More than 11 million working days are lost each year in Britain as a result of back pain. It is estimated that four out of five of us will suffer from back pain at some time in our lives. It is most common among people of middle age, although younger men and women can also be affected. There are two forms of back pain: acute and chronic.

Acute pain comes on suddenly and intensely. It's the kind you usually experience from doing something that you shouldn't be doing or from doing it the wrong way. The pain can come from sprains, strains or pulls of muscles in your back. It may be extremely sore for several days, but doctors say that you can be free of the pain, without any lasting effects, by following these self-help tips.

If you must go to bed, keep it brief. 'Most people think that a week of bed rest will take away the pain,' says back expert David Lehrman. 'But that's not so. For every week of bed rest, it takes two weeks to rehabilitate.'

A study conducted at Texas University bears this out. Researchers studied 203 patients who attended a walk-in clinic complaining of acute back pain. Some were told to rest for two days, others for seven days. There was no difference in the length of time it took for the pain to diminish in either group, reports one of the researchers, Dr Richard Deyo. But those who got out of bed after only two days returned to work sooner.

Put your back pain on ice. The best way to cool down an acute flare-up is with ice, says pain researcher Ronald Melzack. It helps to reduce swelling and the strain on your back muscles. For best results, he says, try massaging the site of the pain with an ice pack - or a bag of frozen peas - for seven or  eight minutes. Do this every few hours for a day or two.

Try some heat relief. After the first day or two using ice, doctors suggest you switch to heat, says chiropractor and physiotherapist Milton Fried. Take a soft towel and put it into a basin of very warm Wring it out well and flatten it so that there are no creases in it. ,1 n your stomach, with pillows under your hips and ankles, and fold he towel across the painful part of your back. Put some cling-film over -he towel, and then put a heating pad, set on medium, on top of the plastic. If possible, place something on top that will create pressure, like a phone book. 'This moist heat will help to reduce muscle spasms,' he explains. You will probably need to enlist a friend to help you with this.

Use heat and cold. If you can't make up your mind which feels better, it's okay to use both methods, says orthopaedic specialist Edward Abraham. It may even have an added bonus: 'an intermittent regime of heat and ice will actually make you feel better,' he says. 'Do 30 minutes of ice, then 30 minutes of heat, and keep repeating the cycle.'

Stretch to smooth a spasm. Stretching a sore back will actually enhance the healing process, says Dr Lehrman, by helping the muscle to calm down more quickly than by simply waiting for it to calm down on its own. He recommends the following stretch for lower back pain: gently bring your knees up from the bed and to your chest. Once there, put a little pressure on your knees. Stretch, then relax. Repeat.

Roll out of bed. Every morning when you get out of bed, doctors advise that you roll out - carefully and slowly. 'You can minimize the pain of getting out of bed by sliding to the edge of the bed,' says Dr Lehrman. 'Once there, keep your back rigid and then let your legs come off the bed first. That movement will act as a springboard, lifting your upper body straight up off the bed.'

or some people, back pain is chronic, an ongoing part of everyday life. --or whatever reason, the pain lingers on for what can seem like an eternity. Other people experience recurring pain: any little movement can set 11 -m motion. The following tips are particularly helpful for those with chronic pain, although people with acute pain can benefit.

Drown pain with a waterbed. An adjustable waterbed that doesn't make  a lot of waves is excellent for most types of back trouble, says Dr Fried.  Dr Abraham agrees. 'In waterbeds, you get an equalized change in pressure on various segments of your body,' he says. 'You can lie in one position for the whole night because of this.'

Become a 'lazy S' sleeper. A bad back can't stomach lying face down. 'The best position for someone resting in bed is what we call the lazy S position,' says Dr Abraham. Put a pillow under your head and upper neck, keep your back relatively flat on the bed, then put a pillow under your knees.'

When you straighten your legs, your hamstring muscles pull and put pressure on your lower back, he explains. Keeping your knees bent puts slack into the hamstrings and takes the pressure off your back.

Sleep like a baby. Sleep on your side in the foetal position for a good night's rest. 'It's a good idea to stick a pillow between your knees when you sleep on your side,' says Dr Fried. 'The pillow stops your leg from sliding forward and rotating your hips, which puts added pressure on your back.'

Take aspirin or ibuprofen every day. Doctors say that this can help to keep back pain at bay. Back pain is often accompanied by inflammation around the site of the pain, says Dr Fried, and simple over-the-counter anti-inflammatory drugs, such as aspirin or ibuprofen, can help to take it away. This can even help when the inflammation is quite severe. Paracetamol is not as effective because it is not an anti-inflammatory drug.

Note: Anti-inflammatory drugs can irritate the stomach lining and cause internal bleeding, says family doctor Stephen Amiel. If you suffer from frequent indigestion, heartburn or stomach ulcers, or you are over 75, you should not take these drugs without consulting your doctor first.

Take nature's anti-inflammatory. If you're looking for a natural anti-inflammatory, try willow bark (salix alba), which can be bought as a tincture or in capsule form in health food stores. 'Willow is a natural salicylate, the active ingredient that gives aspirin its anti-inflammatory power,' says Dr Fried. Taken after meals, it shouldn't hurt your stomach, and it works very well on mild to moderate back pain'. But, as with anti-inflammatory drugs' don't take willow if vou suffer from stomach ulcers or heartburn.

The idea is to bring as much detail to the image as possible. The more involved the image is, the more you are engaged with it and the quicker you will become distracted from the pain.

Learn how to look after your back. It's often said, 'You're as old as your back', yet so many of us misuse our backs horribly, says Dr Amiel. Chronic back pain is often a result of poor posture, bad lifting and sitting habits, and tension.

Learn how to lift heavy objects using your legs, arms and back properly, says Dr Amiel. Check that your computer workstation and chair are adjusted to your dimensions and have a 10-minute break from your screen every hour you work at a computer.

The Alexander technique. Dr Amiel suggests taking a course of ns to learn the Alexander technique. This shows you how to let go of unnecessary tensions, and how to use your body, particularly your back - to help you perform everyday activities as you were designed to.