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Chiropractic Research Review

Lack of Effectiveness of Bed Rest for Sciatica

Tradition, but little data, exists to support the approach that bed rest is the most appropriate treatment for patients with sciatica. This randomized controlled clinical trial measured if two weeks of bed rest did more for patients than watchful waiting for the same period.

image - Copyright – Stock Photo / Register Mark

Subjects of this study at the Maastricht University Hospital in the Netherlands had back pain sufficient to justify two weeks of bed rest. A group of 92 patients stayed in bed in a supine or lateral recumbent position for two weeks, but were allowed to get up to use the toilet and to bathe. The control group of 91 was instructed to be up and around whenever possible but to avoid straining the back or provoking pain. They were allowed to go to work, and bed rest was not entirely prohibited. All patients were allowed to take medication for pain and insomnia.

Investigators did not know which patients belonged to the bed-rest group and which to the control group. The primary outcome measures were the investigators' and patients' global assessments of improvement after 2 and 12 weeks. The secondary outcome measures included changes in functional status and pain scores, absenteeism from work, and need for surgical intervention.

The researchers found no evidence that bed rest is an effective treatment for patients with sciatica. Their conclusion was that "among patients with symptoms and signs of a lumbrosacral radicular syndrome, bed rest is not a more effective therapy than watchful waiting."

Vroommen PCAJ, de Krom MCTFM, Wilmink JT, et al. Lack of effectiveness of bed rest for sciatica. The New England Journal of Medicine, Feb. 11, 1999;340(6), pp418-23.

Chiropractic Research Review

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