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To Rest Or Not To Rest

I thought it was about time I threw somethe 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 regardingyou'll be fine." Strangely enough this was
the prescription of rest.We will begin with anot always successful as an antidote to the
delve back into history, not too long ago mayproblem 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 ofTherapist with all the benefits of hindsight
treatment for back pain.The actual history ofand experience has brought me to the point
low back pain is another story but let's justwhere I believe the best answer lies
revisit the recent past. The time I amsomewhere in between with a balance of
referring to is when you visited your doctorCORRECTLY PRESCRIBED REST AND EXERCISE.I
complaining of back pain and the sum total ofgenerally find that with acute back pain,
the medical help you received was being toldrest 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 topain to settle and allow healing to beginr.
varying degrees I am sure. Some I presumeThis rest is not strict bed rest but is more
lasted for the whole forty two days to theoften than not a prescription of lying down
hour whether or not their pain had gone orfor a period of forty eight hours with
whether they were in sheer agony and otherschanges of position allowed for, as well as
more than likely, lasted until the firstbreaks for trips to the bathroom and for
piercings of boredom roused themselves beforeeating and drinking encouraged periodically
dispensing with the said board.How long agoduring the day. With the correct analgesia I
this practice died out is not easy to say. Infind that this amount and specificity of rest
fact I know at least one osteopath orachieves a state where the back pain is
chiropractitioner in The United Kingdom stillsettled to a degree sufficient to allow
utilises this course of action. This is formovement and therapy to move the process on
sure though now more the exception ratherto 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 ofarmoury. Insufficent rest will see the
weight and movement to be taken off theexacerbation of inflammation and continuation
injured spine so preventing further injuryof pain. Excessive rest will see an onset of
and enabling healing to begin with minimaljoint stiffness, muscle weakness and
disruption. The trouble is that unless thefunctional disability amongst other
spine is fractured the benefits of lying downpossibilities.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 theshort periods of rest of approximately forty
adoption of long periods of bed rest beginseight 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, muscleand movement to return the spine to as
wasting and other complications associatedhealthy a state as possible. This can take
with long periods of immobility.Other thingsvariable amounts of time depending on the
to note are that advice was rarely if at allparticular problem, the details of which are
dispensed as to altering the lying posture toprobably best left for another time.So there
side or front (prone) lying for comfort orwe have it: to rest or not to rest, that is
benefit.As with so many things the pendulumthe question. You now have the
tends to swing markedly to the other extremeanswer.Copyright 2006 Robert RylesRob is a
once the seed of doubt has been planted intosuccessful International Chartered Physical
the consciousness of significant minds. HenceTherapist. He has been a lecturer, researcher
the new school of thought that came intoand therapist for over two decades. His rich
being approximately twenty to thirty yearsexperience of International and Premiership
ago was based on the hypotheses that 'restFootball underpins his specialist knowledge
was bad and movement was good.' So a trip toof sports medicine.



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