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Therapeutics
Bed rest, physiotherapy, and continuation of activities of daily living were equally effective for sciatica

https://doi.org/10.1136/ebm.7.5.154

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    (2002) J Neurosurg (Spine) 96, 45; Hofstee DJ, Gijtenbeek JM, Hoogland PH, et al.. Westeinde Sciatica Trial: randomized controlled study of bed rest and physiotherapy for acute sciatica.. Jan;. :. –9.
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 QUESTION: In patients with sciatica of < 1 month of duration, is treatment with bed rest or physiotherapy more effective than continuation of activities of daily living (ADLs)?

    Design

    Randomised (unclear allocation concealment*), unblinded,* controlled trial with 6 months of follow up.

    Setting

    Outpatient clinic of a university medical centre in the Hague, the Netherlands.

    Patients

    250 patients <60 years of age (mean age 39 y, 60% men) who were referred by general practitioners for sciatica with radicular pain lasting <1 month. Exclusion criteria were the cauda equina syndrome, severe weakness, or previous bed rest or physiotherapy. 225 patients (90%) were included in the 6 month follow up.

    Intervention

    Patients were allocated to bed rest (n=84), physiotherapy (n=83), or continuation of ADLs (n=83). Bed rest could be done …

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    Footnotes

    • Source of funding: Hoelen Foundation.

    • For correspondence: Dr D J Hofstee, St Jansdal Hospital, Harderwijk, Netherlands. DJ.Hofstee{at}StJansdal.nl.

    • ↵* See glossary.