Prolonged Bed Rest After Back Injury Not Advisable

After a back injury, the best thing you can do is to become mobile as quickly as possible. Why?  Just as on long trips by car or plane, you could develop a problem with blood clots in your legs or lungs. A case review in 2000 reported just such a problem for a 29-year-old woman with the onset of acute low back pain from lifting and standing on a ladder at work. The day after the injury she developed pain on both sides of her lower back. She was given medication and several days of bed rest.

When her pain wasn’t better she visited a doctor who did a joint injection. With no relief, she saw a different physician who put her on 2 weeks of bed rest. She continued with bed rest and physical therapy for a total of 21 weeks. She stopped going to physical therapy after she noticed leg pain that got worse with each session. She noticed swelling of her legs the night before she left for a trip by plane.

The morning after arrival to her destination, she was seen by a physician who suspected that she might have a blood clot. A Doppler ultrasound of her legs and VQ scanning (a test for blood clot in the lung) revealed that she had extensive blood clots in her legs and some in both lungs. She had not had problems breathing.

Interestingly, she had no family history of lower leg vascular problems or blood clot. She had no history of smoking. She had been taking birth control pills. The authors suggest prolonged bed rest may have been the cause of her blood clots: not only does the body redistribute fluid when lying down, the heart  has to work harder to pump blood to the lower extremities. This pooling of blood can lead to a blood clot.

Bottom line: if you have leg pain after prolonged bed rest, you may want to suggest to your physician that you be checked for blood clots. This is particularly important if you are taking birth control pills. If the pain makes it difficult to get back on your feet, the authors suggest, anti-inflammatories and analgesics may help you become mobile more quickly.

For more information:”Deep venous thrombosis and pulmonary embolism as a complication of bed rest for low back pain,” C. Slipman, MD; J. Lipetz, MD; H. Jackson, MD; E. Vresilovic, MD, PhD; Archives of Physical Medicine and Rehabilitation, volume 81, issue 1, p.127-129, January 2000.