The Updated Cochrane Review of Bed Rest for Low Back Pain and Sciatica

  title={The Updated Cochrane Review of Bed Rest for Low Back Pain and Sciatica},
  author={K{\aa}re Birger Hagen and Gro Jamtvedt and Gunvor Hilde and Michael F. Winnem},
Study Design. A systematic review within the Cochrane Collaboration Back Review Group. Objectives. To report the main results from the updated version of the Cochrane Review on bed rest for low back pain. Summary of Background Data. There has been a growing amount of evidence showing that bed rest is not beneficial for people with low back pain. However, existing systematic reviews are unclear regarding the effects of bed rest for different types of low back pain. Methods. All randomized… 

Physical therapy for back pain.

The specialty of spine medicine has made significant advances in improving the quality of clinical back pain research in recent years with wide adoption of validated outcome measures and more careful identification and description of patient subtypes.

Musculoskeletal Back Pain

Comparison of physician's advice for non-specific acute low back pain in Japanese workers: advice to rest versus advice to stay active.

It is suggested that advice to rest may not be better than advice to stay active for preventing future episodes of AL BP in Japanese workers, which is consistent with previous studies or guidelines for the management of ALBP in Western countries.

Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline

Current evidence on noninvasive therapies for low back pain in adults is summarized and several therapies that have not been studied in the United States or are not widely available are reviewed in the complete evidence review.

Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

This guideline is to present the available evidence for evaluation and management of acute and chronic low back pain in primary care settings and grades its recommendations by using the ACP's clinical practice guidelines grading system.

Management of a female with chronic sciatica and low back pain: A case report

The addition of muscle activation, muscle inhibition, and a left hip capsule flexibility exercises resulted in remarkable outcomes and appears to be beneficial for eliminating pain and improving function for this woman with chronic right sciatica/LBP.

Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial

The results support early physical therapy as cost-effective relative to usual primary care after 1 year for patients with acute, nonspecific LBP.

The knowledge of low back pain management between physical therapists and family practice physicians

The results of this study may have implications for third-party payers and health care administrators regarding the utilization of physical therapists in the management of patients with LBP in expanded scopes of practice, including direct access and potential placement in primary care clinics.



Bed rest for acute low-back pain and sciatica.

For people with acute LBP, advice to rest in bed is less effective than advice to stay active, and for patients with sciatica, there is moderate quality evidence of little or no difference in pain intensity or functional status between bed rest and exercises.

Systematic reviews of bed rest and advice to stay active for acute low back pain.

  • G. WaddellG. FederM. Lewis
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1997
A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.

Lack of effectiveness of bed rest for sciatica.

Among patients with symptoms and signs of a lumbosacral radicular syndrome, bed rest is not a more effective therapy than watchful waiting.

Does 48 hours' bed rest influence the outcome of acute low back pain?

  • M. Wilkinson
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1995
It appears that 48 hours' bed rest cannot be recommended for the treatment of acute low back pain on the basis of this small study, and large-scale definitive trials are required to detect clinically significant differences.

Acute Low-Back Pain: An Objective Analysis of Conservative Therapy

The results showed that bedrest, as compared with ambulation, will decrease the amount of time lost from work by 50% and analgesic medication, when added to bedrest in the treatment of lumbago, does not provide an advantage over bedrest alone.

Bed Rest or Normal Activity for Patients With Acute Low Back Pain: A Randomized Controlled Trial

The findings of this study indicate that prescriptions for bed rest, and thus for sick leaves, should be limited when the physical demands of the job are similar to those for daily life activities.

Westeinde sciatica trial: randomized controlled study of bed rest and physiotherapy for acute sciatica.

Bed rest and physiotherapy are not more effective in acute sciatica than continuation of ADLs.

Towards a better understanding of low-back pain: a review of the mechanics of the lumbar disc.

By measurement of intradiscal pressure in vitro, the hydrostatic properties of the nucleus pulposus of normal lumbar intervertebral disc was established. The stress distribution within normal discs

Grading quality of evidence and strength of recommendations

A system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts is developed, and a summary of the approach from the perspective of a guideline user is presented.