It can be natural for people with persistent back pain to avoid being active, for fear of making things worse, but often, this can be counter-productive.
As Dr Grahame Brown, a consultant in persistent musculoskeletal pain, and David Rogers, a physiotherapist who specialises in spinal pain explain, while it may feel hopeless when pain won't let up, as the authors stress: "Persistent pain is not necessarily permanent and previous function can be restored."
Here are their top tips to ease persistent lower back pain.
1. Try getting back to normal
When back pain persists for more than a few months and various treatments have had limited benefits, research suggests that focusing less on getting rid of the pain and more on getting back to meaningful activities leads to better functioning and quality of life, and less pain.
2. Don’t overdo it
Do activity gradually and expect to feel worse initially - this is normal.
Don't overdo it, and review your plan weekly.
3. Build up your strength
Start simple, low-level cardiovascular, strengthening and stretching exercises, building up gradually.
4. Avoid stress
Family conflict and stress can affect recovery and should be resolved if possible.
5. Keep working
Staying in work is likely to help your back, not only because of potentially moving more, but also because research shows having a purposeful role leads to people having fewer problems with daily activities.
6. Talk to your doctor about medication
While medication can be beneficial, as it can help people with persistent back pain get moving, Rogers and Brown say it can sometimes prove counter-productive and make recovery more difficult, so being aware of the potential pitfalls of medication is important.
Always discuss changing medication with your doctor.
7. Stay relaxed
Prioritise sleep, take regular breaks from what you do during the day, and relax through breathing exercises, mindfulness or hobbies.
Relaxing can stimulate natural analgesics.
8. Work out what makes it flare-up
Identify flare-up triggers, which aren't necessarily physical movement but can be linked to stress, feelings or even the environment.
Be aware that painful flare-ups are very unlikely to be caused by damage to the spine. Don't let a flare-up make you much more cautious, thus slowing overall recovery.
Back To Life: How To Unlock Your Pathway To Recovery (When Back Pain Persists) by David Rogers and Dr Grahame Brown is published by Vermilion, priced £12.99. Available now