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Cochrane systematic review
Moderate quality evidence that compared to advice to rest in bed, advice to remain active provides small improvements in pain and functional status in people with acute low back pain
  1. Bart Koes
  1. Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Bart Koes
    PO Box 2040, 3000 CA Rotterdam, The Netherlands; b.koes{at}erasmusmc.nl

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Context

Acute low back pain (LBP) and sciatica are common reasons for contacting a primary care physician. There are many options for the initial management of an episode of acute LBP and sciatica including advice to stay active or advice to rest in bed. Until two decades ago the advice to rest in bed was common practice, but over the years this practice has changed towards a more active approach. Currently, almost all clinical guidelines for the management of acute LBP favour the advice to stay active above the advice to rest in bed.1 The question is to what extent this preference for staying active is based on evidence?

Methods

Dahm and colleagues performed a systematic Cochrane review evaluating the effects of advice to rest in bed and the advice to stay active in patients with acute LBP. Literature searches were carried out in relevant databases such as Cochrane Back Review Group Trials register, Medline and …

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