It's time to watch your back

Back pain affects 22 million of us each year in the UK. But many people are suffering unnecessarily, believes Garry Trainer, osteopath and back guru to the stars

Like just about everyone else I know, I have been laid low by back pain several times in my life. As a teenager I had sciatica and for months saw a physiotherapist; when I was pregnant I had an agonisingly unstable back and was treated by an osteopath. Both times the pain receded but never entirely. Now I just live with the fact that whenever my three-year-old demands to be carried I know I'll be troubled by a nagging ache in the small of my back for days to come. The pain, no longer severe, has become a part of my life - not bad enough to seek treatment, nor inconsequential enough to ignore.

Like just about everyone else I know, I have been laid low by back pain several times in my life. As a teenager I had sciatica and for months saw a physiotherapist; when I was pregnant I had an agonisingly unstable back and was treated by an osteopath. Both times the pain receded but never entirely. Now I just live with the fact that whenever my three-year-old demands to be carried I know I'll be troubled by a nagging ache in the small of my back for days to come. The pain, no longer severe, has become a part of my life - not bad enough to seek treatment, nor inconsequential enough to ignore.

But this is not such a bad back story, because like a lot of back conditions, mine is self-regulating and doesn't prevent me from doing what I want to do. For many, the condition is far more acute.

With this week designated as National Back Care Week, there are once again some shocking statistics being banded about which prove that the treatment of back pain in this country is still languishing in the dark ages. Each year in the UK, 22 million people will suffer back pain with 120 million working days lost. 310,000 people are off work with back pain every day and back injuries are the main reason for people taking long-term sick leave.

Back guru, Garry Trainer, (co-author of The No-Nonsense Guide to a Healthy Back and osteopath to the stars) believes if more patients were referred by their GPs to osteopaths, it would be a very different picture. Partly a matter of cost and partly a result of ignorance, the majority of back problems in this country are still treated with anti-inflammatories, bed rest and exercise regimes administered by GPs, surgeons and hospital-based physiotherapists.

Trainer is adamant that osteopathy is a positive and necessary alternative to the anti-inflammatory and bed-rest remedy. His main point is that if back pain is classified correctly and treated appropriately then the problem would be considerably eased and statistics slashed. Osteopathy works because joints get stuck and need a light thrust to release them.

"It treats the causes as well as the symptoms by looking at the predisposing factors which contribute to back pain," says Trainer. "We can treat backs until the cows come home but unless we pay attention to what's causing the pain - such as working with your hands above your head or being hunched over the wheel of the car - and eradicate these things, treatment is a waste of time. Whenever I treat someone the first thing I do is ask a lot of questions and then I come up with a working hypothesis. This means that before I've even examined the patient I've got an idea in my mind of what I'm looking for. Normally my diagnosis is pretty good."

In May this year, after 72 years of lobbying government, the medical establishment finally acknowledged osteopathy as a legitimate protected practice with codes of discipline and ethics. This has helped boost public confidence but also demonstrates that at last the profession is being taken seriously. Equally, osteopaths seem to have more respect for the medics. "We like doctors nowadays," says Trainer, who having seen significant improvements in spinal surgery will now refer patients with disc problems to surgeons who he knows can do more for them than he can (in fact, 10 per cent of back-pain patients require surgery).

He knows too that recent research reinforces the positive claims that osteopaths have been making for years. "At the same time," he says, "I can see why osteopaths haven't ingratiated themselves to doctors. In the past they've made some unsubstantiated claims about what they can achieve and encouraged patients to stop taking medication, which of course doesn't go down too well with doctors. I think it's important that osteopaths - like all complementary therapists - know what they can and can't treat and refer accordingly."

Trainer, 44, is something of a flying "back doctor". Even though his appointment book is always jam-packed, he still finds time to dash to the aid of emergency patients doubled up with muscle spasms. Jumping into his blue Renault Scenic Mégane, he'll drive anywhere in the country (and has even been known to fly to Chicago) to deliver his unique brand of treatment - osteopathy combined with acupuncture. He gets enormous satisfaction from these acute cases because "often people get down off the table - liberated from their pain - thinking you're God. That's a fantastic feeling".

Trained as a medical nurse, Trainer came to England from New Zealand in the late seventies and studied acupuncture and osteopathy. Impressed at how these two disciplines had helped him with recurring back pain following a rugby accident in his twenties, he decided with the zeal of a convert that others should benefit too. "It's an exceptional combination," he says, "because acupuncture acts as a wonderful pain relief by releasing this morphine-like substance known as endorphins."

Over the years he has been much sought after by musicians, actors and dancers. Clients include Dave Gahan of Depeche Mode and Robbie Williams. In 1988 he even closed down his practice for four months to go on tour with George Michael. "It was a fantastic experience," he says, "but may be not a very sensible thing to do because it took me a long time to build up my practice and client base again." At present he's retained to look after the dancers on Notre-Dame de Paris and regularly works with actors from the National Theatre and the RSC.

People flock to his Harley Street and Islington clinics because he has a reputation for putting people straight. With the latest research encouraging people to stay mobile, because staying static just sets up other knock-on effects such as poor circulation and fibrous muscles, he encourages people to take exercise and establish the parameters they can work within, even if it causes discomfort. "For instance I will occasionally go surfing because it's my passion in life and for me the pleasure of the activity outweighs the two or three days of twinges that follow."

A good percentage of back pain is treatable rather than curable, he says, but the ageing process can't be ignored. Joints wear down, bones get thinner and muscles and tendons contract. If you've suffered from back pain during your twenties and thirties, the chances are it will be with you, on and off, for the rest of your life. The question, according to Trainer, is not getting rid of it altogether but managing it well.

While he is gratified that, increasingly, people are seeing the value of osteopathy, he's also disheartened that the future doesn't look too rosy. Companies like the Somerset Cider Company who retained an osteopath for a sum of £4,000 to help reduce the £60,000 yearly loss due to back pain absentees, may receive a splash of publicity in the press but regrettably have no long-term effect on government thinking even though the company estimated that it had reduced absenteeism by 95 per cent.

And most disheartening of all is that the one area where back pain is on the increase is with children. I tell Trainer that I have an 11-year-old daughter who has just started secondary school and am appalled that after just five weeks she has already complained of back ache due to carrying heavy bags around with her all day. This is a problem occurring in secondary schools throughout the country because of a lack of locker space and which, according to Trainer, is already creating a new generation of potential back sufferers.