Complimentary ways with backs

Will therapies such as Pilates, massage and doses of glucosamine help you with a bad back? The charity BackCare has looked at the latest evidence and this is what it found.

CHIROPRACTIC
Chiropractic is a regulated therapy and practitioners must be fully qualified and registered with the General Chiropractic Council. It is based on the idea that problems with the spine affect the nervous system, causing pain and sometimes illness.

Chiropractors use different techniques, one of the most important being adjustments to the spinal joints.

A lot of research has been done on the effectiveness of chiropractic. One major study found it was better at relieving back pain than no treatment and as good as, but not better than, painkillers, exercise and physiotherapy. There have been rare cases in which the treatment has been linked to stroke and paralysis.

The treatment is not advised for people with osteoporosis, malignant spinal disease, blood conditions such as leukaemia or for those taking warfarin or other anti-coagulants.

A BackCare internet survey of 2,240 people who visited its website found that among those who had tried chiropractic, 33 per cent felt it had helped for six months or more, 38 per cent that it had given only temporary relief and 15 per cent that it didn't help.

For more information contact the General Chiropractic Council on 020 7713 5155/www.gcc-uk.org

MASSAGE THERAPIES
Some types of massage can be gentle, while others can be powerful and uncomfortable. Research suggests massage may temporarily ease lower back pain and depression, while improving sleep and range of movement. Massage is best for strains or stress-related tension. It is not advised for those with osteoporosis, or those who have had deep vein thrombosis or other vein problems.

BackCare survey: Helped for six months 25 per cent; temporary relief 56 per cent;

PILATES
This exercise method aims to bring the body back into balance and achieve core stability by strengthening the back and abdominal muscles that support the spine. It is one of the safest forms of exercise for bad backs if properly taught. The movements are often very small but can be more demanding than they look.

There are no major scientific reviews of the effect of Pilates on back pain. Some movements should be avoided by people with degenerative disc disease, especially those that involve bending forwards, arching backwards or twisting the spine.

BackCare survey: Helped for six months 45 per cent; temporary relief 33 per cent; no help 14 per cent.

The Body Control Pilates Association (020 7379 3734/www.bodycontrol.co.uk) lists its professionally trained teachers.

YOGA
There are several different types of yoga but all deal with educating the body, mind and spirit to balance the energy flows within the body and improve health. Many yoga poses are beneficial for bad backs. However, doing some incorrectly could cause damage. In general, if you are using yoga as therapy for a back problem, find a one-to-one teacher.

Although there is much anecdotal evidence on the health benefits of yoga, there is a surprising lack of scientifically rigorous research into its effects on bad backs. Because it works on the mind as well as the body, yoga may help break the vicious circle of pain and depression.

BackCare survey: Helped for six months 42 per cent; temporary relief 36 per cent; no help 13 per cent.

The British Wheel Of Yoga provides details of teachers who have trained to meet certain standards: contact 01529 306852/www.bwy.org.uk

ALEXANDER TECHNIQUE
This teaches you to use your body better by making you more aware of your balance, posture and movements. It is based on the idea that we function as a whole and that, to make improvements, we need to learn to prevent harmful habits such as overtightening muscles and putting too much effort into posture and movements.

There are no independent reviews of the effects of the technique on back pain.

BackCare survey: Helped for six months 32 per cent; temporary relief 33 per cent; no help; 27 per cent.

To find a teacher in your area contact the Society of Teachers of the Alexander Technique on 0845 230 7828/www.stat.org.uk

GLUCOSAMINE
Cartilage prevents bones from rubbing together and helps absorb shock when we move. Glucosamine is found in joint cartilage where it helps to attract water into the joint space for lubrication.

With ageing, the body's levels of glucosamine decrease, which can lead to osteoarthritis. Glucosamine may help osteoarthritis symptoms.

The recommended dose is 500mg, three times a day. However, there has been no major review of the evidence of whether glucosamine helps with back pain. One recent review of 20 studies looking at arthritis of the hips and knees found the substance may be helpful for about six weeks but less so after two to three months. It is unlikely to help back pain not caused by osteoarthritis.

BackCare survey: Helped for six months 36 per cent; temporary relief 28 per cent; no help 34 per cent.