World Library  
Flag as Inappropriate
Email this Article

Bed rest

Article Id: WHEBN0014471554
Reproduction Date:

Title: Bed rest  
Author: World Heritage Encyclopedia
Language: English
Subject: Knee scooter, Rest, National Jewish Health, Acute prostatitis, History of brassieres
Publisher: World Heritage Encyclopedia

Bed rest

The Invalid, painting by Louis Lang in the Brooklyn Museum

Bed rest is a medical treatment in which a person lies in bed for most of some period of time to gain health benefits. Bed rest refers to voluntarily lying in bed as a treatment, and not being confined to bed because of a health impairment which restricts a person from leaving the bed. Even though the practice is still commonly used for an array of conditions, it is not shown to be an effective treatment for any illness.[1]

Bed rest is especially used when prescribed or chosen. Even though most patients in hospitals spend most of their time in the hospital beds, bed rest more often refers to an extended period of recumbence at home. It is commonly part of pregnancy in United States of America where it is prescribed to nearly 20% of pregnant women[2] despite the growing volume of data showing it to be dangerous, causing some experts to call its use "unethical".[3][4][5]


There are no known conditions where bed rest is shown to be an effective treatment.[1] However, bed rest is commonly prescribed in the following cases despite the known risks.

  • For sufferers of acute pain in the spine or joints; for example, in the case of backache the unloading of the corresponding spinal segment decreases the intradiscal pressure, and it would bring relief in cases such as compression of spinal nerve. The prescribed duration of bed rest vary and opinions differ.[6] As a treatment for low back pain, bed rest should not be used for more than 48 hours.[7]
  • Bed rest is prescribed for some maternal or fetal complications of pregnancy, such as preterm labor, high blood pressure, incompetent cervix, or fetal growth problems. In the past it was a general prescription during any kind of pregnancy, now deprecated.[8]
  • Women pregnant with twins or higher-order multiples are at higher risk for preterm labor, preeclampsia (toxemia), and other pregnancy complications, thus bed rest is common in these cases. About 50% of women pregnant with twins will be on some form of bed rest for at least part of their pregnancy. Recent studies have shown that routine bed rest in twin pregnancies (bed rest in the absence of complications) does not improve outcomes; however, bed rest is almost always prescribed for women carrying triplets or more.[9]
  • Heart diseases
  • Bed rest is an important measure in the cases of chorea. In the mild cases it may suffice for treatment.[10]
  • Acute gout, as early ambulation may precipitate a recurrence.[11]

Inclined bed rest is a common practice for people suffering from some forms of Gastroesophageal reflux disease[12][13] and heart disease [14] and for patients who are on a ventilator.[15] Despite its prevalence, several studies exploring the effects of tilting the head of a bed have found no support for beneficial health claims.[16][17]

Adverse effects

Prolonged bed rest has long been known to have deleterious physiological effects, such as muscle atrophy and other forms of deconditioning such as arterial constriction.[18] Besides lack of physical exercise it was shown that another important factor is that the hydrostatic pressure (caused by gravity) acts anomalously, resulting in altered distribution of body fluids. Even physical exercise in bed fails to address certain adverse effects.[19]

It is also a major cause of thrombosis,[20] mainly by reducing blood flow in the legs.[21]


This man in 1945 England has been prescribed complete bed rest, and accepts assistance so as not to sit up to drink

Complete bed rest refers to discouraging the person in treatment from sitting up for any reason, including daily activities like drinking water.[22]

Placing the head of a bed lower than the foot is sometimes used as a means of simulating the physiology of spaceflight.[23]


As a treatment, bed rest is mentioned in the earliest medical writings. The rest cure, or bed rest cure, was a 19th-century treatment for many mental disorders, particularly hysteria. "Taking to bed" and becoming an "invalid" for an indefinite period of time was a culturally accepted response to some of the adversities of life. In addition to bed rest, patients were secluded from all family contact in order to reduce dependence on others. The only person that bed rest patients were allowed to see was the nurse who massaged, bathed, and clothed them. Patients were also not allowed to use their hands at all. In some extreme cases electrotherapy was prescribed. The food the patient was served usually consisted of fatty dairy products in order to revitalize the body with new energy. This cure as well as its name were created by doctor Silas Weir Mitchell, and it was almost always prescribed to women, many of whom were suffering from depression; especially postpartum depression. It was not effective and caused many to go insane or die. In the middle of the 20th century, bed rest was still a standard treatment for markedly high blood pressure. It is still used in cases of carditis secondary to rheumatic fever. Its popularity and perceived efficacy have varied greatly over the centuries.

Some negative effects of bed rest were historically attributed to drugs taken in bed rest.[24]


  1. ^ a b Bed Rest Ineffective as Therapy : The Journal of Family Practice
  2. ^ Bed Rest During Pregnancy
  3. ^ Allen C, Glasziou P, Del Mar C (October 1999). "Bed rest: a potentially harmful treatment needing more careful evaluation". Lancet 354 (9186): 1229–33.  
  4. ^ Is It ‘Unethical’ To Prescribe Bed Rest For Pregnant Women? | CommonHealth
  5. ^
  6. ^ Weiner, Richard (2002). Pain management: a practical guide for clinicians. Boca Raton: CRC Press. p. 741.  
  7. ^  , which cites
  8. ^
  9. ^ Crowther, Caroline A; Han, Shanshan; Crowther, Caroline A (2010). "Hospitalisation and bed rest for multiple pregnancy".  
  10. ^ NINDS Sydenham Chorea Information Page of the National Institute of Neurological Disorders and Stroke
  11. ^ Page 251 in: Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins.  
  12. ^ Richter, Joel E.; Donald O. Castell (April 1981). "Current Approaches in the Medical Treatment of Oesophageal Reflux". Drugs 21 (4). 
  13. ^ Hamilton, John W; Ronald J. Boisen MD; Dennis T. Yamamoto MD; Joanne L. Wagner; Mark Reichelderfer MD (May 1988). "Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid". Digestive Diseases and Sciences 33 (5): 518–522.  
  14. ^ Reynolds, Sharon RN, CS-ACNP, MSN; Waterhouse, Kathleen RN, CS-ACNP, MSN; Miller, Kathleen H. RN, CS-ACNP, EdD (2001). "Head of bed elevation, early walking, and patient comfort after percutaneous transluminal coronary angioplasty". Dimensions of Critical Care Nursing 20 (3): 44–51.  
  15. ^
  16. ^ Wojner, Anne W.; El-Mitwalli, Ashraf; Alexandrov, Andrei V. (February 2002). "Effect of Head Positioning on Intracranial Blood Flow Velocities in Acute Ischemic Stroke: A Pilot Study". Critical Care Nursing Quarterly 24 (4). Current nursing practice for the care of patients with ischemic stroke advocates routine elevation of the head of the bed (HOB) to 30°. Evidence supporting this practice is lacking, and it may reflect inappropriate generalization of findings from studies conducted primarily on traumatic brain injury patients with associated increased intracranial pressure to the ischemic stroke population. 
  17. ^ Vincent J. Miele MD, Ali Sadrolhefazi MD, Julian E. Bailes MD (May 2005). "Influence of head position on the effectiveness of twist drill craniostomy for chronic subdural hematoma". Surgical Neurology 63 (5). 
  18. ^ Bleeker MW, De Groot PC, Rongen GA, et al. (October 2005). "Vascular adaptation to deconditioning and the effect of an exercise countermeasure: results of the Berlin Bed Rest study". Journal of Applied Physiology 99 (4): 1293–300.  
  19. ^ Woods, Susan L. (2005). Cardiac nursing. Hagerstwon: Lippincott Williams & Wilkins. p. 921.  
  20. ^ Mitchell, Richard Sheppard; Kumar, Vinay; Robbins, Stanley L.; Abbas, Abul K.; Fausto, Nelson (2007). "Chapter 4". Robbins basic pathology (8th ed.). Saunders/Elsevier.  
  21. ^ Hypercoagulability during Pregnancy Lab Lines. A publication of the Department of Pathology and Laboratory Medicine at the University of Cincinnati. September/October 2002 Volume 8, Issue 5
  22. ^ Mayo Clinic Staff (2011). "Bed rest during pregnancy: Get the facts - Mayo Clinic". Retrieved 27 March 2014. 
  23. ^
  24. ^ Dock, William (1944). "THE EVIL SEQUELAE OF COMPLETE BED REST". Journal of the American Medical Association 125 (16): 1083.  
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.