Back on your feet for a cure

Back pain is the most commonly reported symptom after headache and tiredness.

Various estimates have been made of its enormous cost, in sick days and in the burden it imposes on health services.

Although there are measures to prevent it, back pain is indiscriminate, striking the straight as well as the bent, the thin as well as the fat, the fit as well as the slothful.

Six out of 10 people suffer back pain at some time in their lives and millions consult their GPs each year.

But to what effect? A new report suggests very little will help a bad back.

The best treatment is to grin and bear it - and carry on.

The treatment of back pain has undergone a revolution in the last couple of decades.

It is a lesson in how radically medicine can change its approach.

The traditional treatment of extended bed rest, traction and manipulation under anaesthetic went out a decade ago.

Sufferers are now advised to swallow a couple of Paracetamol, get some physical manipulation if necessary to get them back on their feet and, above all, to keep moving.

The latest advice comes from York University.

Its report, Acute and Chronic Low Back Pain, amounts, in essence, to a series of don'ts:

* Don't go to bed - it prolongs recovery, makes no difference to the pain, reduces satisfaction (compared with staying active) and leads to a longer period off work.

* Don't try exercise therapy - aerobics, for example - although there is evidence this can be effective for chronic back pain lasting longer than six months.

* Don't waste your money on spinal manipulation - osteopathy, chiropractic and similar techniques - unless you need immediate relief to enable you to carry on your normal activities. Manipulation can give short-term improvement but does not appear to speed recovery.

* Don't bother with lumbar supports, traction, injections or acupuncture - the evidence for them is unclear, limited or contradictory.

- HERALD CORRESPONDENT