How much should I rest with back pain / sciatica?

In this episode I’m answering the question, ‘how much should I rest with back pain / sciatica’ and I will be dispelling some myths, which exist in both ends of the spectrum.

At one end of the spectrum we have the old advice, which is take to your bed for two weeks with back pain or sciatica. That is terribly bad advice and led to all sorts of long-term disability for a generation, or more, of people with persistent and recurring lower back pain. You should not rest that much and can definitely overdo rest. Equally at the other end of the spectrum, there are people who do not rest enough. In essence, the easy way to assess this is are you the sort of person that takes to their bed with a cold and who other people might say ‘do you think he’s just overdoing this’. Or at the other end of the spectrum, are you someone who just can’t stay still and is always on the go? And who believes in the ‘no pain, no gain’ approach.

Use it but don’t abuse it

If you’re on either end of the spectrum, you’ve got it all wrong. The sweet spot of course, is somewhere in the middle and it’s summarized in the use it, but don’t abuse it principle, which I introduce you to in episode two.

(So if you’re listening to/reading this and you have not listened to the foundation episodes one to six, please go back and start at the beginning. Episodes one to six will give you a huge amount of value in terms of understanding how lower back pain and sciatica works and the overall approach that we take here, which is very evidence based. This stuff works, but it only works if you apply it.)

Sometimes I phrase it as use it or lose it, but don’t use it. However, in that phrase, you can see that it’s very important that you stay active. If you don’t use your physical capacities, they slowly decline. And some of us very rapidly decline. So it’s important to maintain what physical ability you have, but equally not to abuse it.

What does ‘don’t abuse it mean’?

It means don’t do things that hurt, that increase your pain and don’t do things that lead to your pain being worse in the long run, though that can be really difficult to measure. Briefly going back to those foundational episodes, some problems in the lower back, you can irritate them and not know it at the time because it takes hours, sometimes up to 36 hours for the inflammatory consequences to peak. So you can do something today, feel fine, and then tomorrow morning, and particularly the morning after that might be the worst pain that you get. And that’s because the inflammation takes a long time to build up.

Finding the sweet spot

It is vitally important that you remain as active as you can within the limits of pain, but that you don’t overdo it. Your body needs rest in order to recover. We’re talking about helping tissues to heal and they cannot heal if you’re constantly fatiguing them. So you have to give them opportunities for rest. You also have to give your nervous system some calm down time. Now that doesn’t have to be complete rest as in lying down in bed. It could be some nice easy fluid movement that doesn’t hurt. Which could be as innocuous and every day as just standing and gently swaying your hips from side to side, for example, while preparing a meal. Any movement that doesn’t hurt is a good thing, use it but don’t abuse it.

How much should I rest with back pain and/or sciatica?

So it’s a very brief episode, and I hope it’s helpful for you to understand that it’s vitally important to stay mobile, but to have sometimes brief periods of rest because it’s during the rest periods that your tissues regenerate and your nervous system has the opportunity to calm down. So there we have it. How much should I rest with back pain and sciatica?It depends and you need to find that sweet spot between staying active but not overdoing it and fatiguing and exhausting your system.

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