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Related Experiment Videos

Lack of effectiveness of bed rest for sciatica

P C Vroomen1, M C de Krom, J T Wilmink

  • 1Department of Neurology, Maastricht University Hospital, The Netherlands. pvr@sneu.azm.nl

The New England Journal of Medicine
|February 11, 1999
PubMed
Summary

Bed rest for sciatica (lumbosacral radicular syndrome) showed no significant benefit over watchful waiting. Both treatments resulted in similar improvements in pain, function, and work absence after 12 weeks.

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Area of Science:

  • Neurology
  • Orthopedics
  • Evidence-Based Medicine

Background:

  • Bed rest is a common recommendation for sciatica, but its efficacy lacks robust scientific evidence.
  • Lumbosacral radicular syndrome, commonly known as sciatica, affects a significant population, necessitating effective treatment strategies.

Purpose of the Study:

  • To evaluate the effectiveness of two weeks of bed rest compared to watchful waiting for managing lumbosacral radicular syndrome.
  • To determine if bed rest offers superior outcomes in terms of patient-reported improvement, pain reduction, and functional status.

Main Methods:

  • A randomized controlled trial involving 183 patients diagnosed with lumbosacral radicular syndrome.
  • Patients were assigned to either a two-week bed rest regimen or a watchful waiting approach.

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  • Outcomes included global assessments of improvement, pain scores, functional status, work absenteeism, and surgical intervention rates, assessed at 2 and 12 weeks.

    • Main Results:

    • No statistically significant difference in global improvement was observed between the bed rest and watchful waiting groups at 2 or 12 weeks.
    • Pain intensity, symptom bothersomeness, and functional status showed no significant variations between the two treatment arms.
    • Absenteeism from work and the need for surgery were comparable in both the bed rest and watchful waiting groups.

    Conclusions:

    • Bed rest for two weeks is not more effective than watchful waiting for patients with lumbosacral radicular syndrome.
    • Current evidence does not support the routine recommendation of bed rest for this condition.