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Chiropractic Research Review

Bed Rest: More Harm than Good?

Bed rest is recommended as treatment for a number of conditions, including low back pain, myocardial infarction and rheumatoid arthritis. The idea of prescribing bed rest for illness perhaps stemmed from a quote by Hippocrates: "In every movement of the body, whenever one begins to endure pain, it will be relieved by rest." This practice has seen little change, despite evidence to the contrary.

This authors in this review conducted an exhaustive search of MEDLINE and the Cochrane library in an effort to assess the available research on the relative benefit or harm of bed rest as treatment for any condition.

Papers on randomized controlled trials of bed rest vs. early mobilization for any medical condition were gathered and analyzed.

Results: The authors found 39 trials on bed rest for 15 different conditions (5,777 patients). In 24 trials investigating bed rest following a medical procedure, no outcomes improved significantly and eight worsened significantly. In 15 trials investigating bed rest as a primary treatment, no outcomes improved significantly and nine worsened significantly.

These findings suggest that bed rest has not been shown to be an effective treatment option. The authors conclude, "We should not assume any efficacy for bed rest. Further studies need to be done to establish evidence for the benefit or harm of bed rest as a treatment."

Note: The methods used in this study were meticulous. A detailed list of all conditions evaluated for response to bed rest is included.

Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet 1999:354, pp1229-33.

Chiropractic Research Review

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