Back pain is incredibly common. It is estimated around 80 per cent of adults will experience it at some point in their lives. Although you shouldn’t have to tolerate any pain, there will be some signs when a back pain is more than just a passing niggle.
We spoke to a sports injury specialist and an osteopath, both experts in treating muscle and joint pain, but with different foundational philosophies and methods, about the most common issues they see in clinic, and how to know your pain deserves further attention.
“Back pain can stem from muscles, joints, discs, nerves, or occasionally be referred from elsewhere in the body, such as the kidneys, gallbladder – or in women, it is sometimes linked to the reproductive system – and each type of back pain tends to respond to a slightly different approach,” explains osteopath Anisha Joshi (@osteoanisha).
“Pain is really just information. It’s your body’s way of flagging that something would benefit from a bit of attention, whether that’s a movement pattern, a new load you’re not used to, or tension in the shoulders and lower back”.
The nervous system and the musculoskeletal system are more closely linked than many realise. “Stress and emotional load can influence how the back feels,” Joshi continues. “I see this often in patients who notice their back becomes more sensitive during demanding weeks, not necessarily their most physically active ones.”
Back discomfort and lower back symptoms can be linked to things such as footwear, vision or breathing patterns, she adds. “Looking more broadly, rather than solely at the area that feels sore, often supports longer-lasting improvements.”
David Vrettos, sports injury specialist, and founder of Reverse Chronic Pain, adds that one of the least understood aspects of chronic back pain is the relationship between pain and the nervous system. “We know from extensive research that pain is produced by the brain as a protective response, and that in chronic pain this response can become over-sensitised, generating pain that persists long after any injury has healed. This doesn’t mean the pain isn’t real, it is, but it does mean that understanding what’s driving it influences what helps”.
A daily pill to treat diabetes that helps with weight loss is on sale from today.
The UK is the first country in Europe to approve this medicine.
Who can get the pills?
- Pharmacies across the UK will stock Foundayo, made by Eli Lilly.
- It is only available privately, though it is being assessed for a potential NHS rollout.
- It is for type 2 diabetes patients and those with a BMI of above 30, or 27 with a weight-related condition.
- The pill is taken at various dosage levels once a day, at any time.
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Counterfeit warning
Pharmacists welcomed the launch as a step forward for people who are eligible but can’t use weight-loss injections.
They warned people against fake weight-loss pills and reminded them only to buy from licensed pharmacies.
The approval of Wegovy, the UK’s first weight-loss pill, sparked a spate of counterfeit pills.
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What to know about the head-on A66 crash that killed seven
Seven people died over the weekend after a police car crashed into another vehicle that was travelling the wrong way on a dual carriageway near Middlesbrough.
Families paid tribute to the victims, as police urged the public not to speculate on the crash. Here’s what we know.
No survivors
Cole Robert Worthy, 17, Theo Rae, 17, Makai Saddington, 18, and Michael Robert Cahill and Jacob Matusiak, both 23, died when the Volkswagan Passat they were in collided with the police vehicle.
PC Matthew Blades, 37, and PC Tom Clough, 38, were also pronounced dead at the scene.
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Families pay tribute
The wife of PC Blades (R) said: “He gave his life in the line of duty, protecting and serving others with courage, dedication and selflessness.”
The family of PC Clough (L) described him as “our hero” who was “always on public duty throughout his short life”.
On Monday morning, a fundraiser set up to support the two families had raised over £300,000.
How did the crash happen?
- Cleveland Police launched a chase after the Passat, believed to be using cloned plates, activated an ANPR camera.
- PC Blades and PC Clough were not involved in the chase but were called to the area.
- The pursuit took just under seven minutes and was called off seconds before the crash when the Passat began travelling the wrong way.
- Blades and Clough’s car was driving the right way.
Don’t speculate, police say
These were brave officers protecting our communities and serving our residents who didn’t return home to their families at the end of their shift.
Whilst this investigation is ongoing… I would strongly urge people to avoid speculation and respect the privacy of the families.”
Cleveland Police Chief Constable Victoria Fuller
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Burnham makes first overseas trip as PM to Ukraine – what to know
The Prime Minister arrived in Kyiv this morning to mark Ukraine’s independence day.
He is promising to share with Ukraine classified information to help build long-range missiles.
Burnham pledges support
- Burnham said UK support “will not waver” and Russia should be “in no doubt of our resolve”.
- He will chair his first meeting of the Coalition of the Willing, the group that would send peacekeeping troops to Ukraine.
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What is Burnham giving Ukraine?
Burnham will allow defence firm MBDA to release classified information on UK components for the British-French SCALP long-range missile, also known as Storm Shadow.
The missile has already been supplied to Ukrainian forces, but releasing the secret technical information will allow Ukraine – with French support – to manufacture locally.
How has Russia responded?
Earlier this month, Russia’s Embassy in the UK warned of “consequences” following confirmation that British-made drones were used in Ukrainian strikes on Russia.
The embassy said the “deeper [the UK’s] involvement in the conflict… the higher price it will pay”.
President Vladimir Putin has also threatened Britain over seizing Russian “shadow fleet” tankers.
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How to be more grateful for daily life in five easy steps
The world feels like a difficult place at the moment, and it can feel very hard sometimes to find things to be thankful for; when we are overwhelmed, we have less capacity to notice and reflect on the good things. Yet, ironically, proactively cultivating gratitude is one of the things that can actually help us feel less stressed.
NHS GP dR RADHA
The science
Research has shown that feeling or expressing thanks can actually alter our brain.
- The balance of neurotransmitters change; more serotonin and dopamine (feel good chemicals) are produced.
- This can be long lasting if we make gratitude a regular habit.
- We also get a decrease in our cortisol (stress hormone) levels which helps lower anxiety.
- Being grateful can strengthen the nerve pathways which triggers positive emotion.
How can we build gratitude?
Change your words
Instead of seeing something as a problem, try to see the opportunities within it.
Our brains are very receptive and what we read or write can alter our emotional system.
Express it
This will not only make you feel good, but you will also get a positive response from others.
How can we build gratitude?
Notice more
Throughout your day, try to notice all the things that are going well; has someone opened a door for you, or smiled?
The basics
By being thankful for the small things every day, we are far more likely to be and stay healthy so that we can enjoy them.
What to do
Gratitude can lead to feelings of optimism, lower our blood pressure, and improve sleep quality.
- Write down what potential good aspects there are to the things you don’t feel like doing, or even what could be worse about it.
- Spend a few minutes writing down three things that you are looking forward to that day, or the good things that have happened to you that day.
- Say thank you to yourself for the things you have achieved, or managed to get through and changed that day.
Sales of battery
electric vehicles hit a record high last year.
Starts at £22,995 for the smaller battery
Available with either a 40kWh battery or a larger 52kWh pack, that offers almost 255 miles, the latest, retro-inspired Renault 5 is both a joy to behold and a hoot to drive.
The interior has been lavished with a level of detail that’s typically reserved for more expensive cars.
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A champion of EV efficiency
It offers a remarkable 491 mile range on a single charge from the 85kWh battery.
It is a technological masterclass inside with the ability to option screens that span the entire width of the dashboard, including an optional display for the front passenger.
Priced from £37,400
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It’s a lot of money to part with, but this is arguably all the car you will ever need.
The £89,000 Macan is a premium SUV that somehow manages to blend Porsche’s reputation for dynamics and sporty driving with everyday practicality.
The 95kWh batteries can go from 10 to 80 per cent in as little as 21 minutes from the fastest public charging outlets.
With the business class-style six seat configuration costing a staggering £76,995, it is by far the most expensive Kia ever made, but it backs up its financial demands with a suite of genuinely useful and impressive onboard technology.
It’s fast, goes a long way between stops and charges relatively quickly but the interior is bland, the onboard technology is infuriating and the experience is devoid of emotion.
All of its gadgetry can’t disguise the fact that performance is weak, even for a typically zippy EV, the ride is fussy at slower speeds and it’s not in the least bit enjoyable to drive on a country road.
- While good value (prices start at £17,935) for the 200-mile max range, there are more interesting options from Hyundai, Citroen and Renault for similar money.
- It attempts to wow with tech, much of which hinders, rather than helps.
- There’s no tangible benefit over mounting your phone to the dash.
- Simply an average driving experience, adequate range and slow charging speeds.
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The kitchen gadgets under £25
Victorinox paring knife
It’s comfortable to hold, with a point sharp enough for scoring pastry.
ProCook cast iron pan
For unbeatable searing and heat-retention, cast iron is the top choice.
Tesco chopping board
Priced at just £22, I’ve yet to find another board that matches it for sheer value and quality.
The kitchen gadgets under £25
Pyrex jug
It is the perfect vessel for blending smooth sauces, melting butter, or warming stock. It won’t stain like plastic and the red measurements never fade.
Salter scales
“I’ve had my slim little set of Salter Disc Scales for over a decade, and I’m delighted to see they are still made to exactly the same reliable design today.”
Microplane grater
It uses photo-etched stainless steel teeth that stay razor-sharp for a decade, something the lookalike copycats simply can’t match.
Braun hand-held blender
It’s an essential for everything from making velvety soup to getting the lumps out of white sauce.
Bodum cafetiere
As well as delivering great results, cafetieres are easy to clean and there’s no ongoing filter paper costs or pod recycling to deal with.
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The kitchen gadgets under £25
Oxo peeler
What truly sets it apart is the chunky, rubberised handle that absorbs pressure and stays completely non-slip, even if your hands are wet. It is inexpensive and incredibly durable.
Falcon pie dish
Made by fusing porcelain onto heavy-gauge steel for smooth durability, it is dishwasher, freezer, hob, air-fryer and oven-safe.
The golden rules for a happy, secure relationship
Psychiatrist and neuroscientist Dr Amir Levine, author of bestselling book , explains why we behave the way we do in love.
Golden rules for happy relationships
Start with your own behaviours
The foundation of a secure, connected life is being what I call CARRP: that means being consistent, available, responsive, reliable and predictable. All of these qualities can be enacted in small gestures every day.
Express your needs
People need consistency and connection to feel safe. This is not, ‘You hurt my feelings by never replying to me’, it’s more ‘this is the kind of contact that helps me feel secure’.
Golden rules for happy relationships
The appendix ‘inflammation’ rule
If a relationship repeatedly inflames your nervous system, you need to disengage and deprioritise it.
Lean on community
You don’t need hundreds of friends. You need people and places that regularly remind you that you belong.
Stop blaming childhood
Humans are much more complicated than: ‘this happened to you, therefore you are doomed to be anxious’.
Reach for a
secure script
When something unsettles you in a relationship, your first reaction is not always the most accurate one.
If you’re anxious, your brain may jump very quickly to: ‘this is the beginning of the end’. If you’re avoidant, your brain may say: ‘this person wants too much from me, I need to get away’. So one very practical thing you can always do is pause and ask: ‘What would a secure person do here?’
Loneliness elsewhere
When people talk about loneliness, they often assume it means you don’t have enough people in your life. But you can be surrounded by people and still feel lonely if those relationships leave you feeling excluded, ignored or disconnected.
What to do
- Build a community that works for your temperament and gives you regular, reliable moments of connection.
- You can still be kind to people while not treating them as someone who belongs in your inner circle.
- Explain what you need. Sometimes people simply don’t realise how you are experiencing them.
- Check in with people: does this person actually feel that I’m reliable? Do they experience me as predictable? That’s the only way that you can start to become more secure.
Do some foods leave
you feeling hungry rather than satiated? Experts say there are…
Foods that leave you hungrier
A bowl of cereal and glass of orange juice
More refined cereals are digested quickly, and fruit juice, whilst one of your five-a-day, contains less fibre than whole fruit. This might mean you find yourself hungry again within 1-2 hours of eating this breakfast.
Swap the orange juice for a whole orange, the cereal for oats and milk or serve it with Greek yoghurt or a boiled egg. This would increase the fibre and protein content; two nutrients strongly linked with fullness.
Foods that leave you hungrier
These pastries are made primarily from refined flour and butter, and are relatively low in protein and fibre.
Toast and jam
Shop-bought packs can contain a lot of white rice, which is digested quickly, and the protein content is often modest.
Foods that leave you hungrier
Vegetable soup
On its own, it is often very low in protein and calories, so hunger can return quickly.
Unless it’s loaded with veggies, it’s probably pretty low in fibre.
Liquids are generally less filling as they require little chewing which may not trigger satiety signals.
Foods that leave you hungrier
Snack bars
They are ideal for a quick pick-me-up, but if reducing hunger is what you’re after, it’d be better to swap it out.
Low-fat yoghurt
A full-fat plain Greek yoghurt with berries and seeds tends to be much more filling due to the protein, fat and fibre.
On an empty stomach, it can actually increase your appetite.
What to eat instead
Instead of thinking about avoiding foods, think about what you can add to them.
- Add beans, lentils or shredded chicken to your vegetable soup and pasta.
- Thicken your smoothies with Greek yoghurt, chia seeds and oats.
- Apple slices with peanut butter, yogurt with berries and hummus with oat biscuits are better snack options than a pre-made snack bar.
- Have alcohol alongside a balanced meal containing protein and fibre.
Back pain can be categorised in different ways. “Acute pain is typically mechanical ( i.e. through movement), recent, and often has a clear cause (lifting, sudden movement, trauma),” Vrettos explains. “It usually resolves in six to 12 weeks or less. Chronic, meanwhile, is persistent, lasts beyond three months, and is where it gets more complex.”
It is either “specific” – “When a clear structural cause can be identified (fracture or nerve root compression, for example)” – or “non-specific”. A significant proportion of back pain is “non-specific”, meaning the cause is unclear, even with imaging. Here, the experts describe different kinds of back pain they commonly see among patients and when to seek help.
Acute mechanical back pain
Sudden onset, often after a specific movement or lift, localised, sharp or achey, worse with movement. “This typically signals muscle strain, facet joint irritation or minor disc irritation,” Vrettos says. “It’s generally managed by staying active with gentle movement, short-term over-the-counter pain relief and avoiding prolonged bed rest. Seek help if it hasn’t improved after two to three weeks, or if radiating into the leg.”
Muscular back pain
“The one I see most often in clinic,” Joshi says. “It tends to feel like a dull ache or tightness, often more noticeable with certain movements and easing with rest. It’s generally linked to muscle strain, movement patterns, or joints not moving quite as freely as they could. It’s very common, and tends to respond fairly quickly to treatment. Left too long, the body may start compensating, which can sometimes lead to discomfort in other areas.”
Disc-related back pain
“This often shows up as a deeper, more central ache that can feel more noticeable with bending, lifting or longer periods of sitting,” Joshi says. “It relates to the discs between the vertebrae and how they’re being loaded day to day. It’s common, particularly from the mid-thirties onwards, and sits on a wide spectrum from very mild to more noticeable.”
It can feel like pain radiating into the buttock and/or down the leg, often below the knee, and may include pins and needles, numbness, or weakness in the leg, Vrettos adds. “This can signal nerve root irritation, usually from a disc bulge pressing on a nerve. Seek help relatively promptly, especially if you have weakness or bladder/bowel changes. It usually resolves with time (in most cases, within three months) with physio, and specific nerve mobilisation exercises. Avoiding prolonged sitting.”
Inflammatory back pain
“This tends to be less common,” Joshi says. “It’s usually more noticeable first thing in the morning or after rest, and often eases with movement, which is the opposite pattern to most other types of back pain.” If your back genuinely feels better the more you move and less comfortable the longer you’re still, it’s worth mentioning this to a professional, she advises.
Vrettos adds: “Seeking help is important. Early diagnosis and treatment significantly improves outcomes. Exercise is key, but specialist input is essential.”
Chronic non-specific lower back pain
Chronic back pain persists for more than three months, it can be constant or episodic, is often disproportionate to any identified structural cause, and frequently worse with stress and better on holiday or when distracted, Vrettos explains. “This is where pain has outlasted tissue healing, often driven by central nervous system sensitisation.”
“Look for someone who understands persistent pain, not just structural diagnosis. Pain neuroscience education and psychological approaches addressing fear and avoidance will be helpful, along with graded activity, building trust and resilience in the brain and body.”
Compression fracture
“This typically presents as a sudden onset, often in post-menopausal women, after minimal trauma or even spontaneously,” Vrettos explains. “It is usually localised to a specific vertebral level and can be a sign of a fracture, most commonly related to osteoporosis. It requires urgent imaging, medical pain management; bracing sometimes, and addressing underlying bone health.”
Postural and desk-related back discomfort
This tends to feel like a tight or achy sensation that builds through the day and eases once you move, Joshi says. “It’s extremely common in anyone who spends long periods of time in one position, particularly while seated, with limited movement through the day. On its own, it’s rarely a sign of anything to worry about, but it’s a helpful early nudge.”
When to see a specialist
Interestingly, Vrettos says, for non-specific back pain, evidence suggests that aggressive investigation early on (such as scanning and multiple specialist appointments) can actually reinforce the idea that something is seriously wrong and maintain pain. “Early reassurance and staying active is often more beneficial.”
That said, there are certain red flags which may suggest a serious underlying health condition that require urgent medical attention.
As a general guide, “if your discomfort is mild, comes and goes, and feels a little better with gentle movement, that’s probably just the body’s way of communicating”, Joshi says. “So giving it a week or so to settle down is reasonable.”
It’s worth being assessed by a professional if your discomfort feels more intense or seems to be building rather than settling over weeks of self-management; if pain travels down a leg or radiates below the knee, particularly alongside tingling, numbness or weakness; if it is consistently disturbing your sleep, or feels more noticeable first thing and eases with movement; or if it follows a fall, accident or specific injury, the experts agree.
Red flags, which require urgent care and being seen by a doctor, include if you experience back pain alongside things like changes in, or loss of, control of bladder or bowel function; numbness in the inner thighs or groin; sudden or progressive leg weakness; back pain that is progressively worsening with no periods of relief; back pain with sudden unexplained weight loss, or persistent back pain in someone with a history of cancer, Vrettos says.
Who to see
When it comes to back pain specialists, physiotherapists, osteopaths and chiropractors can all be effective in addressing musculoskeletal back pain. While they each have different philosophical foundations, in modern practice there is typically overlap in their approaches.
Vrettos says: “Avoid anyone who tells you that you’ll need treatment indefinitely, shows you frightening images of your spine, or discourages other forms of care.”
Five tips for managing everyday back pain, from osteopath Anisha Joshi
- Gentle movement. Regular, comfortable movement can support the area, whereas long periods of complete rest aren’t always a helpful approach.
- Change position regularly. Rather than waiting until you feel the need to move, build in regular breaks, standing for even a minute every 30-45 minutes.
- A strong, supported core is helpful. This isn’t just about the abdominals, it’s the deeper stabilising muscles that support the spine.
- Sleep position can make a difference. For side sleepers, a pillow between the knees may help keep things a little more aligned overnight.
- Look at the wider picture, not just the sore spot. A tight area often feels better with a stretch in the short term, but understanding what’s contributing to it tends to make that improvement last longer.