OBJECTIVE: To establish the effectiveness of bed rest for lumbosacral radicular syndrome. DESIGN: Randomised clinical trial. METHOD: Primary care patients with a lumbosacral radicular syndrome were referred by the general practitioner to the neurology department of Maastricht University Hospital in the period of February 1995 to December 1996. They were randomly assigned to either bed rest or watchful waiting during 14 days. Effects were measured 2 and 12 weeks after the treatment. The primary outcome measure was improvement as experienced by the patient and evaluated by the observer. Secondary outcome measures were pain, bothersome of complaints, functional status, satisfaction, absenteeism, need of specialist treatment and operations undergone. The analysis was made on the basis of 'intention to treat'. RESULTS: A total of 183 patients were enrolled: 92 in the bed rest group (47 males and 45 females, mean age 44 years) and 91 in the control group (56 males and 35 females; mean age 48 years). After two weeks, 64 patients (70%) in the bed rest group reported improvement as compared with 59 patients (65%) in the watchful waiting group (adjusted odds ratio: 1.2, 95% confidence interval 0.6 to 2.3). After 12 weeks 87% of the patients in both groups reported improvement. The secondary end points were similar in both groups. CONCLUSION: For patients with a lumbosacral radicular syndrome, bed rest is not a more efficient therapy than watchful waiting.

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