Compliance among general practitioners in France with recommendations not to prescribe bed rest for acute low back pain

Abstract

Acute low back pain is a very common reason for general practitioner visits. Objective. – To evaluate practices among French general practitioners regarding the prescription of bed rest in patients with low back pain. Methods. – 2000 general practitioners were to include the first three patients presenting within the first 3 d of onset of acute low back pain without nerve root pain. The characteristics of the pain, social and demographic characteristics of the patients, and treatments prescribed by the physicians were recorded. Results. – 5355 patients were included, of whom more than half had a history of one or more episodes of low back pain. The mean pain severity score on a 100-mm visual analog scale was 57.2 ± 22.7 mm. Bed rest was recommended to 27.6% of the patients, for a mean duration of 4.4 d. Patients to whom bed rest was recommended were significantly more likely than the other patients to have chronic low back pain (32.1% vs. 26.5%) and received a greater number of medications. Bed rest was associated with significantly poorer outcomes in the multivariable analysis adjusting for confounding factors. Conclusion. – Recommendations to avoid bed rest in patients with acute low back pain are widely followed in France. Furthermore, our results confirm that bed rest is associated with poorer outcomes.