Have a look at www.intramuscularstimulation.com (IMS) it explains why acupuncture works by default, no ying, yang or qi and that when IMS/ dry needling is used within an orthodox orthopaedic diagnostic framework it works so much better than esoteric `hit and miss` acupuncture. IMS has a well researched and rehearsed evidence/ patho-physiological base to it. Effective, minimal side effects and contra-indications and cheap.
Trigger points which respond superbly to palpation and needling are thought to be responsible for up to 75% of all musculo-skeletal pain. Big in The States, less popular but growing here.

Robin Shepherd, Guildford, Surrey

Magnus, I count myself at least as skeptical as you and had the same reservations about acupuncture - until I saw it work on a cow. Now it's entirely conceivable that what I saw was the work of a skilled illusionist, but, against that, my guess is that if we knew the full extent of the slaughter inflicted by "conventional medicine" we'd be horrified. All we know for certain is that it gets it right some of the time - about the same success rate that I can claim for me and plumbing.

Ken Leyland, Liverpool, U.K.

If your Osteopath is jumping on your back and you're praying he/she gets it right you're seeing the wrong osteopath. Mine sometimes is so gentle I'm not sure he is doing anything and I always get results. It's a real science not guess work.
Just because you don't understand something doesn't mean it doesn't work.
You don't like your back pain, try swimming. It does wonders for back pain. Try taking some personal responsibility and quit whining and making fun of other people's choices.
An Art and Science that has survived for 1000's of years must have something to it. The problem is some people get a few 100 hours of training and call themselves experts in TCM (traditional chinese medicine) when in reality it takes years to learn and master. So perhaps these people who had the accupuncture done, didn't have it done by well trained people. Perhaps the 'sham' Accupuncture wasn't really a sham. How did they control for this? How do they know they didn't release any endorphins?

Ellen Samuels, somewhere, USA/NY

I have suffered terribly from lower back pain, to the point that in June 2006 I could do little more in the morning except crawl on all fours. The solution (not necessarily cure), in addition to medication, was to undertake a daily series of gradual stretching exercises focused on improving overall core body strength. The book Back in Control by Dr. David Borenstein provides a very good guide. Within 10 weeks I was off of the medication and the pain was quite manageable. I then moved from the daily stretching program to working with a trainer to improve core strength even more. I am now completely pain free, in better shape than in years, and with a margin of safety for back issues. My conclusion is that back problems often result from overall poor physical condition, thus poor posture and the concommitant stress on the lower spine. Thus, doing nothing and letting the pain recede really is not a solution. The pain is a warning sign to get back into shape. Best regards.

David Ralston, Clifton, Virginia USA

It sounds like you should try it and then tell us. There's enough persistent testimony to give it the benefit of your doubt. Don't dismiss it because of the qi explanation. No one knows why it works, the most plausible explanation I've heard is that it manipulates the pain matrix in the brain. I wouldn't soldier on with no remedy only to find out years down the line that it works. (And I had been too proud a skeptic all that time)

tim, london, uk

I've suffered in the past from a fair amount of back trouble. I had a fantastic Chiropractor(now retired) who only failed me once in many years. I've listened to many people with back trouble, and often they have their own preferred treatments, but chiropractic certainly worked for me.
Since I stopped playing tennis and badminton, and taken up smoother forms of exercise, I've had no problems, so I no longer need chiropractic.

A. Taylor, Nottingham,

I woke up one morning with what appeared to be low level whiplash. I couldn't move and it took an hour for me to painfully get out of bed. Convinced the pain would go away I did not consult a doctor (it was the weekend and we wouldn't expect NHS Doctors to be available then, would we?). A week later, I still found myself in pain, unable to move my head and neck more than the slightest fraction. In desperation I attended my local Chinese Medicine woman. One hour later the pain had gone, and I could move my head and neck fully. I have no idea how it works, and I'm scared of needles, but the fact is that it did work, and I didn't have to go and see a Doctor who would have no doubt given me some pills to mask the pain and put me on a months long waiting list for some sort of therapist.

Medicine is an evolving science, it does not yet have all the answers, why is it deemed so 'fashionable' to dismiss the ancient and accumulated wisdom that the Chinese have been turning to for years?

Anne, Manchester,

I may be wrong about this, but as I understand it, a placebo can sometimes work even when the patient is sceptical.

I use travel bands for my travel sickness, which are just two bumps of plastic on the inside of elasticated material around the wrists (i.e. pressing down on a supposed acupuncture point). I was deeply sceptical of the benefits of these prior to use, having had no joy from various pills or other approaches, but they have worked so well that I have persisted with them for 15 years (although less often now, as the sickness itself occurs less). I'm still unconvinced by the underlying rationale and suspect these are placebos, but that's fine by me.

Perhaps it's worth Magnus giving the random pin-jabbing a go...

James Clarke, London,

I suppose that we all have different types of back injuries, so the treatment might be different for each of us.

Mine is a pretty boring L4-L5 injury that responds well to a quick dose of anti-inflammatory drugs and a 1-2 days of physio. Certainly not your several weeks.

I would suggest picking up a copy of the "Back Doctor" by Hamilton Hall. The book describes the different back injuries and what the medical profession can do for you; but mostly it is about you taking ownership of fixing your back.

Finally, after much skepticism on my part, an Olympic athlete friend of mine, convinced my to take up Pilates. I still think it is goofy, but it does seem to help quite a bit.

kevin, Ottawa, Canada

I had back pain for 7 years. I tried everything and eventually a new physio doing an initial exam spotted that I had a vertebrae our of place. Poppped it backed into place and hey-presto a.o.k.

Moral - identify the problem and the cure will follow.

Steve, Zürich, Switzerland

For back pain caused by arthritis leading to trapped nerves, daily stretches and exercise give relief and even prevent further pain provided the discipline is maintained after the pain has been minimised. The problem is that many sufferers do not continue with the discipline until the pain has minimised ( a process which can take months), or, when some relief has been gained, do not continue with the regime.
Provided that the pain is accepted as a spur to changing the habits of a lifetime, and making new ones, it can be a great life!

Gordon Cardew, NORWICH, UK

I have just one phrase...... Global warming/climate change.

Bob, London, uk

Frie martin & Kay Leeds:

Did you read the above peice at all? The whole point is that yes, nearly half of people got pain relief from acupuncture, but about the same number of people got pain relief from sham acupuncture. All this nonsense about qi energy and meridians is just that - nonsense!

Now, perhaps there is something in having needles stuck into you as there's bound to be some physiological response. Perhaps it's down to placebo, which can be very effective itself. Whichever of these it is, it certainly seems that the traditional chinese explanations are simply wrong.

Frie Martin, where's the evidence that acupuncture has been know to work for thousands of years? It may have been used for ages, but that doesn't mean it works.

Tristan, Guildford, UK

Three weeks ago, I had trouble with a frozen knee. When I bent the joint to less than ninety degrees, I was in a great deal of pain. After just one acupuncture session, I recovered full range of movement. You can be as pompous as you want about the therapy -- that doesn't change the fact that it worked for me.

Above all, one thing it did not require in any way, shape or form was belief. Nor did the therapist even begin to suggest I put any faith in anyone or anything. If your body responds to the treatment, it responds; if it doesn't, it doesn't. I'm not going to scoff at you because you don't respond; please don't scoff at me because I do.

Rob, London, UK

Frie Martin, Echternach, Luxembourg

"Should you in that case not accord the same respect to treatments which have been around ,and known to work, for thousands of years?"

Of course I forgot we were doing so well with medical treatments up until the invention of the scientific method and progress based on unbiased results (double blind trials etc.).

Sorry about the sarcasm but look at our modern advances in medicine and technology. All of this has come about because we now need cold, hard, unfriendly evidence.

You might think reality is unromantic, but if you transported back in time to thousands of years, you might well only live to 40, die in childbirth, plague, wound infection or be burned at the stake.

BP, London,

I realize there's all sorts and degrees of back pain. But what works for me is a bar of strong-smelling soap (Irish Spring) under the fitted sheet, in the curvature of my back right at the waist. I used to waken all stiff and in pain. Not now. Have no idea how it works. And wouldn't you think a large lump of a bar of soap would disturb one's sleep? Well, it doesn't. As a cure, it's cheap, legal, effective, and non-invasive. I pass it on in case it would help even one sufferer.

Maewynia of Pennsylvania

Maewynia, Pennsylvania,

You say people shouldn't phoo phoo the advances of modern medicine.
Should you in that case not accord the same respect to treatments which have been around ,and known to work, for thousands of years?

And your description of an ostiopath's treatment is grossly unfair.
Sure there are a few hamfisted ones around, but a good one will never treat you the way you describe.

Have you ever tried any of the treatments you talk about in such a negative way?
A closed mind is probably a far worse problem for you than the pain in your back!

Frie Martin, Echternach, Luxembourg

Is a 'hair lip' what we used to call a moustache?

Robert H., Birmingham,

Jeremiah1974: And your evidence is what exactly?

zeno, Glasgow,

I have also been a chronic back pain person. Chronic pain changes one's psyche. I did find relief for my problem with physical therapy and a great physical therapist who was more willing than the doctors to pursue the root of my problem.

Best of luck with your problem. I hope you find relief.

Mary Knight, Pittsburgh, PA, USA

You should try some of this www.tapping.com

New-age munbo jumbo... but it works. :)

Jeremiah1974, Bristol,

I, too, have suffered for years from a bad back. At least an MRI scan told me why I had pain. The blame is degenerative disc disease. OK, so what options are there for treatment? Well, it's not possible to have artificial discs installed with, it seems, a very good outcome. Trouble is that the NHS won't pay for this treatment and offers the cruder laminectomy and fusion with all its attendant risks and failures.

I, too, have worked out ways to mitigate the pain and put up with the limited range of movements.

Without doubt, osteopathy has been the most successful treatment I've had, but as the author comments, when a bulky 18st rugby-playing osteopath has his knuckles buried amongst your vertebrae, and he suggests that you relax as he throws all his weight across your body, I for one find it hard to comply.

What I find unacceptable is that much of my pain comes from muscle spasm which can be treated without analgesics by using very low doses of diazepam. My GP refuses to offer it!

Captain Grumpy, Southampton, England

I suffered from a trapped sciatic nerve and shredded disc which eventually resulted in major surgery.The only time I got relief from agonizing pain in almost every position taken,was when acupuncture was administered by the surgery physiotherapist.It came back once I tried to walk again when the nerve was trapped again, but it was a blissful relief for that time.Maximum strength and dosage painkillers didn't work as well as that, even using a TENS machine to supplement their effect. I am not an enthusiast for bizarre therapies, but acupuncture really did work as pain relief. In any case it is a major mainstream treatment in China and is hardly some quack remedy.

kay, leeds,

Having suffered a bad back for 20 years I know that what you say is true. My tips.
1) Stairmaster as much as possible.
2) don't jog.
3) don't sit cross legged or wash the dog. leaning over is bad.
4)have as much sex as possible.
5)get a massage when not having sex.
6) when it gets really bad drink beer.
7)get on with whatever you want.

pierre, peterborough,

I don't get this article. The writer bemoans the fact he has chronic back pain, writes about how acupuncture may/may not work for back pain... and then never tries it?????

Scott, irvine, usa/ca