Whatever happened to the idea that bedrest can help with back pain? When my back hurts, I just want to lay on the couch. But my doctor and physical therapist both gang up on me and insist I stay active, exercise, and show up for work everyday. Is that really sound advice?

Long-gone are the days when long periods of bedrest was the number one treatment choice for back pain. Now we know without a shadow of a doubt that such advice can make things worse, not better.

At the same time, doctors are prescribing far fewer muscle relaxants and narcotic painkillers. The reason is the same: research data does not support the use of these treatment methods. Back pain simply isn’t any better with (compared to without) these measures. And the potential negative side effects of medications makes this option less than desirable.

Anytime the patient reports constant and severe pain (or they simply don’t get better with conservative care), it’s a red flag of something more serious. It could be a tumor or infection. At that point, more advanced studies may be ordered (e.g., X-rays, MRIs).

But, in general, most people with low back pain who follow the stay active advice feel better and return to work and regular activities quickly.