4. What to Do in Sudden Attack of Backache.
Use ice pack (frozen peas!), bed-rest, possible first aid support using strapping or corset type support.

Avoid anything which hurts the area. Stay still. Get advice.

5. When to Call In or Visit an Osteopath or Chiropractor
All chronic back conditions can be helped to some extent, once serious pathology has been ruled out.

Acute back pain where no organic disease is present usually benefits. Recent studies show chiropractic/osteopathic methods speed up recovery compared with rest of other methods, such as those used in physiotherapy.

6a. Where to Find an Osteopath/Chiropractor
Obtain names of local MROs or MBCAs from registering authority. General Council and Register of Osteopaths, 56 London Street, Reading, Berks. (0734-576585)

Ensure osteopath is member of Register as this guarantees 4 year full-time training or MD training plus osteopathy. Look in Yellow pages for box of MROs or members of British Chiropractic Association. MCOs are members of college of Osteopaths and will have had a six year part time training which is also very sound.

6b. When Should MD be Called First?
If in any doubt as to nature of problem see a doctor or consult a registered osteopath. If the problem is not the result of active degenerative disease (arthritis, osteoporosis etc) an osteopathic practitioner will help to some extent, and will be trained to know what not to treat and when to refer to MD specialist.

6c. What Conditions Should be Suspected in Back Pain Which is Not Clearly of Mechanical Origin?
Pain of mechanical origin will usually cause pain related to movement (not normally painful at rest).

If mechanical pain is severe it may continue at rest but adoption of new position will usually ease it. If pain is persistent at rest suspect deeper pathology or structural damage. Mechanical pain is usually intermittent.

If pain is noted when a joint is actively moved in one direction and passively moved in another then soft tissue involvement is probable.

If joint pain is noted on active and passive motion in same direction then internal joint dysfunction is likely.

7. What Osteopaths Do, What Chiropractors Do.
Methods of joint mobilisation and structural reintegration will be discussed and demonstrated. Basically osteopaths mobilise restrictions with due attention to soft tissues and to total mechanism. Chiropractors tend to deal more with local problem and to use very specific high velocity low amplitude adjustment techniques, usually based on interpretation of x-rays of the area.

In general osteopaths use less invasive (gentler) approaches.

8. Exercises to Help Back Problems.

• Lying on back, light 'flattening' of back to bed/floor while alternately, and slowly, stretching heel away from body. Repeat five times each side.

• Lying on back always have knees slightly flexed over cushion/ bolster. Exercise to ease low back tension/disc conditions involves bringing one knee up towards chest, held at knee by same side hand, and then bringing other leg up similarly. Lie holding knees in this curled position (usually painless, stop and abandon if painful). As exhalation occurs ease knees towards shoulders, hold for a second or two and slowly return to starting position on inhalation. Repeat for several minutes (20 cycles or so) Do this every hour or two when in pain.