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The Treatment of Acute Low Back Pain-Bed Rest, Exercises, or Ordinary Activity
NEJM 332:351-355, Malmivaara,A.,et al, 1995
See this aricle in Pubmed

Article Abstract
The patients were randomly assigned to one of three treatments:Bed rest for two days(67 patients),back-mobilizing exercises(52 patients),or the continuation of ordinary activities as tolerated(the control group;67 patients).Outcomes and costs were assessed after 3 and 12 weeks.After 3 and 12 weeks,the patients in the control group had better recovery than those prescribed either bed rest or exercises.There were statistically significant differences favoring the control group in the duration of pain,pain intensity,lumbar flexion,ability to work as measured subjectively,Oswestry back-disability index,and number of days absent from work.Recovery was slowest among the patients assigned to bed rest.The overall costs of care did not differ significantly amount the three groups.Among patients with acute low back pain,continuing ordinary activities within the limits permitted by the pain leads to more rapid recovery than either bed rest or back-mobilizing exercises.
 
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cost effectiveness
low back pain
pain,back
practice guidelines
prognosis
treatment of neurologic disorder

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