What are the side effects of long term bed rest?

September 22, 2025 •

4 min read

Studies show that prolonged bed rest, even for as little as one week, can lead to significant muscle atrophy and bone density loss. While sometimes medically necessary, the consequences of extended immobility can impact nearly every system in the body. So, what are the side effects of long term bed rest?

Quick Summary

Extended periods of immobility from bed rest can cause severe deconditioning in the cardiovascular, musculoskeletal, and other body systems, leading to muscle weakness, bone density loss, blood clots, and psychological distress. These complications are often easier to prevent than to treat, requiring careful management.

Key Points

Muscle Atrophy: Long-term bed rest causes a rapid loss of muscle mass and strength, particularly in the legs, which can lead to significant weakness and mobility issues.
Bone Density Loss: The lack of weight-bearing exercise weakens bones by causing them to lose mineral content, increasing the risk of osteoporosis and fractures.
Cardiovascular Deconditioning: Immobility reduces the heart's efficiency and blood volume, leading to a decreased ability to manage gravity, which can cause dizziness and an increased heart rate upon standing.
Blood Clots (DVT): Reduced blood flow from inactivity increases the risk of dangerous deep vein thrombosis, where clots form in the legs and can potentially travel to the lungs.
Pressure Ulcers: Constant pressure on the skin, especially over bony areas, can cause painful and infectious bedsores.
Psychological Effects: Extended immobility often leads to mental health issues like depression, anxiety, frustration, and social isolation.

The profound impact on the body's systems

Long-term bed rest, once a common prescription for various ailments, is now recognized by the medical community as a practice with significant health risks. Research has shown that without the normal gravitational stress of being upright, the human body begins to decondition rapidly. The longer the period of immobility, the more severe the consequences, affecting everything from muscle strength and bone density to cardiovascular health and mental well-being.

Musculoskeletal deterioration: The visible effects

One of the most immediate and noticeable side effects is the rapid deterioration of the musculoskeletal system. The body's major weight-bearing muscles, particularly in the legs and trunk, lose strength and mass at an alarming rate. For a healthy person, strength can diminish by up to 15% in just one week. This process, known as muscle atrophy, also makes a person more susceptible to falls and injury once they become mobile again. Additionally, the lack of pressure on bones causes a decrease in bone mineral density (osteoporosis), making them weaker and more brittle over time.

Complications and prevention

Muscle Weakness and Atrophy: As muscles are not used, they begin to break down, leading to a significant loss of strength and endurance. This can severely limit a person's mobility and independence during recovery.
Contractures: Muscles and tendons can shorten and harden, causing permanent stiffness and deformity in joints. This is a painful condition that often requires physical therapy to correct.
Osteoporosis: Without the stress of weight-bearing activity, bones lose calcium and other minerals, increasing the risk of fractures.

Cardiovascular deconditioning: A hidden danger

The heart and blood vessels are also profoundly affected. In an upright position, the cardiovascular system works against gravity to pump blood throughout the body. During bed rest, this workload is significantly reduced, leading to a host of problems. Plasma volume decreases, and the heart's pumping efficiency diminishes. This results in a reduced maximal oxygen consumption (VO2max), meaning the heart has to work harder to do less.

Cardiovascular side effects

Orthostatic Intolerance: This condition, characterized by dizziness or fainting upon standing, occurs because the body is no longer accustomed to managing blood pressure changes related to gravity.
Deep Vein Thrombosis (DVT): A major risk, DVT involves the formation of blood clots in the deep veins, usually in the legs. Immobility causes blood to pool and move more slowly, increasing the chance of clot formation. These clots can be life-threatening if they break off and travel to the lungs, causing a pulmonary embolism.
Increased Heart Rate: Even at rest, a person's heart rate may increase as the heart becomes less efficient.

Other systemic complications

Beyond the musculoskeletal and cardiovascular systems, extended immobility affects nearly every other part of the body. The respiratory system can experience decreased lung ventilation, increasing the risk of pneumonia. The digestive system slows down, often causing severe constipation. The skin is prone to pressure ulcers, also known as bedsores, from constant pressure and friction in one spot. Urinary tract infections and kidney stones can also become more common.

Comparison of bed rest effects


System	Early Effects (within 1-2 weeks)	Long-Term Effects (weeks to months)
Musculoskeletal	Mild muscle weakness, reduced endurance	Significant muscle atrophy, severe weakness, joint contractures, early osteoporosis
Cardiovascular	Reduced plasma volume, mild orthostatic intolerance	Decreased cardiac reserve, marked orthostatic intolerance, higher DVT risk
Pulmonary	Reduced lung ventilation, minor atelectasis	Pneumonia risk, decreased respiratory capacity
Integumentary	Skin redness and irritation from pressure	Pressure ulcers (bedsores), infections
Neurological	Mild dizziness, poor coordination	Impaired balance, reduced proprioception, increased fall risk
Psychological	Irritability, boredom, frustration	Depression, anxiety, social isolation, feelings of helplessness

Psychological and cognitive effects

Confining a person to a bed for a long period can take a severe toll on their mental health. Feelings of isolation, frustration, and helplessness are common, potentially leading to anxiety and clinical depression. A person’s sense of independence and self-worth can be damaged, especially for those accustomed to an active lifestyle. The constant, unchanging environment and lack of social interaction exacerbate these feelings. Cognitive function can also suffer due to decreased stimulation and blood flow to the brain, potentially affecting memory and concentration.

Strategies for prevention and recovery

Because preventing complications is easier than treating them, healthcare providers focus on minimizing the negative effects of bed rest whenever possible. This can include getting patients moving as soon as their condition allows, or performing in-bed exercises if they cannot. Physical therapy is critical for regaining lost strength and mobility. Other strategies include frequent repositioning to prevent pressure ulcers, proper hydration and nutrition to aid digestion and bone health, and using compression stockings or medication to prevent blood clots.

For a deeper understanding of cardiovascular health and how to maintain it, visit the American Heart Association.

The long road to recovery

Recovering from prolonged bed rest is a slow, gradual process that requires patience and dedication. A personalized physical therapy regimen is essential to rebuild muscle strength, regain balance and coordination, and increase cardiovascular endurance. Psychological support, such as counseling or support groups, can help address the mental health challenges. With proactive management and a comprehensive rehabilitation plan, it is possible to recover and return to a more active and independent life. The key is recognizing the potential dangers early and working closely with healthcare providers to mitigate the risks.

Frequently Asked Questions

Significant muscle atrophy can begin very quickly, with studies showing noticeable loss of strength and lean tissue in as little as one week of bed rest.

Cardiovascular deconditioning is the weakening of the heart and blood vessels. Bed rest reduces the heart's workload by eliminating the stress of gravity, leading to decreased plasma volume and a less efficient heart pump.

Yes, prolonged bed rest can significantly impact mental health. Many people experience frustration, helplessness, boredom, and social isolation, which can lead to depression and anxiety.

Pressure ulcers, or bedsores, are painful skin injuries caused by sustained pressure. They can be prevented by regularly repositioning the person in bed (e.g., every two hours), using specialized mattresses, and ensuring proper skin hygiene.

Yes. When you are immobile, blood flow slows down, especially in the legs. This increases the risk of deep vein thrombosis (DVT), the formation of blood clots, which can be life-threatening if they move to the lungs.

Working closely with a healthcare team is crucial. Strategies include: early mobilization if possible, in-bed exercises, wearing compression stockings, following a good nutritional plan, and ensuring frequent repositioning to prevent bedsores.

While it can be a necessary treatment for certain severe medical conditions or injuries, modern medicine increasingly favors minimizing bed rest to prevent the serious complications associated with prolonged immobility.