Bed rest vs staying active for acute low back pain and sciatica
I came across this article on medicalnewstoday.com: Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Dahm KT, et al.The Cochrane Database of Systematic Reviews 2010, Issue 6. The article discusses the fact that for years the standard prescription for acute back pain was just "rest." More recently doctors have been instructing their patients to stay as active as they can.
An updated review article by lead researcher at the Norwegian Centre for Healath Services Kristin Thuve Dahm, states "Normal daily activity seems to be the best way for patients with low-back pain to get better."
The Chochrane Library is a publication that evaluates medical research and is an international organization and examines the content and quality of existing medical trials. No new studies have been published for hearly 10 years on the benefits of bed rest. The review of the studies showed that there was basically no difference in outcome with bedrest compared to continued activity. However, those who stayed active experienced more pain reduction, but supposedly it was not clinically significant. In addition, the studies found great improvements in the ability to function if the participants remained active. The same was true for those suffering from "sciatica."
They interviewed Dr. Joel Press from Northwestern for this article. Interestingly enough he trained with Dr. Hauser. He states, "We're almost always better moving than not moving. Structures in your back get their nutrition from movement; they have no realvascular system and are supplied with with blood by motion, soaking it up like little sponges."
He also reports that negative changes associated with immobilty are seen right away. Even in medical training you are taught that each day of immobility represents 2-5% loss of strength per day you are on bed rest. So it makes sense to keep moving.
This review also looked at bedrest compared to activity with physiotherapy and found no additional benefit.
Dr. Press continues to say that "not all back pain is the same and that there are alot of different causes." He says that the chance of finding a single treatment to benefit all patients is not good.
 Caring Medical Commentary: We have been saying for years that movement is good for healing. In fact, we coined the acronym MEAT as an opposite line of thinking to the traditional RICE treatment for acute injuries. RICE by the way stands for Rest, Ice, Compression, and Elevation; where MEAT stands for Movement, Exercise, Analgesics, and Treatments. Immobility is detrimental to healing, conversely movement is beneficial because it improves blood flow to the injured area, removing debris. One of the effects of movement is the generation of heat, which increases blood flow. This is also one of the reasons we encourage use of heat application (heating pad etc) to an injured area vs ice for ligament and tendon injuries. Gentle range-of-motion exercises also help improve blood flow. Natural analgesics (or painkillers) such as enzymes like bromelain or Enzyme Max will help reduce swelling an increase waste transport. Treatments that are used to increase blood flow and immune cell migration to the injured area that will assist with ligament and tendon healing are things such as PT, massage, chiropractic, ultrasound, or if more agressive treatment is needed, Prolotherapy.
Prolotherapy, as you know, is quite effective as an initial treatment for acute pain, particularly in the case of acute sports injuries.
So interestingly enough, the above study states that resuming activity and bedrest have the same effect on healing, we would beg to differ. What the study failed to mention was a very successful treatment that can drastically improve painful conditions, especially for those with back pain and/or sciatica, where missed work, reduced activity, and altered lifestyles can cause a lot of strife for a person. Our comprehensive study of 145 patients with back pain was presented in the Journal of Prolotherapy, 2009: 3:145-155.
Treatment of these patients with Hackett-Hemwall dextrose Prolotherapy for degenerative joint and spinal disease, including back pain, SI pain, and sciatica was shown to decrease not only the pain, but also improve range of motion, exercise ability, and other physical and psychological factors important to those with low back pain.
Thus we say, yes, we agree with movement to help improve back pain, but also add natural analgesia and treatments such as Prolotherapy to help actually cure the underlying problem and prevent it from reoccurence.
 Here Dr. Hauser performs Prolotherapy in his Oak Park, IL office.
Have you received Prolotherapy for back pain and care to share your story? We'd love to hear from you! Or maybe you have back pain and are looking for an alterative to surgery, pain pills, or "live with it." Give us a call at 708-848-7789 or email us at drhauser@caringmedical.com.
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