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• Most back pain, even when it feels terrible, is not due to a serious disease. Sometimes aches and pains can last a long time but this doesn't mean it is serious. It can be frustrating, but it does usually settle within days or a few weeks, at least enough to let you get on with your life.

• A proportion of people who get backache will get it again within a couple of years. But that still does not mean that it is serious. Most people return to normal activity between episodes.

• Your back is designed for movement: it needs movement - a lot of movement. The sooner you get moving and doing your normal activities, the sooner you will feel better.

• Resting for more than a day or two usually doesn't help and may prolong pain and disability.

• The people who cope best with back pain are those who stay active and get on with life despite the pain.

• Bed rest for more than a day or two actually prolongs the pain. If you have to rest, don't lie half slumped. Try to keep your back straight. Lie on your front (with a pillow under your tummy), on your back (with a pillow under your knees) or on your side (with a pillow between your knees), whichever is most comfortable.

• Limit you activities for a time, if needed - but stay active and get on with your life.

• Try not to slouch and avoid sitting for more than 20-30 minutes without getting up and moving around/stretching.

• Do not hesitate to use painkillers if you need them. You can safely ease the pain and get active: your body will not let you do any damage. Surprisingly, over the counter painkillers, are often the most effective for back pain. Paracetamol is the simplest and safest.

• Heat and cold can give short term relief and allow you to move better eg a well padded hot water bottle, a hot shower, or frozen peas wrapped in a damp towel placed on the sore area for 5-10 minutes.

• Manipulation/joint mobilisation may help if done by a qualified professional - a registered physiotherapist, osteopath or chiropractor. However you shouldn't need treatment for months on end and you should be shown ways to keep your joints moving and your muscles strong.

• Gentle movements can help ease the pain. Build these up steadily in the first few days, before you stiffen up, then progress to more organized exercise.

Remember - anxiety, stress and muscle tension can increase your pain so try to relax.

Some back exercises

Exercise gets your back moving again. It helps to stretch tight muscles and joints and stops the working parts seizing up. Getting stiff joints and muscles working can be uncomfortable but that does not mean you are doing any damage. Athletes accept that when they start training, their muscles can hurt.

Try these exercises slowly, a few at a time, often during the day. They may cause discomfort but this shouldn't be severe or long lasting. You may feel increased discomfort during exercise, but once stop, this should reduce and become easier. If the pain gets progressively worse, ask your physiotherapist whether to continue the exercise, or modify it.

1. Pelvic tilt

Lying on your back with your knees bent, place your hand in the small of your back. Press your back onto your hand, hold for a few seconds, release.

2. Knee rolling

Keeping your shoulder on the floor slowly roll both knees over to one side, starting gently, repeat to the other side.

3. Alternate leg hugs

Lying on your back with your knees bent, bend one up and hold it with your hands. Gently draw it up towards your chest, hold for a couple of seconds then gently lower. Repeat this with the other knee, gently taking it toward your chest.

4. Back extensions

Lying on your front, place your hands palm down level with your ears. Push up on your arms to straighten your elbows and arch your back as far as you can manage. (Don't try to get all the way up straight away- if it is very uncomfortable, you can start off by just propping on your elbows.) Keep your hips down. Relax and let your back sag. Hold this position for a few seconds then gently lower.

5. Back bends Stand with your hands at the base of your back. Let your hips relax forward and lean back slowly over your hands. Don't forget to keep your knees straight.

What to do if problems occur

If you have severe pain which gets worse over several weeks instead of better, or if you are unwell or losing weight, you should see your doctor.

Here are a few symptoms, which are all very rare, however if you do suddenly develop any of these you should see a doctor straight away.

• Difficulty passing or controlling urine.

• Numbness around your back passage or genitals.

• Numbness, pins and needles, or weakness in both legs.

• Unsteadiness on your feet.

PALS

The Patient Advice and Liaison Service (PALS) ensures that the NHS listens to patients, relatives, carers and friends, answers questions and resolves concerns as quickly as possible. If you have a query or concern, please visit them in the Information Centre on Level 2 at North Devon District Hospital or contact them on 01271 314090.

Have your say

Northern Devon Healthcare NHS Trust aims to provide high quality services. However, please tell us when something could be improved. If you have a comment or compliment about a service or treatment, please raise your comments with a member of the ward staff in the first instance.

Please also take the time to complete a comment card 'Tell us what you think', so we can make improvements.

If you would like to make a formal complaint, please contact the Customer Relations Manager on 01271 322334 or put your concerns in writing to the Chief Executive, Northern Devon Healthcare Trust, Raleigh Park, Barnstaple, EX31 4JB.

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