Lengthy bed rest prescribed for acute low back pain: experience at three general medicine walk-in clinics

Early gradual ambulation is currently recommended for patients with acute low back pain if results of neurologic examination are normal. Bed rest for up to 2 days is considered optimal. To assess management practices, we retrospectively reviewed the medical records of individuals with acute back pain treated at three independent general medicine walk-in clinics. Patients having an acute flare-up of chronic back pain were excluded. Bed rest was recommended at the initial visit for 171 patients who had normal findings on neurologic examination. The duration of recommended bed rest was recorded in 76 of these 171 patients' medical records (44%). The median duration of recommended bed rest was 5.5 days (range 1 to 14 days). Most patients (60/76 [79%]) were advised to rest in bed longer than 2 days. Even if all patients in whom duration of bed rest was not recorded had been told to rest in bed for 2 days or less, bed rest prescriptions would still have been too lengthy in 60 of these 171 patients (35%). This practice may prolong the recovery of patients with acute low back pain.