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Conservative options in the management of spinal disorders, Part I. Bed rest, mechanical and energy-transfer therapies.

Current literature does not support the efficacy of solitary use of energy-transfer therapies, such as ice or heat treatments, or electrotherapy, for the treatment of idiopathic back pain. Bed rest does not alter the natural history of back pain, and in fact can be detrimental to optimal recovery. Mechanical therapies, such as traction and orthoses, have limited usefulness. Although orthoses do not appear to weaken the trunk, they also do not appear to alter posture out of the brace, do not consistently diminish back muscle action during activities, and do not immobilize the spine. There have been no conclusive studies to substantiate the solitary use of any of these forms of treatment, although some may be beneficial at times in an adjunctive role.