Surgery, steroid injections and opiods are pointless experts warn. Staying active, job satisfaction and a positive attitude are key.

Up to nine million people suffer with back pain in Britain, and a series in The Lancet says it is routinely badly treated. One in seven GP appointments is for back pain. This places significant pressure on resources in primary care.

A change in approach to treating back pain is needed. Exercise and psychological therapy should be the focus,

Primary Care Direct has supported a pain management consultant to set up Optimum Pain Management Ltd, a company specialising in delivering pain management.