What actually helps with chronic low back pain?
Strength and stabilisation exercises have the strongest evidence base for chronic low back pain; if the effect is insufficient, anti-inflammatory drugs are the first pharmacological step, but opioids and surgery can almost always be avoided.
Strength and stabilisation exercises (such as core training) are the most effective approach for chronic low back pain. They outperform other forms of exercise, including cardiovascular training. Exercise therapy in general reduces pain by an average of about 7 to 13 points on a scale of 100, and improves daily functioning. That is a modest but demonstrated effect, consistent across multiple meta-analyses.
Rest does not work, even though it used to be the standard advice. Inactivity does not improve chronic pain. Exercise is safer than it sounds: temporary muscle soreness in the first few weeks is the most commonly reported side effect, but there are no serious risks.
Beyond exercises, there are more non-pharmacological options that the American College of Physicians guideline recommends as first choice: multidisciplinary rehabilitation, cognitive behavioural therapy, mindfulness, yoga, tai chi and acupuncture. The evidence for these varies in quality, but they are explicitly placed above medication as a starting point. A newer approach, Cognitive Functional Therapy (a combination of behavioural psychology and tailored physiotherapy), also shows positive signals, but has so far only been studied in smaller trials.
If none of that works, anti-inflammatory drugs such as ibuprofen are the first pharmacological choice. Tramadol and duloxetine come after that. Opioids are at the bottom of the list: they are only appropriate when everything else has failed, because of the risk of addiction and other side effects.
What you are better off avoiding: ordering an MRI or X-ray purely out of habit, spinal injections and back surgery are used far more often worldwide than the evidence justifies. For chronic low back pain they generally offer no greater benefit, and they increase the risk that symptoms will become entrenched.
Three meta-analyses on exercise therapy (PMID 16034851, 25681408, 28436583), one guideline from the American College of Physicians (PMID 28192789), one population-level review on overtreatment (PMID 29573872) and one limited abstract on Cognitive Functional Therapy (PMID 29669082). The strength of evidence varies by treatment.
What helps with osteoarthritis (joint wear)?
Exercise, losing weight where applicable in the case of excess weight, and an anti-inflammatory gel on the knee have the strongest supporting evidence; always discuss oral pain medication with your doctor because of the side effects.
How do I keep my joints supple and prevent osteoarthritis?
Exercise and maintaining a healthy weight are the best-supported ways to prevent osteoarthritis and manage symptoms; however, no treatment stops the disease once it has begun.
Does mewing really work for a sharper jawline?
There is no clinical evidence that mewing improves the jawline in adults. Serious tongue-exercise therapy does exist, but is intended for functional problems such as abnormal swallowing, not for cosmetic purposes.
Can I prevent or slow down early-stage hearing loss?
Noise-induced hearing loss is largely preventable by limiting exposure to sounds above 85 dB(A) and wearing hearing protection. Once the damage is permanent, there is no going back.
Does collagen help your joints and your skin?
For joint pain, particularly in knee osteoarthritis and active athletes, oral collagen (approximately 10 grams per day) has a reasonably well-supported positive effect. For the skin there are indications, but these are less robust and partly come from commercially involved researchers.
What are the symptoms of an underactive thyroid and when should you see a doctor?
An underactive thyroid produces vague complaints such as fatigue, weight gain and cold intolerance, but the diagnosis can only be made through a blood test. If you have recognised several complaints for a while, discuss them with your general practitioner.