms to go into overdrive, which can have dire consequences for you later on. In particular, the cable muscles down the back of the spine go into automatic protective mode. This not only compresses your spine rigid, which heightens the irritability of the underlying problem segment, but also brings about a more covert response where the deepest layer of both your tummy small spinal muscles permanently switch off. When this happens, it is much more difficult to get you back to a painless state again. I believe it is also one of the chief causes of chronicity in human back problems.
Going to bed as a permanent option is not an option. But time out in bed gives respite from the struggle at the height of a crisis. It stops the problem gearing up and making itself worse through joining
itself into the rich, cyclic cocktail of pain and fear, and then more
As soon as the peak of your crisis has passed it is imperative you get the spine moving again (preferably while still on your back to eliminate the compressive effects of gravity). To this end, it is often a good idea to ask your doctor to prescribe both muscle relaxant drugs (Valium is the best) and anti-inflammatories as well. The bed-rest and absence of pain (you may want to take painkillers as well) often gives you the best possible starting platform from which you can start afresh with your back. Doing the appropriate spinal appeasing exercises is often all you need to break free of your problem, once and for all.
Read more here about Sarah's video showing you how to get back pain relief from a few simple exercises
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