Treatment of Acute Sciatica

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In patients with acute sciatica, bed rest and advice to stay active have similar outcomes on their functional status and perceived improvement. (Strength of Recommendation [SOR]: A) Spinal manipulation increases improvement compared with placebo; also, specific spinal pulling and turning manipulation techniques are more effective than traction. (SOR: A) Nonsteroidal anti-inflammatory drugs (NSAIDs) are similar to placebo in overall improvement. (SOR: A) Epidural steroid injections are unlikely to be beneficial. (SOR: A)

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