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WITHDRAWN: Bed rest for acute low-back pain and sciatica.

Abstract

BACKGROUND

Low-back pain (LBP) is a common reason for consulting a general practitioner, and advice on daily activities is an important part of the primary care management of low-back pain.

OBJECTIVES

To assess the effects of advice to rest in bed for patients with acute LBP or sciatica.

SEARCH STRATEGY

We searched the Cochrane Back Group Specialized Registry, CENTRAL, MEDLINE, EMBASE, Sport, and SCISEARCH to March 2003, reference lists of relevant articles, and contacted authors of relevant articles.

SELECTION CRITERIA

Randomised or controlled clinical trials with quasi-randomisation (alternate allocation, case record numbers, dates of birth, etc.), in any language, where the effectiveness of advice to rest in bed was evaluated. The main outcomes of interest were pain, functional status, recovery and return to work.

DATA COLLECTION AND ANALYSIS

Two authors independently selected trials for inclusion, assessed the internal validity of included trials and extracted data. Investigators were contacted to obtain missing information.

MAIN RESULTS

Eleven trials (1963 patients) were included in this updated version. There is high quality evidence that people with acute LBP who are advised to rest in bed have a little more pain [Standardised Mean Difference (SMD) 0.22 (95% Confidence Interval (CI): 0.02, 0.41)] and a little less functional recovery [SMD 0.29 (95% CI: 0.05, 0.45)] than those advised to stay active. For patients with sciatica, there is high quality evidence of little or no difference in pain [SMD -0.03 (95% CI: -0.24, 0.18)] or functional status [SMD 0.19 (95% CI: -0.02, 0.41)], between bed rest and staying active.For patients with acute LBP, there is moderate quality evidence of little or no difference in pain intensity or functional status between bed rest and exercises. For patients with sciatica, there is moderate quality evidence of little or no difference in pain intensity between bed rest and physiotherapy, but small improvements in functional status [Weighted Mean Difference 6.9 (on a 0-100 scale) (95% CI: 1.09, 12.74)] with physiotherapy. There is moderate quality evidence of little or no difference in pain intensity or functional status between two to three days and seven days of bed rest.

AUTHORS' CONCLUSIONS

For people with acute LBP, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active. There is little or no difference in the effect of bed rest compared to exercises or physiotherapy, or seven days of bed rest compared with two to three.

Authors+Show Affiliations

National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, PO Box 23 Vindern, 0319 Oslo, Norway.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

20556750

Citation

Hagen, Kåre Birger, et al. "WITHDRAWN: Bed Rest for Acute Low-back Pain and Sciatica." The Cochrane Database of Systematic Reviews, 2010, p. CD001254.
Hagen KB, Hilde G, Jamtvedt G, et al. WITHDRAWN: Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010.
Hagen, K. B., Hilde, G., Jamtvedt, G., & Winnem, M. (2010). WITHDRAWN: Bed rest for acute low-back pain and sciatica. The Cochrane Database of Systematic Reviews, (6), CD001254. https://doi.org/10.1002/14651858.CD001254.pub3
Hagen KB, et al. WITHDRAWN: Bed Rest for Acute Low-back Pain and Sciatica. Cochrane Database Syst Rev. 2010 Jun 16;(6)CD001254. PubMed PMID: 20556750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - WITHDRAWN: Bed rest for acute low-back pain and sciatica. AU - Hagen,Kåre Birger, AU - Hilde,Gunvor, AU - Jamtvedt,Gro, AU - Winnem,Michael, Y1 - 2010/06/16/ PY - 2010/6/18/entrez PY - 2010/6/18/pubmed PY - 2010/7/28/medline SP - CD001254 EP - CD001254 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 6 N2 - BACKGROUND: Low-back pain (LBP) is a common reason for consulting a general practitioner, and advice on daily activities is an important part of the primary care management of low-back pain. OBJECTIVES: To assess the effects of advice to rest in bed for patients with acute LBP or sciatica. SEARCH STRATEGY: We searched the Cochrane Back Group Specialized Registry, CENTRAL, MEDLINE, EMBASE, Sport, and SCISEARCH to March 2003, reference lists of relevant articles, and contacted authors of relevant articles. SELECTION CRITERIA: Randomised or controlled clinical trials with quasi-randomisation (alternate allocation, case record numbers, dates of birth, etc.), in any language, where the effectiveness of advice to rest in bed was evaluated. The main outcomes of interest were pain, functional status, recovery and return to work. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion, assessed the internal validity of included trials and extracted data. Investigators were contacted to obtain missing information. MAIN RESULTS: Eleven trials (1963 patients) were included in this updated version. There is high quality evidence that people with acute LBP who are advised to rest in bed have a little more pain [Standardised Mean Difference (SMD) 0.22 (95% Confidence Interval (CI): 0.02, 0.41)] and a little less functional recovery [SMD 0.29 (95% CI: 0.05, 0.45)] than those advised to stay active. For patients with sciatica, there is high quality evidence of little or no difference in pain [SMD -0.03 (95% CI: -0.24, 0.18)] or functional status [SMD 0.19 (95% CI: -0.02, 0.41)], between bed rest and staying active.For patients with acute LBP, there is moderate quality evidence of little or no difference in pain intensity or functional status between bed rest and exercises. For patients with sciatica, there is moderate quality evidence of little or no difference in pain intensity between bed rest and physiotherapy, but small improvements in functional status [Weighted Mean Difference 6.9 (on a 0-100 scale) (95% CI: 1.09, 12.74)] with physiotherapy. There is moderate quality evidence of little or no difference in pain intensity or functional status between two to three days and seven days of bed rest. AUTHORS' CONCLUSIONS: For people with acute LBP, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active. There is little or no difference in the effect of bed rest compared to exercises or physiotherapy, or seven days of bed rest compared with two to three. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20556750/WITHDRAWN:_Bed_rest_for_acute_low_back_pain_and_sciatica_ L2 - https://doi.org/10.1002/14651858.CD001254.pub3 DB - PRIME DP - Unbound Medicine ER -