BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6978.542 (Published 25 February 1995) Cite this as: BMJ 1995;310:542

For ten years experts in the treatment of back pain have been recommending exercise rather than bed rest for attacks of acute pain not associated with sciatica. A controlled trial in Finland (New England Journal of Medicine 1995;332:351-5) compared bed rest for two days with back mobilising exercises or the continuation of ordinary activities as much as could be tolerated. This third approach came out best: recovery was slowest in patients assigned to rest in bed.

Women from families in which several relatives have had breast cancers and who are found to have one of the breast cancer genes should clearly be offered something more than counselling, though no preventive treatment has yet been shown to reduce mortality. A review in “JAMA” (1995;273:577-85) suggests that they should be offered clinical breast examination and mammography every six months beginning between the ages of 25 and 35. They should also be given the chance at least to discuss the possibility of prophylactic mastectomy, and they should also be offered similar preventive treatments for ovarian cancer (which is associated with some breast cancer genes).

Indeed, the National Institutes of Health …

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