Until quite recently, medical advice for low back pain was rest and painkillers. But clinical trials have shown that keeping moving, even if it’s painful, creates much better outcomes for back pain sufferers.
Why would that be?
Well to begin with, bed rest weakens us really quickly. Studies show a 12% decline in muscle strength per week (see note 1) and commensurate loss of muscle mass. Which means that if we stop moving, it makes it even harder to get going again. And weakening tummy muscles in particular will mean that we have even less support for our back than we previously had before the back pain kicked in. This is part of what is known as ‘core stability’ and very important for both our overall stability and even the health of our inner organs. Ligaments and tendons around our joints, and even the nerves that supply all these tissues can be negatively affected too.
Secondly, our bone health and density is linked to use, and weight-bearing exercise. Walking counts here. Every step we take stimulates the cells in our bones to keep metabolising bone to keep us strong and keep the calcium in our bones. When we rest our cells also respond – by taking calcium out of bone to use for other things, which can ultimately predispose us to kidney stones. This applies to all bones in the body, not just legs, pelvis and lower back. They all need movement to stimulate bone health and strength. So resting weakens bone.
Beyond these two major effects, bed rest is known to negatively affect us in almost every way, involving our hormones, sense of well-being, lung and heart health, immune system function, and more besides.
But rather than dwell on the downsides of rest, perhaps we should think about the benefits of movement? During our osteopathic training we were shown time and again that movement and health are almost equivalent for our bodies, both as a whole and in part. NICE guidelines (see note 2) now minimise use of ‘RICE’ (Rest, Ice, Compression, Elevation) for ankle sprains because again it has been shown that tissues repair better when they are moved – it helps strength and blood flow which brings healing faster.
Lastly, all movement and exercise help the body as a whole. All our joints are supported by all our bones, muscles and other joints. Think of the body as being held together by inner elastic (fascia) which is always in reciprocal tension so that as one bit of us moves, all of our body adjusts to the movement. This is a principle known as Tensegrity (see note 3), and it helps us counteract gravity. So the joints in our lower backs need the joints in our pelvis and shoulders to be working well to help them stay healthy and not get compressed by our own weight . Exercise like pilates and yoga help the whole system function well together, and reinforce healthy movement patterns.
So even if you are feeling a bit crocked, try and keep going, you’ll feel better for it and recover more quickly. Let us know if you need a bit of help to speed your recovery!
Julia
Notes and links
1. Effects of bedrest 5: the muscles, joints and mobility
3. Tensegrity
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