| I thought it was about time I threw some | | | | the doctors with low back pain yielded a |
| light on to a particular aspect of back pain. | | | | "good dose of exercises and carry on at work, |
| This particular aspect is the one regarding | | | | you'll be fine." Strangely enough this was |
| the prescription of rest.We will begin with a | | | | not always successful as an antidote to the |
| delve back into history, not too long ago may | | | | problem either.Today the pendulum of medical |
| I add but considered prehistoric to some, | | | | opinion for me as a Chartered Physical |
| especially in terms of the methods of | | | | Therapist with all the benefits of hindsight |
| treatment for back pain.The actual history of | | | | and experience has brought me to the point |
| low back pain is another story but let's just | | | | where I believe the best answer lies |
| revisit the recent past. The time I am | | | | somewhere in between with a balance of |
| referring to is when you visited your doctor | | | | CORRECTLY PRESCRIBED REST AND EXERCISE.I |
| complaining of back pain and the sum total of | | | | generally find that with acute back pain, |
| the medical help you received was being told | | | | rest is needed to take the stress off the |
| to go home and lie on a board for six weeks. | | | | back structures to help the inflammation and |
| This people duly did and were compliant to | | | | pain to settle and allow healing to beginr. |
| varying degrees I am sure. Some I presume | | | | This rest is not strict bed rest but is more |
| lasted for the whole forty two days to the | | | | often than not a prescription of lying down |
| hour whether or not their pain had gone or | | | | for a period of forty eight hours with |
| whether they were in sheer agony and others | | | | changes of position allowed for, as well as |
| more than likely, lasted until the first | | | | breaks for trips to the bathroom and for |
| piercings of boredom roused themselves before | | | | eating and drinking encouraged periodically |
| dispensing with the said board.How long ago | | | | during the day. With the correct analgesia I |
| this practice died out is not easy to say. In | | | | find that this amount and specificity of rest |
| fact I know at least one osteopath or | | | | achieves a state where the back pain is |
| chiropractitioner in The United Kingdom still | | | | settled to a degree sufficient to allow |
| utilises this course of action. This is for | | | | movement and therapy to move the process on |
| sure though now more the exception rather | | | | to the next level.So rest is neither good nor |
| than the rule.So was it or is it effective? | | | | bad. It is just a tool for us to use in our |
| To a degree yes. It allows the stresses of | | | | armoury. Insufficent rest will see the |
| weight and movement to be taken off the | | | | exacerbation of inflammation and continuation |
| injured spine so preventing further injury | | | | of pain. Excessive rest will see an onset of |
| and enabling healing to begin with minimal | | | | joint stiffness, muscle weakness and |
| disruption. The trouble is that unless the | | | | functional disability amongst other |
| spine is fractured the benefits of lying down | | | | possibilities.The answer seems to lie |
| are essentially achieved in forty eight to | | | | (pardon the pun) with utilising initial and |
| seventy two hours. After this time the | | | | short periods of rest of approximately forty |
| adoption of long periods of bed rest begins | | | | eight hours to reduce the effects of acute |
| to have more negative than positive effects. | | | | inflammation and then use graded treatment |
| These effects include joint stiffness, muscle | | | | and movement to return the spine to as |
| wasting and other complications associated | | | | healthy a state as possible. This can take |
| with long periods of immobility.Other things | | | | variable amounts of time depending on the |
| to note are that advice was rarely if at all | | | | particular problem, the details of which are |
| dispensed as to altering the lying posture to | | | | probably best left for another time.So there |
| side or front (prone) lying for comfort or | | | | we have it: to rest or not to rest, that is |
| benefit.As with so many things the pendulum | | | | the question. You now have the |
| tends to swing markedly to the other extreme | | | | answer.Copyright 2006 Robert RylesRob is a |
| once the seed of doubt has been planted into | | | | successful International Chartered Physical |
| the consciousness of significant minds. Hence | | | | Therapist. He has been a lecturer, researcher |
| the new school of thought that came into | | | | and therapist for over two decades. His rich |
| being approximately twenty to thirty years | | | | experience of International and Premiership |
| ago was based on the hypotheses that 'rest | | | | Football underpins his specialist knowledge |
| was bad and movement was good.' So a trip to | | | | of sports medicine. |