I think most people think rest is good for pain, but is that always the case?
A common problem
This week I saw someone in clinic with back pain that was stopping him doing any of his normal activities. He’d stopped all his usual sport and recreation (usually 5-6 times a week). He’d rested completely, but the problem was getting worse if anything.
We see this all the time in clinic. People who get an injury, or have pain, resting, expecting it to get better. Sometimes it will, and sometimes it will not only not help, it will sometimes make it worse.
So is rest good for pain?
There is no simple yes or no answer to this. It depends on the cause of the pain. Often it comes down to what we call load and whether you are overloading the problem area, or underloading it.
Rest can be absolutely required. If you’ve caused an injury by overworking a structure, a period of rest is beneficial to let the irritation calm down. The problem is though, rest can result in the direct opposite problem. That the structures aren’t getting enough load. In that case, they become less tolerant to any pressure going through them. That’s when day to day activities can start to cause problems.
The problem with rest
In the case of the patient with lower back pain, 2-3 days of active rest (where you’re not actively playing sports or doing heavy tasks but you’re still moving around) might have helped ease his symptoms. Beyond that, structures start to get stiff and weak. From that point on, normal movement isn’t possible, and so the pain is likely to continue, or get worse.
A common pain cycle
Often what we see is something like this:
Here you can see that inactivity (rest) results in a downward spiral. When any area of your body is allowed to become stiff and weak, it’s likely to hurt. Often we see people whose pain has reduced a bit, or has changed whilst they’ve been resting, but often, their activity levels have dropped hugely.
What this shows is that getting the right advice about how much you should be doing, at the right time, is vital. Often it can start the pain relieving process by getting you doing the right thing. As the pain gets less, you can start to do more. More movement, and crucially, strengthening too. In our terms, this means increasing the load on the area. The opposite of rest. But it has to be the right amount of load at the right time. That’s usually where Physios and Sports Therapists come in. We are load specialists and help you do more of the right things at the right time.
More movement often means less pain
For my back pain patient, being told which movements he could do has had an instant impact. After 3 months of back pain, doing progressively less, he’s already moving more, with significantly less pain. He should be back in the gym and starting to increase what he can do by next week. He has gone from being a young man who struggled to put his shoes on, let alone play sport, to someone who can get back to the gym simply by moving more.
The key for him was knowing the right movements and understanding that rest wasn’t going to help. In fact it was hindering him.
So, is rest good for pain?
The right amount of rest, for a limited period of time is often good for pain. However, the idea of just resting until the pain goes away and then getting back to normal activity rarely works. Practically everyone will struggle to return to their normal activity by just resting. The key is knowing when to start increasing your activity, and by how much. That’s where Physio comes in.
Wherever possible, we try to give you advice that you can follow at home to treat yourself. However, when and how much activity to do to best help your pain is so individualised, that is really needs to be recommended by a good Physio or Sports Therapist. They can assess you, and work out which are the best things for you to do, and at what intensity. They can then guide you through your recovery and back to full activity.
As you’ll know if you’ve read any of our previous blogs, we don’t believe anyone should have to put up with pain. If you’re stuck in the first pain cycle, please see someone to help guide you out of it. Someone who can help you get moving, get stronger and get back to normal activity.
If you’re close to one of our clinics you can book an appointment with one of our Therapists by clicking here.
If you’re not near us, then I’d urge you to find a great local Physio or Sports Therapist to help you.