There's been a very interesting series on television where a renegade magician has been breaking the code to reveal how many of the best known tricks are done. In one sense this is taking away a part of the fun in watching magic. You always hope to be able to see how it's done. But even when you know, there's still a great sense of theater in actually seeing the same tricks performed. Some of the skills involved are remarkable. You can admire them even though you know what's happening. When you apply this to the world of marketing, you can still find the skills remarkable even though the results are less admirable.

We're talking about the great trick played on the public over the last thirty years. Back in the 1970's, doctors were still considered the power in the medical land. It was their skills and know-how that stood between a patient and death. But there was already a subtle change underway. Surgeons were the top dogs. Nothing could ever replace their knowledge and expertise. But ordinary doctors? Well, their job could be redesigned so that, once the diagnosis was complete, all they need do is prescribe the latest miracle cure from the labs of the pharmaceutical industry. Fast forward to today and you find the revolution is complete. It's very difficult to persuade newly qualified doctors to work in private practice. The pay and status are low. Everyone wants to work in a hospital where their reputations can be higher.

It's a sad fact of life. Most doctors are just pill pushers and, even in this role, they are under threat from nurse practitioners who can easily diagnose the simple problems and identify which pills should be dispensed. And then there are the online pharmacies that are only too happy to dispense the pills and cut out the people in the middle. Yet, in all this, one key factor is overlooked. Many of the treatments and therapies are more effective than the drugs.

Let's just accept that pain can affect every part of the body and make every proposed movement a test of courage. Relying on drugs for long-term relief is to risk dependence and face a serious drain on your savings. It's better to look at the alternates. The first and best option is to begin movement. It can start with walking or swimming where the water takes the weight off the joints. Backed up by physical therapy to develop the right muscles, you break through the pain barrier and emerge more mobile with less pain. If you prefer movement allied with meditation, there's yoga to stretch and encourage greater flexibility. This can be encouraged by the use of massage and other manipulative techniques.

Obviously, if you have had a period of inactivity, coming back to movement can cause pain. It's therefore appropriate to take Tramadol to keep the pain under control while the body remembers how to move and rebuilds strength. However, as mobility returns, the drug should be phased out. The intention is to achieve a point where you can live a good quality life without having to rely on a drug like Tramadol to get through the day.