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See the back of daily pain; After a new study finds paracetamol doesn't work for easing lower back pain, Michele O'Connor looks at the causes and treatments for bad backs.

Byline: Michele O'Connor

WHETHER it is an ache, tension, or stiffness, most of us will experience back pain at some stage in our lives. And celebrities aren't immune either.

Golfer Tiger Woods withdrew from this month's Ryder Cup after being plagued by back pain all season.

But although paracetamol is usually the first-line treatment for GPs dealing with acute attacks of lower back pain, a major trial has now shown the painkiller does not help recovery or reduce pain levels.

In fact, say Australian researchers, advice and reassurance can do as much good for back-pain patients as regular doses of paracetamol.

So, what DOES work for your back pain? Here's our guide UPPER OR MIDDLE PAIN COMMON CAUSES: Pain in the upper and middle of the back is more unusual, as this area - known as the thoracic spine, running from the base of your neck to the bottom of the rib cage - does not move or flex as much as the lower back.

Poor posture, sudden twisting or turning, sleeping on a soft mattress, muscular strains and sprains, obesity and pregnancy are typical triggers.

If pain persists, diagnoses could include a herniated disc, arthritis, inflammation of the joints, nerve damage or even osteoporosis.

TRY THIS: Consider seeing a physical therapist.

Depending on the cause of your back pain, a physiotherapist, chiropractor or osteopath may be able to help. SELF?HELP: "Wrap up warm," says Sammy Margo, a chartered physiotherapist.

"Drafts can magnify muscle spasm, so wear as many air-trapping layers as possible.

ActiPatch "And bear in mind that stress can also increase muscle spasm - so find a positive stress reliever."

ALT LTL ERNAT ERNA IVE TREAT REAT REA MENT: Both structural (focusing on specific tissues) and relaxation posture," says Margo. TRY THIS: Nonsteroidal antiinflammatories such as Nurofen Express (PS3.56 for 16) are the most effective painkillers and come in the form of topical gels or tablets.

For severe pain, your GP may prescribe a stronger painkiller such as tramadol, and a short-term muscle relaxant (usually diazepam) for severe muscle spasm.

Physiotherapy is available through the NHS. Tens T machines can stimulate nerves to block pain.

And heat-wraps are highly effective.

SELF?HELP: Lose excess weight, stay active and think before lifting anything, advises Margo.

Bend at the knees - never the waist and build up the core abdominal muscles that support the spine through Pilates. ALTL TL ERNAT ERNA IVE TREAT REAT REA MENT: NICE has approved acupuncture as a costeffective NHS treatment.

Some GPs, pain nurses ome GPs, pain nurses and physio-therapists are trained to perform it.

PosturePlast (PS14.40 for four, Boots) placed against the spine relieves back pain while helping to correct the posture.

TIP: Always be aware of your posture when sitting and standing: "Think 'BBC' - Bums to Backs of Chairs'" advises Margo.

"This ensures you sit upright and avoid the dreaded 'C' slump.

SHOULDER PAIN COMMON CAUSES: Stress, carrying a heavy bag and using laptops and tablets on your lap are key triggers for aching shoulders, says Margo. TRY THIS: Ice and heat can make a significant difference, says physiotherapist and osteopath Tim Allardyce.

"Ice numbs the pain, reduces swelling and inflammation, and aids the healing process - but use a cold pack, ice bag or frozen peas wrapped in a towel intermittently (for around five minutes) not continuously.

"Heat improves the blood circulation, bringing fresh oxygen to the affected area and relaxes the muscles.

"Use a hot-water bottle with a towel wrapped around it for 20 minutes, three times per day."

Try Boots Pharmaceuticals Hot/ Cold Compress (PS6.99) SELF?HELP: "Don't rest the shoulder completely or it will stiffen up," advises Allardyce.

"Keep it mobile and use it in its comfortable range.

"Avoid painful movements while the pain is acute. Don't lift your arms above your head or do any sports such as golf or badminton."

Clear out your bag and alternate arms when carrying.

ALT LTL ERNAT ERNA IVE TREAT REAT REA MENT:A University of Lancaster trial showed the Bowen technique - massaging the connective tissues that wrap around our muscles and link them to the bone - helped those with a frozen shoulder regain full mobility. Visit for a practitioner.

And try Tiger Balm Neck & Shoulder Rub (PS6.99, Superdrug) to stimulate circulation and relax tense neck and shoulder muscles. TIP: Take time out mid-morning T and afternoon to sit with your hands in your lap and gently pull shoulder blades up, then back and down. Hold for 10 seconds and repeat 10 times.

SCIATICA COMMON CAUSES: "Although people talk about a 'slipped disc', discs cannot actually slip," explains Dr Keith Souter, author of 50 Things You Can Do TODAYT To Manage Back T Pain (Summersdale, PS6.99).

Sometimes a disc bulges in the same way that a car tyre can bulge if there is a weakness in the wall and often it can "prolapse" or partially rupture.

Both can cause sciatica by compressing or irritating the sciatic nerve, the main nerve supplying the leg. Pregnancy and osteoarthritis are other common causes.

TRY THIS: Over the counter antiinflamatory painkillers such as ibuprofen. Hot or cold compression packs and rubefacients (heatproducing preparations) can also help.

The heat produced by these rub on ointments overrides pain signals to the deeper tissues by a process called counter-irritation, explain Dr Souter.

Otherwise your GP may refer you to a specialist for an epidural steroid injection, which delivers strong anti-inflammatory medication directly to the inflamed area. SELF?HELP: Avoid prolonged sitting, standing or walking. It usually takes just a few days to recover from sciatica. In the meantime, remain active (no bed rest!) and keep changing your position.

ALT LTL ERNAT ERNA IVE TREAT REAT REA MENT:CBT (Cognitive Behavioural Therapy) can train you to react differently to pain. Electromagnetic Pulse Therapy may also help - try ActiPatch (PS19.99, Boots). TIP: "Try and stand with both feet firmly planted on the ground and tilt your pelvis slightly forward to ensure your weight is distributed evenly.

Alternatively, switch your weight from one foot to the other," says Margo.

FOR | information, advice and support contact the charity BackCare on 0845 130 2704 or visit (Swedish) massage therapy can help to ease pain, say scientists at the Group Health Research Institute in the US.

TIP: Get properly fitted for a bra. If your breast weight isn't properly supported, the muscles in your neck and thoracic spine (upper back) constrict to carry the load while bras that fit too tightly can restrict blood flow to the spine or dig into the middle of the spine, putting pressure on the nerves in the back.

(upper back) constrict to carry the load while bras that fit too tightly can restrict blood flow to the spine or dig into the middle of the spine, putting pressure on the nerves in the back.

LOWER BACK COMMON CAUSES: Around 80% of lower back pain is diagnosed as 'nonspecific'.

(PS19.99 Boots) "The most likely causes are poor core stability due to bad posture and weak stomach muscles, bending and lifting with incorrect techniques, excess weight and poor sleeping


Ibuprofen painkillers like Nurofen can help ease sciatica sufferers' pain

Poor posture can lead to back problems

ActiPatch (PS19.99 Boots)
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Title Annotation:Features
Publication:The Journal (Newcastle, England)
Date:Sep 25, 2014
Previous Article:GPs: We need to invest now; Crisis looms as numbers set to fall in region.

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