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