Back Pain: Exercise or Rest?

Research conducted in 1987 by Dr Gordon Waddell in one of the most prestigious journals of spinal research, Spine, suggested there is little doubt that rest, and in particular prolonged bed rest is harmful in the treatment of low back pain.

In contrast there is no evidence that activity is either harmful or makes the problem worse. There are many studies demonstrating that controlled exercises will restore function, reduce distress and illness behaviour, facilitate a return to work and actually reduce pain. The main theme of the treatment of lower back pain has changed from rest to rehabilitation.

Therefore to get better from back pain: Move it or lose it

How does Physiotherapy treatment help back pain sufferers?

It is suggested that inactivity and especially bed rest cause substantial weakness and loss of tissue from the musculoskeletal system. These changes include a loss of bone, muscle and connective tissues, a reduction in muscle strength, endurance, physical fitness, and decreased joint ranges of movement in all individuals with reduced activity levels.

In the spine, the health of the joints and disc is dependant on repeated low stress movements. This is not surprising when we know that healthy joint cartilage requires regular mechanical loading and unloading to ensure the passage of the normal joint lubricating fluid and nutrients across joints and discs. The principle findings from animal research support this, demonstrating that degeneration of joint cartilage occurs when the joint is not moved or used. The regular loading and unloading of joint cartilages that occurs with physiotherapy treatment and exercises helps the process. In a similar fashion, the intervertebral disc, receives nutrition from fluid transfer primarily from the surrounding tissue. 

Physiotherapy in the form of movement considerably assists disc nutrition and health. Especially when pain limits normal movement.

The major advances in treatment of back pain and other musculo-skeletal conditions in the last ten years have been based on intensive, early, active physical treatment. This approach has been shown to decrease pain, increase healing rate, and assist in a better result long term.

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