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Prolonged bed rest is generally not beneficial for patients with nonspecific low back pain, but what about sciatica? In this blinded, controlled trial from the Netherlands, researchers randomized 183 patients with presumed sciatica either to two weeks of bed rest or to a control group in which they were instructed to be "up and about whenever possible." Two thirds had a positive straight-leg-raising test, 38% had sensory loss, 17% had muscle weakness, and half had nerve-root compression on MRI.
Patient-reported rates of improvement were not significantly different at 2 weeks (70% in the bed-rest group and 65% in controls) or 12 weeks (87% in both groups). Several pain scores were also similar in the two groups. Moreover, the two groups had n…