A herniated disc, also known as a slipped disc or ruptured disc, is a condition that occurs when the inner gel-like core (the nucleus pulposes) of an intervertebral disc protrudes through a tear in the outer fibrous ring (the annulus fibrosus). This can place pressure on surrounding nerves, resulting in pain, numbness, or weakness.
One of the most common questions patients have after diagnosis is whether it is better to rest or stay active. While conventional wisdom once favored bed rest, contemporary medical research paints a more nuanced picture. In this article, you will gain an understanding of the pros and cons of rest versus movement for individuals with herniated discs.
The intervertebral discs serve as cushions between the vertebrae in the spine. Over time or due to sudden strain, these discs may herniate, causing compression of nearby nerves. The most commonly affected areas are the lumbar (lower back) and cervical (neck) regions.
Understanding the mechanism of injury is crucial to determining the appropriate course of treatment, including how much rest is needed and when to resume movement.
For decades, the standard advice for back pain, including herniated discs, was extended bed rest. Physicians believed that immobilization would reduce inflammation, prevent further damage, and allow tissues to heal. However, this approach has increasingly come under scrutiny.
Studies from the late 20th century began to challenge this view. For instance, a 1999 randomized controlled trial published in the New England Journal of Medicine compared two weeks of bed rest with 12 weeks in patients suffering from sciatica due to a herniated disc. The results showed no significant benefit from prolonged rest, and most patients improved regardless of rest duration.
Current guidelines favor staying active within pain limits. The North American Spine Society, along with other organizations like the American College of Physicians, recommends remaining physically active to the extent possible.
In a study published in the New England Journal of Medicine, researchers found that patients who participated in a structured exercise program recovered faster than those who relied solely on passive treatments like rest or medication.
This does not mean rest is entirely unnecessary. During acute flare-ups—particularly when pain is severe—short-term rest may be appropriate. Limiting activity for 24 to 48 hours can reduce inflammation and avoid further aggravation of the disc.
Even during rest periods, some movement—like gentle stretching or changing positions frequently—is encouraged to prevent stiffness and circulatory problems.
Once the acute pain diminishes, a gradual return to activity is crucial. The key is choosing low-impact exercises that do not place excessive stress on the spine.
According to a systematic review, supervised exercise therapy is more effective than usual care in reducing pain and improving function in herniated disc patients.
Not all movement is beneficial. Certain activities can exacerbate the condition and delay recovery. Avoid:
Consulting with a spine specialist or physical therapist ensures your activity plan is both safe and effective.
Sometimes, patients avoid movement due to pain, creating a vicious cycle of deconditioning and worsened symptoms. In such cases, short-term use of medications can help:
However, these treatments are supportive and should not replace movement and rehabilitation strategies.
Movement is typically beneficial, but some red flags may indicate a more serious condition that requires medical intervention:
If any of these symptoms are present, seek immediate medical evaluation.
So is it better to rest or move with a herniated disc? The evidence strongly supports a balanced approach. Short-term rest may be helpful during acute flare-ups, but prolonged inactivity is counterproductive. Instead, guided low-impact movement fosters healing, reduces pain, and prevents long-term disability.
The modern consensus is clear: stay as active as your symptoms allow and let rest serve as a short-term tool, not a default strategy. Working with a healthcare provider to tailor your activity level ensures the best chance for recovery.
If you have a herniated disc that is not responding to conservative treatment, a discectomy may be discussed and potentially recommended. Although this is generally a very successful procedure, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.