Expert Physiotherapy, Chiropractic, and Orthotics Services for Optimal Health

Is Bed Rest Worsening Your Back Pain?


Posted by Dr. Scott Wilson | 15-Oct-2022

  • Many back pain sufferers believe that bed rest is the best way to relieve pain
  • Prolonged bed rest doesn’t actually resolve back pain and, in some cases, may even make it worse
  • Depending on the cause of your back pain, increased activity may actually be the best treatment option

Chronic back pain is a painful condition that is seen in people of all age groups. There are several factors that contribute to back pain such as poor posture, age-related muscle weakening, genetic disc issues, arthritis, and even pregnancy. Prescribing bed rest for back pain used to be the common practice among healthcare professionals but recent studies have shown that prolonged rest may do more harm than good. Resting in the same position for prolonged time periods can reduce the muscle’s strength and flexibility, leading to more severe back pain and possible re-injury in the tissue. Because of this, prolonged periods of bed rest, and even prolonged stretches of inactivity such as sitting, standing, or sleeping, can make your back pain worse. Here’s a quick overview of specifically how prolonged bed rest can worsen your back pain and what you can do about it.

How Prolonged Bed Rest Can Worsen Your Back Pain

Prolonged bed rest can cause lower back pain, can aggravate existing back pain by weakening your muscle strength or can result in a higher risk of back injury due to spinal instability and insufficient load-bearing capacity of the spine.

1. Bed Rest Alters The Spinal Biomechanics

Prolonged bed rest or inactivity can have drastic effects on your musculoskeletal system by altering the spinal biomechanics. This can result in: 

  • Abnormal lengthening of the spine
  • Atrophy of spinal musculature
  • Increase in intervertebral disc (IVD) height and area
  • Altered IVD composition

These changes in the spinal biomechanics can worsen your back pain and can even lead to other musculoskeletal conditions.

2. Bed Rest Deconditions The Body Muscles

Atrophy of spinal extensor muscles is another consequence of prolonged bed rest. It affects the multifidus, and either causes atrophy or hypertrophy of flexor muscles such as the abdominal group and psoas muscle. These muscles aid your spine in the backward and forward movement. It can become weak and reduce mass (atrophy), leading to severe back pain that takes more time to heal. 

3. Bed Rest Alters The Disc Size

Prolonged bed rest, and even prolonged sitting or inactivity, can lead to an increase in intra-discal pressure. These pressures on your disc can lead to bulges, protrusions, and even possible herniations. As they worsen, these conditions can lead to a degenerative cascade which increases degenerative changes including stenosis, ligamentous hypertrophy, and facet arthritis.

Treating Back Pain

Here are a few proven and effective ways to treat lower back pain:

1. Ice And Heat

The application of ice and heat is a temporary treatment that is proven to provide relief in most cases. Lowering the body temperature with an ice pack can: 

  • Constrict the blood vessels
  • Reduce swelling 
  • Decrease inflammation
  • Cause a numbing effect

Once the painful inflammation has been alleviated you can then apply heat to the lower back to improve the flexibility of soft tissues, muscle movements, and the overall functioning of the lower back. 

2. Exercise

Exercise and staying active is a widely adopted treatment for back pain and is more effective than bed rest. It not only provides relief, it also strengthens the core and abdominal muscles which helps to guard against reinjury. Doctors often prescribe physiotherapy and exercises as a treatment for lower back pain because physiotherapy includes multiple low-impact exercises that keep your back muscles moving and quicken the recovery process. 

3. Interventional Therapy For Severe Cases

Sometimes the cause of lower back pain can be the result of health conditions such as:

  • Internal disc disruption
  • Vertebral fracture or infection 
  • Lumbar nerve roots
  • Herniated disc or inflammation
  • Spinal stenosis 
  • Scoliosis
  • Kyphosis
  • Spondylolisthesis
  • Metastasis
  • Post-laminectomy syndromes
  • Severe trauma 

For such conditions, temporary treatment methods may not provide relief. In those cases, a combination of interventional therapy and physical therapy may be needed to ease chronic lower back pain. Interventional therapy focuses on leveraging imaging guidance techniques such as fluoroscopy to inject steroids or medications such as opiate and botulinum toxin into the affected soft tissue, joints, or nerve roots. 

4. Physiotherapy Treatment

Active strategies such as physiotherapy and exercise are recommended over passive methods like rest, and medications to treat lower back pain. Physiotherapy is one of the most effective non-invasive treatments that focus on improvements in body function, strengthening core muscles, and providing relief to back pain. Physiotherapy treatments are effective for people of all age groups as it mostly includes back strengthening exercises that can be done by anyone, including senior adults and pregnant women. The treatment mostly includes:

  • Controlled movement
  • Breathing exercises
  • Stretching exercises
  • Core strengthening exercises
  • Technology-Supported Exercise Therapy
  • Neurological Physical Therapy
  • Massage therapy
  • Mobilization and Manipulation Therapies

Minimizing Back Pain During Sleep

Even though prolonged bed rest can worsen back pain, adequate sleep along with physical activity is  recommended for relief. While lower back pain can significantly impact your quality of sleep, there are certain sleeping positions that can relieve lower back pain and considerably minimize the effects at night. 

Avoid sleeping positions that can put pressure on your spine, neck, shoulders, hips, lower back, knees, and heels. These sleeping positions have a significant impact on your body’s alignment and can significantly contribute to lower back pain. Sleeping on your stomach is the worst position for this condition. It flattens the natural curve of your spine and puts more pressure on your spine’s muscles and joints. Continuously sleeping on your stomach can also result in neck or shoulder pain because your neck is rotated and held at a different angle.

Other effective ways to reduce back pain during sleep include:

  • Try different sleeping positions until you find the one that provides some relief
  • Switch to a new mattress that provides optimal comfort and support for your back
  • Be extra careful when you get in and out of bed every day
  • Try gentle stretching exercises for back pain relief before getting into bed
  • Consult with your doctor and try medications that can provide some relief
  • Try relaxation techniques and breathing exercises to reduce stress

Frequently Asked Questions About Lower Back Pain

Q1: Is it better to rest or to be active if you have back pain?

Answer: It depends on the nature of your condition but, generally speaking, it’s better to avoid prolonged bed rest and stay as active as possible. Long periods of inactivity can contribute to a weakening of your core muscles and will only make your condition worse over the long term. It can also lead to other health challenges.

Q2: How can I heal lower back pain fast?

Answer: If your lower back pain is caused by sprains, muscle spasms or other minor impacts, you can try:

  • Ice and Heat therapy
  • OTC Medications
  • Rub on Medicated Creams and ointments
  • Take Joint Health Supplements
  • Stretch and Strengthening exercises

Q3: Is bed rest good for herniated discs?

Answer: As always, too much bed rest can worsen any back condition. For herniated discs, bed rest should not exceed 48 hours. While performing daily activities, you should take frequent rest breaks and avoid sitting for long periods of time. 


Most often, lower back pain is caused by strain in the muscles, spinal atrophy, pinched nerves, muscle weakness, or irritated joints or ligaments in the back. In these cases, physiotherapy can be a very effective form of treatment that can provide lasting relief. 


If you or someone you know is struggling with back pain, contact us today and let us show you why, at Physiomed, Healthier Starts Here.

Dr. Scott Wilson

Dr. Scott Wilson is the Founder & Chairman of Physiomed; one of Canada’s largest franchised networks of inter-disciplinary healthcare clinics. A graduate of Canadian Memorial Chiropractic College, Dr. Wilson founded Physiomed in 1994 and has since grown Physiomed to over 30 clinics in Southern Ontario and British Columbia. With hundreds of practitioners from over a dozen disciplines, Dr. Wilson and Physiomed have helped over 100,000 Canadians with physiotherapy, chiropractic, massage therapy, orthotic therapy, compression therapy and clinical conditioning as part of a program of rehabilitation and health optimization. In addition to helping patients improve their physical and mental well-being, Dr. Wilson has also mentored hundreds of practitioners to provide better care while enjoying more fulfilling careers. He is also a keynote speaker on many health related topics including how physiotherapy, chiropractic and health & wellness treatment can help with stress, weight loss, and unlocking the true potential within to achieve lasting physical well-being.

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