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A French study indicates that the rest in bed, usually prescribed in the event of acute lumbago, has a harmful effect on the evolution of lumbar pathology. It involves, indeed, a risk of chronicity

A painful lumbago
The lumbago, pain located in the bottom of the back on of the 5 lumbar vertebrae level, has a high prevalence, which makes of it a true problem of public health in the industrialized countries. The acute lumbago, so called lumbago, or more familiarly backache, is a painful lumbar blocking by wrist of the intervertebral discs. The beginning is brutal, on effort, traumatism or clumsy movement, sometimes with perception of a cracking. The magnitude of the pain varies, but is often very painful. Up to now, the doctors prescribed rest in bed during a few days before taking gradually a normal activity again. A practice that a French investigation conducts in general medicine comes to contradict.

A investigation conducts in general medicine
The lumbago constitutes a very frequent reason for consultation in general medicine. This is why the French researchers carried out their investigation near 2.000 general practitioners in order to collect the data concerning the regulation of the rest in bed. Each general practitioner had to include at the date of the investigation the first three patients suffering, since less than three days, from an acute lumbago without irradiation of the pain in the leg (or with an irradiation not exceeding the knee), without associated neurological sign nor specific sign evoking a tumor or an infection. These patients had to consult for the first time for this problem. On total, 5.355 old patients from 18 to 55 years (average age 40 years) were included. More half of them, actually, had already undergone one or more episodes of lumbar pains.

Occupation and circumstances
The occupation included in many cases, presumed factors of risk, such as a bad positioning of the trunk (42%), activities of handling (32%), considerable muscular efforts (18%). A patient on two however did not formulate any complaint in connection with his professional situation. Among the circumstances of occurred of the lumbago, the general practitioners noted a domestic activity (39%), an accident at work (22%) and the practice of a sport (16%). The mechanism of the lumbago was activated by a movement without great deal of effort (32%), the carrying of a load (32%), a supported effort like pushing or drawing (20%) and a fall or a traumatism (8%).

Risk of chronicity
The rest in bed was recommended to 28% patients for one 4,4 days average duration. Among the latter, the doctors noted thereafter a percentage significantly higher of chronicles lombalgic, compared with the group without rest in bed (32% against 26%), as well as a more important recourse to the drugs. In addition, the evolution of the lumbago significantly appeared more favorable in the group without rest.

Conclusion: in the event of no complicated acute lumbago, it is important to be able to move quickly. It is all the interest of a good antalgic/anti-inflammatory treatment, which facilitates the resumption of the movements.





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