Basis, indications and risk

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Neuroreflexotherapy (NRT) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

Maintaining level of activity

It consists of remaining as active as the pain allows, and leading as normal a life as possible while the pain lasts.

Objective

To shorten the duration of the pain, to decrease the limitation of activity while the episode lasts, and to diminish the risk of the pain becoming chronic.

Theoretical base

To maintain a maximum level of activity can improve the evolution of patients with back pain through several mechanisms:

1. There are studies that demonstrate that, through a reflex mechanism, movement tends to relax the muscles. For example, it has been demonstrated that the stretching of the membrane that surrounds the facet joint relaxes the back muscles. This would explain why maintaining the highest possible level of activity prevents or improves muscular contracture and, inversely, maintaining rigid or constant postures - for example, in bed - facilitates the appearance or persistence of muscular contracture.
2. There are studies that demonstrate that muscular tone is rapidly lost. Including after a short four day rest, muscular tone can start to decrease. This would explain why those patients who have bed rest take longer to recuperate and to lead a more normal lifestyle than those who do not.
3. There are studies that demonstrate that in subjects who have a predisposition due to psychological or social factors, the limitation of activity strengthens the fear of pain and establishes a vicious circle which increases the risk of the pain lasting longer and of reappearing. Maintaining the highest possible level of activity decreases the risk of this occurring.

Scientific Proof of its Efficacy

All of the scientific studies done to date demonstrate that maintaining the highest level of activity permitted by the pain is effective in shortening its duration, in shortening and improving limitations to normal lifestyle, and in reducing work absenteeism.

Risks

None.

Indications

Recommendations based on the available scientific evidence coincide in stating that it is necessary to remain as active as possible during the period of pain, and to avoid bed rest.