Why Resting When You Have Chronic Pain Is An Outdated Idea

When I ask new Pilates clients how they have been previously managing their chronic back, hip, knee, or shoulder pain a common response I hear is - "I've been resting it."  When I ask them if resting seems to be working in the long term they admit that their pain is either not improving or increasing.  There is a growing body of evidence to suggest that "resting" when you have chronic pain is delaying the healing process.  There is strong evidence that prolonged bed rest does not improve outcome (pain, disability, days missed from work, or functional ability).  When I had glandular fever more than 25 years ago now I was warned not to move from my bed for 6 weeks and if I did I would develop chronic fatigue syndrome. Too terrified to leave my bed except to go to the bathroom, I followed the advice exactly. What happened? I developed chronic fatigue syndrome. Most of the time I was too ill to move, but I definitely could have benefitted from 5 min gentle movement sessions.  Let's take a look at the history and outcomes of bed rest to see why bed rest for chronic pain has become so ingrained in our culture and why we should replace resting with moving where appropriate.

Where Did The Idea That Resting Helps Chronic Pain Originate?

In the 1800s, bed rest was widely prescribed for various medical conditions, including back pain, infectious diseases, and mental health issues often for 6-8 weeks.  Physicians believed that providing the body with ample rest allowed it to conserve energy and direct its resources toward healing injured or diseased tissues.  While bed rest may have provided some relief for certain conditions, it also carried risks, including muscle atrophy, joint stiffness, and complications associated with prolonged immobility. Many patients developed mental health issues from the isolation as we now know human connection and interaction are vital for our mental well-being.  Movement is essential for our physical and mental health but when you have chronic pain it needs to be targeted and specific to your individual needs

How Does Movement Benefit Chronic Pain & Promote Healing?

If you have had surgery in the last few years you will know firsthand that the aim is to get you back on your feet as soon as possible for short periods after the procedure. There are exceptions to this but the general rule is to start walking as soon as possible as prolonged immobility after surgery can increase the risk of complications such as blood clots, pneumonia, pressure ulcers, and muscle weakness. Moving and engaging in gentle exercise helps to stimulate blood circulation, prevent stagnation, and reduce the likelihood of developing these complications. Prolonged bed rest for chronic pain carries similar risks and while small amounts of rest can be beneficial, too much is harmful. It is now widely accepted that moderate exercise can produce an anti-inflammatory response in the body and brain. One study suggests just 20 minutes of low-intensity exercise is sufficient to produce this anti-inflammatory response and as inflammation is present in so many painful conditions this is a very encouraging finding for pain sufferers. Joseph Pilates was ahead of his time when he said "Change happens through movement and movement heals," and we now have the evidence to prove it.

How To Start Moving & Keep Moving With Pilates

When you are dealing with chronic pain and the idea of moving seems daunting, my online Pilates program is the ideal place to begin.  After an Initial Assessment with me, you can begin with just 5-10 minutes per day of therapeutic movement and gradually increase the duration of your Pilates sessions as you become more comfortable and confident. It's also very personalised and I can suggest which exercises are ideal for your individual needs. The key is to start small and build on that. Short walks are also a good place to start and I mean very short. Depending on your circumstances you begin with a 2 or 3 minute walk and build from there. It's crucial to start small and avoid overwhelming your nervous system if you haven't been moving for a while.  Even small amounts of movement will add up to great things that will change your life!

Caution: When Is It Not Safe To Move?

Always check with your medical practitioner before moving if you have chronic pain.  Moving during an acute pain episode or severe illness is not advisable. Acute pain is usually much shorter in duration as opposed to chronic pain which can persist for months or years.  You may not be allowed to weight bear after certain joint replacement surgeries or may be advised not to move if you have fractured bones. So it's always best to obtain medical advice to ensure moving is appropriate for you.

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