by Dr. David Borenstein M.D. updated 8/2021

Dek would be The Basic Back Pain Relief Program

Basic therapy for low back and leg pain can work for you as long as your pain is not from a systemic illness. Pain from a mechanical disorder such as muscle strain, joint irritation, herniated disc, or hip arthritis, for example, can improve if you control physical activities, use over-the-counter pain medications, stay fit with aerobic exercise, and—most importantly—self-educate. If your back pain improves, you probably won’t need any more evaluation to speed your recovery. If you are in doubt about your recovery, contact your physician immediately.

Control Physical Activities but Limit Bed Rest

In the past we were told to lie down if we had back pain, to let the muscles rest and heal. This is wrong! Now we know that bed rest is no better to resolve back pain than being up and walking around. Movement seems to help the tissues of the back heal more rapidly, too. Extended bed rest, on the other hand, deconditions the heart, lungs, stomach, and skeletal muscles. So keep bed rest to a minimum. Studies have shown that two days of bed rest is as good as seven days of bed rest for the relief of back pain. The benefits of bed rest are also limited if pain travels to your leg. In a study of 183 people with sciatica from a herniated disc, people given bed rest for two weeks did no better than those allowed to walk around.

On the other hand, being out of bed does not mean returning to your usual daily work and recreational activities. Stay home from work until you are able to walk or stand for thirty minutes without pain, and you feel comfortable sitting for twenty to thirty minutes without increased pain. If you have acute low back pain, limit your activities and you will have a faster recovery and be much less likely to have chronic or recurrent episodes of low back pain. Increase activity as pain decreases.

Bed Rest Positions

When bed rest is indicated, a couple of positions are most comfortable. The semi-Fowler position places the least pressure on spinal discs, joints, and muscles: Put a small pillow behind your head and two to three pillows under your knees to flex your hips and knees. Your mattress should be firm, but it may feel better to lie on a comforter on the floor.

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Get Out of Bed Carefully

Another comfortable position is on your side with a flat back, with your legs curled up with a pillow between your knees. This is a side semi-Fowler position and is the way to get into and out of bed. Push against the bed with your lower arm while letting your legs slide off the edge of the bed. The weight of your legs will swing your chest up with the help of your lower arm. To get back into bed, do the reverse. Shift your upper body weight to the palm of your hand resting on the bed. Slowly let your body down, shifting your weight to your forearm, elbow, and shoulder while you swing your legs up to the bed. Keep your back straight.

Don’t Sleep on Your Stomach

This position is particularly stressing on the lumbar spine because it increases the curve and tends to stretch the muscles in the pelvis, causing more pain. If you have to sleep on your stomach, put a pillow or two under your abdomen. This will flatten your spine and place less pressure on the psoas muscle in the pelvis.

From Back in Control by Dr. David Borenstein