Well now, I've done a lot of research on back pain management and I'm as confused as you are. As if it's not enough that one has to endure back pain, one must also, all the experts agree, manage it. Odd. They never talk about managing toothache.

So, why back pain management? Although it's never said in so many words, I suspect that back pain is one of those rather nasty disorders that, while not socially unacceptably nasty, doesn't ever really go away. We're not talking here about your wife's pregnancy back pains or back pain caused by a tumour; we're talking your average Joe's back pain that just ... won't go away.

The bad news is that this sort of general back pain is usually caused by bad posture and incorrect back health. The good news is that essentially general back pain is a consequence of bad back pain management and can be managed by good back pain management. Make sense?

When back pain treatment doesn't work, it's time to start managing the pain. Back pain management, like back pain, varies for different individuals. For some, back pain management means learning to put up with it and maybe taking a pain killer when it becomes really unbearable. But that's not good back pain management.

Good back pain management starts with changing your lifestyle and your attitude towards your body, particularly your back and spine.

-- Your spine supports you; without it, you'd be a a floppy toy. Your spine is supported by the muscles of your back. When they're weak and / or inflexible, your spine strains to perform even the most simple movements, including bending and carrying. So, the first step in managing back pain is to develope a gentle exercise program to keep your muscles fit, supple and healthy.

-- There are many types of exercise that are good for your back muscles, including yoga, walking and swimming. Water aerobics, for instance, is fun, inexpensive and recommended by most doctors and experts in the field of back pain management.

-- Adopt a healthy lifestyle. This includes eating correctly, exercising and substituting cigarettes and punishing exercise routines with homeopathic herbal and vitamin supplements.

-- Learn about good posture, particularly if you have a job that has you always sitting at a desk or if you are on your feet all day. Always bend the knees when bending or lifting; always hollow the back when kneeling; when carrying, distribute weight evenly; when standing for long periods stand with your feet slightly apart; when pushing or pulling try to keep your back straight and take the strain on your arms.

Back pain management should be seen as a long-term investment in good health.

A long soak in a hot tub, the steam delicately scented with the fragrance of oil of lavendar. Candles throw thin shadows on the damp walls. Music plays softly in the background. You're content, relaxed, following a delicious meal including oysters and just a few wicked drops of champagne. Your partner has promised you a sensuous back massage when you get out of the tub ... and then, who knows?

An erotic fantasy? No, just sure-fire back pain relief.

Back pain relief doesn't have to be only about traction or exercise routines thought out by a particularly sadistic ex-marine (probably on the run) or vile-tasting herbal back pain relief remedies created by Hyde's evil twin - the chemist from hell.

Back pain relief should be pleasant, relaxing, relieving, simple, enjoyable and effective.

Visualization techniques, massage, hot or cold therapy treatments, good posture training programs, light exercise routines, a sensible diet, yoga for back pain relief, hynotherapy, acupuncture and the purchase of a good bed will all contribute to relieving your back pain.

Unless, of course, your back pain is caused by a seemingly unrelated disease; but most Americans suffer some form of backache at some stage in their life and the reality of back pain is that it is most often caused by poor posture, too little exercise, work-related back strains and stresses, sports injuries or a touch of arthritis.

For these conditions, back pain relief involves a variety of sensible treatments that include stopping smoking, learning new posture habits, taking the dog for a walk every night and pampering your back with regular massage.

I suffer with severe upper back pain, caused by sitting over a typewriter most of the day, even when I'm not working. I relief it by massaging my shoulders when I take a break; I swim every day and then lie on the firm grass and do some gentle yoga; I make a conscious effort to sit with my legs comfortably and firmly on the ground when I'm at my desk; I treat myself to a hot bath once a week that includes an infusion of garden herbs; I take vitamins daily and I make sure I walk around every half hour to relieve muscle tension.

My oldest friend (in both senses of the word) suffers with what she calls her 'bad knees'. She can hardly climb a flight of stairs. And so she avoids exercise. Fatal mistake. Back pain relief is a matter of practicing good back health; just as you shower or bath every day to keep your skin healthy. Exercise is vital to keep the muscles of your spine supple and strong to enable them to perform their job - keeping you upright.