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Evidence summaries

Bed Rest for Acute Low-Back Pain and Sciatica

Advice to rest in bed appears to be less effective than advice to stay active for people with acute low-back pain. For patients with sciatica, there is little or no difference between the two approaches. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 10 studies.

For patients with acute LBP, results from two trials (N = 401) suggest small improvements in pain relief (SMD 0.22 (95% CI 0.02 to 0.41) and functional status (SMD 0.29 (95% CI 0.09 to 0.49) in favour of advice to stay active. For patients with sciatica, there is moderate quality evidence of little or no difference in pain relief (SMD -0.03 (95% CI -0.24 to 0.18)) or functional status (SMD 0.19 (95% CI -0.02 to 0.41)), between advice to rest in bed or stay active.Low quality evidence (3 RCTs, N = 931) suggests little or no difference between exercises, advice to rest in bed or stay active for patients with acute LBP. Low quality evidence (1 RCT, N = 250) suggests little or no difference between physiotherapy, advice to rest in bed or stay active for patients with sciatica.

References

  • Dahm KT, Brurberg KG, Jamtvedt G et al. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev 2010;(6):CD007612. [PubMed]

Primary/Secondary Keywords