A large placebo-controlled trial (1650 patients) carried out at the George Institute for Global Health in Sydney, Australia demonstrated that taking paracetamol does not speed recovery or reduce back pain when compared with placebo. The researchers conclude that patients should remain active and wait to get better while perhaps using a heat pack.

Alternatively they could consider using herbal medicines. A Cochrane review (http://summaries.cochrane.org/CD004504/herbal-medicine-for-low-back-pain) has shown three herbal medicines to be effective in treating episodes of back pain The herbs tested were oral administration of Devil’s Claw 
(Harpagophytum procumbens ) and White Willow Bark (Salix alba), and topical application of Cayenne (Capsicum frutescens ). The review contained ten randomized controlled trials that included 1567 adults with non-specific acute or chronic low back pain. All three herbs reduced pain in comparison to placebo.

The herbs selected by a Medical Herbalist depend on the particular presentation of each individual patient but would aim to relieve pain, decrease inflammation, reduce muscle spasm, promote healing, improve circulation and maintain stamina. 

We should all be concerned about the increase in antibiotic resistance. This is the loss of the ability of an antibiotic to control or kill bacterial growth. Some infections such as tuberculosis, gonorrhoea, pneumonia and septicaemia are now becoming hard to treat with antibiotics. It's estimated that drug-resistant strains of bacteria are responsible for 5,000 deaths a year in the UK and 25,000 in Europe. This has severe health implications for the future not only for the treatment of infections but also in the prophylactic use of antibiotics to prevent infection during cancer treatment and routine operations.

The increase in resistance has resulted from the overuse of antibiotics in the treatment of infections and the extensive use of antibiotics in animal husbandry and intensive farming. The extent and implications of antimicrobial resistance to treatment are described in a World Health Organisation fact sheet (http://www.who.int/mediacentre/factsheets/fs194/en/).

Herbal medicines may have a role in combating antibiotic resistance. They have a significant potential to treat minor infections so sparing the use of precious antibiotics for more serious cases. There are many medicinal herbs which have antimicrobial action and they were used traditionally in the treatment of infection.

A recently published letter in the Times from Professor Moore and Dr Flower at the University of Southampton identifies the potential of herbal medicines to treat mild, self-limiting conditions seen in general practice such as respiratory and urinary infections.

David Cameron has commissioned a review into why so few antibiotic drugs have been developed and he states that "We are in danger of going back to the dark ages of medicine unless we tackle the growing resistance to antibiotics."

This might suggest that we do not wish to return to a time when only herbal medicines were available for treatment. There are, however, clear differences in today’s use of herbal medicines. Modern conditions, considerably more hygienic than in previous centuries, mean that the milder action of herbal medicines can be more effective. Modern research has identified the antimicrobial action of plant constituents, which herbs are most effective and the therapeutic doses required. Furthermore, research has shown that a combination of antibiotics and herbal medicine can enhance the action of antibiotics and help to overcome antibiotic resistance.

The benefit of using the approach taken by a Medical Herbalist is that a tailored combination of herbs is used to both treat the infection and enhance the ability of the body’s own immune system to fight infection.

We should all consider using herbal medicine to prevent and treat mild infections and keep antibiotics for the treatment of more severe infections.