A recent survey confirmed what most of us have known for years. At some point in most people's lives, you pull up short. There's this sudden violent pain coming from your lower back. No matter what you do to twist or turn, to rub it or ignore it by lying down flat on the ground, it just goes on hurting. It's one of life's great mysteries, often striking without obvious reason. One minute, you are healthy, the next you are paralyzed.

Of course there are times when you feel the injury come, usually when you are lifting something using your back rather than the power of your legs. It's often forced because you have to reach inside the trunk to lift out something heavy. But it can equally come because you have been overusing muscles. For all the back is a wonderful piece of engineering, the discs can be damaged when you play too much sport or exercise too vigorously. And then there's the aging process. Even though you promise yourself you will stay active and take all the right supplements, osteoarthritis still wears down the joints in the spine, putting pressure on the nerve roots. Or there can be damage to a hip joint and, when you start walking with a limp, this throws your back out. Finally, there can be problems with drugs. For example, people who take steroids for too long can weaken bones and produce compression fractures.

So how should you deal with the problem? The first is self-help. Sometimes a combination of hot or cold packs reduces any swelling and eases pain. Add in a little rest and the problem may go away as suddenly as it arrived. But if the pain persists, you now enter a world of high technology and guesswork. There are some very impressive machines out there, all designed to look inside the body. There are the traditional x-rays, CT scans, MRIs and ultrasound imaging. Some surgeons like to inject a colored dye into the spinal column and tip you up and down to watch the dye run up and down. In some cases, you may be lucky and an obvious cause is detected. Then it may come down to surgery. Or with physical therapy, hot and cold packs and counseling, you may be able to relieve the main symptoms and resume a reasonably normal life.

If you have inflammation, there are some excellent drugs to bring this under control and, of course, you have Ultram to control the pain. The use of a painkiller can often be essential because of the need for stretching and exercise. If mobility is to be restored, the only way is to remind your body how it can move. Swimming can be the best form of exercise because the water supports the body weight and takes the pressure off the joints. But whatever is done, Ultram is useful because it relieves the pain while you restore the mobility. However, you should always have professional advice. The fact there is no pain does not mean you can suddenly move without further damaging yourself. Properly designed exercises are better than those you invent for yourself.