EXERCISE AND MASSAGE

Mercer, a consultant physiotherapist at Western Sussex Foundation NHS Trust. NICE suggests hands-on therapies are used alongside exercise for back pain without sciatica. Osteopathy is a hands-on therapy which involves manipulating bone, muscles, ligaments and connective tissue. It may be best for back pain where there is muscular tension or spasm.

DOES IT WORK? A 2016 study by researchers at the University of Sydney involving 30,850 people over six months found that patients with back pain who carried out a range of exercises reduced their risk of painful twinges by 35 per cent. A U.S. study published in 2013 in the Annals of Family Medicine found those who had osteopathy had significantly reduced low back pain, compared to those who received sham osteopathy. Patients had six treatments over 12 weeks. Research published in the American Annals of Internal Medicine in 2011 suggested that those with back pain recovered faster and experienced fewer symptoms if they did a 12-week course of yoga instead of conventional exercise. The Alexander Technique, which teaches improved posture and movement, has also been shown to be of benefit. Patients with recurrent low back pain who had lessons in the technique had less pain compared to those who had normal care, according to a study in the BMJ in 2008.

CAN I GET IT ON THE NHS? Physiotherapy and osteopathy are available on the NHS, but access is limited. Privately, physio costs £40-£60 for a half-hour session and osteopathy £40-£100 for half an hour.