When to Rest — and When to Move — With Acute Pain

If you’re experiencing pain after an injury, illness, or surgery, you may be wondering if you should rest or start moving, despite the pain. The truth is, both are important for helping your body heal.

With acute pain, “Rest reduces inflammation and prevents further injury,” says Nicole Matar, MD, an interventional pain and spine specialist at Hospital for Special Surgery in Stamford, Connecticut. “In the first 24 to 72 hours, relative rest allows the inflammatory phase of healing to occur appropriately.”

Taking it easy is probably a welcome prescription if you’re in discomfort. But it’s also important not to fall into the trap of kicking your feet up for too long. “You want to give your body a small grace period to get that initial healing going, but you do want to start moving sooner, rather than later,” says Conor O’Donovan, DPT, who treats people in the pain management center at Shirley Ryan AbilityLab in Chicago. “While you might avoid moving entirely most of the first day, after that brief time, getting in some gentle movement is also crucial.”

How you balance the two will determine how quickly and comfortably you nix the pain and bounce back.

It’s important to talk with your doctor and devise a plan for rest that’s best for you. How you should take it easy will depend on the pain and what’s causing it, but as a general rule, some variation of RICE — rest, ice, compression, elevation — is often the way to go, says Dr. Matar. “That being said, rest is more aligned with taking it easy and not true bed rest.”

Rest may be the way to go if you have:

• Sharp or intense pain
• Swelling, redness, or warmth. These can be signs that you still have a lot of inflammation around the injury.
• Tightness or weakness that keeps getting worse. “If you’re experiencing progressive loss of range of motion — it’s getting tighter and stiffer — or progressive weakness, that’s a sign you’re doing too much,” says O’Donovan. (In some cases, though, tightness or stiffness can also be a sign that you need to move more, so talk with your healthcare provider about what course of action is best for you.)
• Pain that worsens with movement. “If you're waking up the next day after doing a lot of moving and the pain is worse than it was yesterday, you probably overdid it,” says O’Donovan.

You may want to rest less and move more when:

• Serious injury is ruled out.
• Swelling is going down and pain is improving.
• You’re feeling a little bit stiff. “Gentle movement helps circulation, prevents stiffness, and reduces nervous system sensitization,” says Matar. “You don’t need to wait for all of the inflammation to disappear.”
• You notice yourself being cautious with movement. “Pain often leads to guarding or altered biomechanics, which can result in muscle strains that are not part of the initial injury, and it’s important to avoid that as much as possible,” says Matar.

How much and what types of physical activity you should be doing while recovering from acute pain is very individual, and it’s important to discuss a movement plan fully with your doctor and/or physical therapist.

Here are some basic guidelines about what movements tend to be beneficial:

• Range-of-Motion Exercises You might work on upping your range of motion, especially in the area where you’re experiencing pain. Physical therapy is often part of the equation, says Matar, or you can try gentle yoga, tai chi, or strength moves with just your body weight or light resistance. It’s all about starting slowly and progressively loading as you get stronger and have less pain. “The intensity of your exercise or movement should increase slowly, based on how well you’re tolerating it,” she says.
• Light Walking Cut back on how much you might normally walk, especially if it makes the pain flare up. For instance, you might go out for a 10-minute walk instead of your usual 30 minutes, says O’Donovan.
• Isometric Strength Training This type of resistance exercise, which involves holding weight in a static position (without movement), is a good place to start with an injury, especially if the pain increases with movement, says O’Donovan. Isometric strength training has been shown to preserve muscle strength and improve the pain threshold to support rehab without overstressing the injured area.

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As for using braces and other devices designed to keep the injured area stable, don’t assume you should wear one, unless your doctor recommends it. “A risk factor for chronic pain is fear of movement, and with a brace, we’re breeding a fear of moving and getting back to the activities that you want to be doing,” says O’Donovan. Instead, maintaining gentle, safe movement is a good idea for healing and to avoid stiffness in muscles and joints. But above all, he adds, make sure you listen to your healthcare provider’s plan, which has been tailored for you.

Bottom line: It’s about finding the right balance. You don’t want to take it too easy when dealing with acute pain, but you shouldn’t push yourself too far beyond your comfort zone right now either. This can lead to prolonged inflammation or reinjury. As a general rule, if you’re doing something and it hurts, stop, says Matar. “Mild discomfort during activity is acceptable, but movement should not be sharply painful.”

• After an injury, illness, or surgery, both rest and gentle movement are important for recovery. A day or two of rest can help calm inflammation, but staying still for too long can slow healing and increase stiffness.
• As pain and swelling improve, gradually engaging in light movement, such as walking, range-of-motion exercises, and gentle strength work, can support circulation, preserve mobility, and prevent chronic pain.
• The key is balance: Avoid pushing through sharp or worsening pain, follow your doctor’s guidance, and increase activity slowly, based on what your body can tolerate.