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2011年6月26日 星期日

Low Back Pain And Sciatica - Should I Rest Or Keep Active?


It's a dilemma faced by many. You have suffered an attack of low back pain or sciatica and do not know whether to rest or keep active. I will now explain the main principles which will help guide you to the right decision.

Fortunately, the days are long gone (with the odd exception) where those suffering with low back pain or sciatica were advised to have bed rest for days on end. This is probably one of the worst things you could do for your pain.

Without doubt, the emphasis is on keeping active. However, this does not mean you need to grin and bear it and soldier on through pain, this could also make things worse. Ultimately, you need to be aware of what your body is telling you and act accordingly.

As the body is healing itself, it is important we do not place too much stress across the injured structures i.e. keep too active, as this will simply interfere with the healing process. I can use the analogy here of trying to run too soon after you have torn a muscle in your leg. If you were to do that, you would not be surprised if you made the injury worse.

However, it is equally important that some stresses are placed across those same structures. This is because the strength of those injured tissues after healing will be related to the stresses they encountered during healing. If all you do is rest your low back/sciatic nerve, the pain may well subside eventually, but it will only be used to 'resting i.e. not doing very much. If you were to then increase the stresses across them significantly afterwards, they may not be able to tolerate this and therefore the potential for re-injury is increased.

Consequently, the important factor here is getting the happy medium between activity and rest.

So how do you know what the happy medium is then?

You listen to your body. If you are placing too much stress across your low back or sciatic nerve, your body will let you know by causing you pain. These pain messages are a warning system for you, that you are not allowing it to heal itself as it would like to. If, however, you allow the body to heal itself by not placing too much stress across the structures concerned, your body will keep quiet and you will perceive no, or very little, pain.

Do not be misled into thinking that it is best to place no, or very little, stress across the injured structures though. As I mentioned above, it is important to place some stresses across them, so they heal stronger.

Therefore, if you have rested and feel your pain is beginning to subside, be sensible, but slowly begin to increase the degree of activity you are performing. If you can do this without aggravating you pain - fantastic, slowly but surely continue to increase your levels of activity as time passes.

If on the other hand, as you begin to increase your levels of activity you feel your pain begin to worsen, you are potentially interfering with the healing process. Therefore ease off back to a level you were comfortable with. Stick with that level for a day or so and then, providing things are going OK, try to gently increase your activity levels again.

As your low back and sciatica nerve become stronger with this approach, it will be important to carry out specific exercises in order to target certain structures. This will enable you to increase strength and improve flexibility. This will result in the pain you are suffering resolving quicker and also the chances of you suffering a repeat recurrence less likely.








Paul Boxcer - Bsc (Hons) Physiotherapist, has over 13 years experience of treating people in pain. During this time and especially over the last few years, he has concentrated his treatment on those suffering with Low Back Pain & Sciatica. Visit his website blog at http://spinal-health-care.com/blog/ to learn about Paul's unique approach to treating both sciatica and low back pain.

Paul's book"Low Back Pain & Sciatica - A Personalised Treatment Approach" not only explains everything you need to know in order to allow you to cure yourself of the pain you may be suffering with, but by addressing the cause of the problem, it ensures the risk of subsequent episodes is also eliminated. Visit Paul on his Facebook page for further information or maybe ask him a question or two!


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