The Role Of Bed Rest In Acute Low Back Pain

Main Category: Back Pain
Article Date: 06 Jun 2004 - 18:00 PDT

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Acute low back pain is a common problem and clinicians from a number of different disciplines are involved in its management.

Advice on daily activities constitutes an important part in the management of low back pain. In spite of evidence against its efficacy, bed rest continues to be a cornerstone of treatment.

The purpose of this review is to present evidence from literature to determine the effectiveness of bed rest for patients with acute low back pain together with comparison of bed rest versus advice to stay active, bed rest versus other treatment modalities and shorter periods of bed rest (2 to 4 days) versus longer periods (more than 4 days) of bed rest. There is strong evidence to suggest that bed rest is not effective in the management of acute low back pain.

Bed rest, low back pain, treatment, review.

Low back pain is a common reason for consulting one healthcare provider. The lifetime prevalence of low back pain is 60-80%. It is the most common cause of absence from work and early retirement with disability pension1,2. The aim of management of acute low back pain is relief of acute pain and prevention of chronicity.

Low back pain is managed by a number of different healthcare providers using a variety of treatment approaches. Bed rest has been specially advised for a number of medical conditions including low back pain. It is speculated that bed rest is helpful in patients with low back pain as many patients report relief of symptoms in horizontal position and in supine position the intradiscal pressure is minimal3.

Dangers of bed rest such as deep vein thrombosis, bed sores, osteoporosis and pneumonia were identified as early as in 1940s4. Bed rest is also known to be associated with reduction of exercise capacity as well as loss of muscle mass and bone density5.

A recent review6 has questioned the role of bed rest in the management of various medical conditions. Despite evidence against its efficacy, bed rest is still widely used in the management of low back pain7,8.

For many clinicians bed rest continues to be the cornerstone of treatment of acute low back pain. But rest may be advised based on the clinician's personal preference, prevalent clinical practice and experience as well as the socio-economic concerns and patient's demands.

Continue reading here.......Indian Medical Association Journal

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