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This article was originally published in Positive Health issue 63 – April 2001
There was a time when bed rest was regarded as the treatment of choice for back pain. Only ten years ago, it was common for GPs to prescribe one to two weeks of bed rest to their patients suffering acutely from this complaint.
But the health industry can be as fickle as the fashion industry and the choice of treatment as volatile and ephemeral as the length of skirts. As a result, what was once a standard therapy can suddenly fall out of favour, often to be replaced by its exact opposite. This change of mind concerning therapeutic procedures is not always guided by logic and science. Other influences, not so commendable, can condition the stance of the National Health Service or other systems of health care. In these days of the so-called free market and global economy, it is certainly market forces that exert the strongest pressure on our health makers and fakers. When the medical profession and/or pharmaceutical industry want to introduce (or even impose) a totally new therapeutic regime to the public, some coating and coaxing are necessary to ease the swallowing of the new ‘pill’. Spin doctoring is not the preserve of politicians; physicians too, know how to doctor the spin.
Thus, nowadays, bed rest is not on the agenda for those suffering from back pain. Only old fogeys advise this treatment to their patients. Life must be lived in the fast lane; healing has to speed up or shut up. What was once, in certain forms of back trouble, a perfectly sound practice, is now considered heresy. Patients with acute back pain are told to resume normal activity as soon as possible; and, as time is money, the sooner the better. But how do you resume normal activity with a back in an abnormal condition? It’s difficult to move and work with any gaieté de coeur when you are crippled with pain. Not to worry, medicine offers help in the form of two magic bullets: painkillers and anti-inflammatory drugs. With a deadened nervous system and a repressed healing process, a ramrod-stiff back can quickly regain a lithe appearance.
The industrial revolution promised us the end of work; instead we have endless work. The motto of the new economy seems to be toil, toil until you spoil – your life. Recent statistics from America reveal that we are now working the equivalent of an extra month each year compared with ten years ago. Far from having freed us from work, the advent of IT has blurred the vital divide between labour and leisure, between domestic and professional life. Equipped with mobile phones and laptop computers, people working in the service industries carry their office on their backs: they can work wherever they are – and they do! On the way home on the train or the tube, on holidays in Tibet or Timor and at home, ‘sweat home’.
No wonder, then, that bed rest is bad news. Yet, under this working climate, dark clouds bank up in the office skies with their floods of back problems, RSIs and other complaints. This is why big companies are so fond of on-site massage services. No need to leave the office, the desk or even the chair; a little quick-fix rubdown on the spot and off you go! I see a parallel between professional sport and work. To be able to stay on the pitch or court after an injury, players have the doubtful benefits of modern medicine: a little spray here, a little injection of cortisone there, and back they go kicking the ball or whatever else they kick. This heroic and stiff upper-lip behaviour has, however, its drawbacks. The modern gladiator is hobbling and limping from such harsh treatment.
According to The Guardian, of 300 retired footballers, half of them are ‘…found to be suffering from osteoarthritis, a rate five times higher than their non-playing peers of the same age’. This high rate of arthritis is apparently the result of the numerous cortisone injections which they received during their playing careers. I can imagine a time when office workers suffering from any work-related complaint would be treated on the spot in the same expeditious manner. Sport and work united!
In his classic Rest and Pain, John Hilton wrote the following in 1863: ‘Under injury, pain suggested the necessity of, and, indeed, compelled him [man] to seek for, rest. Every deviation from this necessary state of rest brought with it, through pain, the admonition that he was straying from the condition essential to his restoration.’
Not any more, thanks to the magic of painkillers, anti-inflammatory drugs and muscle-relaxants. But let’s not forget that inflammation is a healing process and pain a warning signal. Switching them off with drugs makes you feel that all is well in the Brave New Body. But this is just an artificial form of well-being which may transform an acute condition into a chronic one. Although rest, like any good thing, can be abused (an overdose of rest to recover from an injury, for instance, can lead to stiffness and deformities caused by adhesions), it remains nevertheless an essential health factor which is, paradoxically, much overlooked in our modern times.
In Britain, about half a million people are suffering from RSI. A good use of the self and regular periods of rest could easily and drastically deflate this alarming figure. Yet, although all workers have the right by law to twenty minutes of rest every six hours, those sitting at a desk often fail to make use of this modicum of a breather.
I rest my case: human beings are not perpetual motion machines. Don’t be wicked: take a rest now!