Not a fact anymore

Acute low-back pain is best treated with prolonged bed rest.

What we know now

For most uncomplicated acute low-back pain, prolonged bed rest provides no advantage and can delay recovery. Patients are generally encouraged to remain active as tolerated while serious causes are assessed when warning signs are present.

Why it changed

Pain was interpreted as evidence that movement would worsen injury, making rest standard advice. Randomized trials and systematic reviews found that bed rest was ineffective or slightly harmful compared with maintaining ordinary activity.

Status
Overturned
Category
Medicine
Accepted for
≈140 years
Accepted approximately
19th century–1980s
Changed approximately
1980s–1990s

Some conditions involving fracture, severe neurological compromise, systemic illness, or postoperative instructions require temporary restriction. Those are not ordinary nonspecific back pain.

“Remain active” does not mean ignoring severe pain or immediately resuming every load. Activity can be modified and increased gradually.

Evidence

Sources and what they establish

Primary research

Current evidence

Related entries

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