OBJECTIVE: To assess the efficacy of bed rest and orthoses for low-back pain. DESIGN: computer-aided search of published, randomized, clinical trials, and assessment of the study methods. SUBJECTS: 5 randomized trials evaluating bed rest, and 5 randomized trials evaluating the efficacy of orthoses. MAIN OUTCOME MEASURES: quality score of the methods, based on the 4 categories of study population, interventions, effect measurement, and data presentation and analysis; conclusions of the author(s) with regard to the efficacy of bed rest or orthoses. RESULTS: 2 of the 5 bed rest trials scored more than 50 points (maximum is 100). The results indicated that short periods of bed rest (2 or 5 days, respectively) were as effective as longer periods (4 or 8 days, respectively). Short periods of bed rest were more beneficial regarding absenteeism from work and return to a normal level of activities. 3 of the 5 orthoses trials scored more than 50 points. One of these indicated that orthoses were more effective than the advice on rest and life-style; the 2 others did not report any difference between orthoses and the reference treatments. CONCLUSIONS: Randomized trials evaluating the efficacy of bed rest and orthoses vary widely in their methodological quality. Short periods of bed rest are as effective as longer periods and have less side-effects (including absenteeism from work). Whether a short period of bed rest is more beneficial than no bed rest at all, has yet to be demonstrated. The efficacy of orthoses for treating low-back pain remains controversial, although there are some promising results in the literature.

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