What actually helps with chronic lower back pain?
Strength and stabilisation exercises have the strongest evidence base for chronic lower back pain. If those do not help enough, pain relievers that also reduce inflammation are the first step. Opioids and surgery can almost always be avoided.
Strength and stabilisation exercises (such as core training) are the most effective approach for chronic lower back pain. They outperform other forms of exercise, including cardio-based fitness training. Movement therapy in general reduces pain by an average of around 7 to 13 points on a scale of 100, and improves daily functioning. The effect is modest but well established, and many studies combined point in the same direction.
Rest does not work, even though that used to be the advice. Inactivity does not improve chronic pain. Being active 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 exercise, there are more non-medication options that the American College of Physicians guideline recommends as a first choice: multidisciplinary rehabilitation, cognitive behavioural therapy, mindfulness, yoga, tai chi, and acupuncture. The evidence for these varies in quality, but they are explicitly recommended above medication as a starting point. A newer approach, Cognitive Functional Therapy (a combination of behavioural psychology and tailored physiotherapy), also shows promising signals, but has so far been studied in smaller groups of people.
If none of that helps, pain relievers that also reduce inflammation, such as ibuprofen, are the first medication 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 dependence and other side effects.
What is better avoided: requesting 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 lower back pain they generally offer no better results, and they increase the risk that the complaints become permanent.
Three combined-studies analyses on movement therapy, one American College of Physicians guideline, one population-level review on overtreatment, and one limited abstract on Cognitive Functional Therapy. The strength of the evidence varies by treatment.
What helps against osteoarthritis (joint degeneration)?
Supervised exercise therapy and diclofenac gel have the strongest evidence base in osteoarthritis. Paracetamol and opioids work less well than many people think; discuss medication choices with your doctor, especially if you have heart or stomach complaints.
Does milk really help against heartburn?
Milk has a brief suppressive effect on stomach acid. For persistent symptoms, common antacid medicines work considerably better.
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.
What are the symptoms of an underactive thyroid?
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.
Does collagen help your joints and your skin?
For joint pain due to knee osteoarthritis and for active athletes, collagen is worth trying: 10 grams of collagen peptides per day for 6 months, preferably in combination with exercise. For the skin, 2.5 to 5 grams per day is recommended, but some of the research comes from manufacturers.