The RCGP - Clinical and Special Projects, Clinical Guidelines, Acute Low Back Pain. Contents, Index page


Chapter 3

Principal Recommendations
Linked to Evidence

Diagnostic Triage
Use of X-Rays
Drug Therapy
Bed Rest
Advice on Staying Active
Back Exercises



Staying Active


Recommendations Evidence

Advice on Staying Active

Advise patients to stay as active as possible and to continue normal daily activities.

Advise patients to increase their physical activities progressively over a few days or weeks.

If a patient is working, then advice to stay at work or return to work as soon as possible is probably beneficial.

 Advice to continue ordinary activity can give equivalent or faster symptomatic recovery from the acute attack, and lead to less chronic disability and less time off work than ‘traditional’ medical treatment with analgesics as required, advice to rest and ‘let pain be your guide’ for return to normal activity.
Graded reactivation over a short period of days or a few weeks, combined with behavioural management of pain, makes little difference to the rate of initial recovery of pain and disability, but leads to less chronic disability and work loss.
Advice to return to normal work within a planned short time may lead to shorter periods of work loss and less time off work.


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