Ask anyone with back pain and they are likely to tell you a story about what they were doing when they were "injured". It is often something trivial. I twisted awkwardly as I was getting out of the car or as I was lifting the bag of groceries out of the trunk. When the individuals are more sporty, they may tell you about the tennis match they were on the point of winning or the strikes they were racking up at the bowling alley. But the fairly consistent theme is that pain always follows an injury.

But, more often than not, this confuses cause and effect. Most of the time we have a condition that is slowly reducing our mobility. In everyday life, we go about our business without any awareness until there is a single twist or turn that brings the problem to our attention. This is not to deny that some people do have traffic accidents in which their necks and spine are damaged, or play sports and pick up injuries. But, most people have a moment when the minor problem becomes more obvious. It is easy to link the cause of the pain with the event and not recognize that the pain has been slowly creeping up on us for months.

What happens then? Well, a lot of money has been spent to convince people that pain is a serious problem. No, really. Even though you might think it is obvious, pharmaceutical companies have to teach you that you solve the problem of pain by buying a medication like ultram. Wherever you look, advertisements sell the idea of science as the best treatment for pain. And there is a lot of science that backs up this idea. Thousands of people have been through clinical trials for medications like ultram and have reported reductions in pain with few side effects. This is all intended to reassure the public. "Look", it says, "you don't have to walk around like you're treading on eggshells. We know pain is terrible but you don't have to be afraid anymore. Just take this pill."

But what used to happen in the "good old days"? Well, when the pain got bad enough, a lot of people used to take opiates like laudanum - a tincture of opium. It was notoriously addictive and many would only consider using it when there were no alternatives. The rest of the time, people lived with the pain. This is not what modern capitalism wants us to remember. The pharmaceutical industry needs us to keep refilling the medicine cabinet. But pain management was as much art as science. It varied from relaxation techniques to reduce tension in the muscles and to control fear (when you anticipate pain, fear magnifies the slightest twinge), to religious groups like the Christian Scientists who believed you can transcend pain through prayer.

Now let us be clear. There are some painful conditions like arthritis which so disrupt life that using ultram or an equivalent is entirely appropriate. However, the more quickly you reach for the pills, the less effect they will have over time. Tolerance reduces the effectiveness of almost every medication. So looking at alternatives to painkillers is a good idea if you know that you condition is chronic, i.e. likely to last for some time.