Around a third of all GP consultations are for pain - and as the vast majority of people in pain usually treat themselves first before seeing their doctors, we are only seeing the tip of the iceberg of the pain problem.

In the past, treating pain was easy - but not very effective! We gave aspirin or paracetamol, alone or as mixtures with other drugs, for muscle and joint pains, headaches. That was on the assumption that most of these pains were "inflammatory" or due to "strains", "pulls", or "cramped" muscles. And drugs like aspirin do help them.

We gave antacids for indigestion, because we believed that most indigestion was due to over-activity of acid in the stomach. And we gave gas-reducing medicines to relieve lower bowel cramps and bloating pains.

Persistent bowel pains were relieved by "antispasmodics" on the assumption that they were caused by cramps in the bowel muscles. For more serious pain, such as constant pains due to arthritis or to cancers, we moved on to "opiates" - drugs akin to heroin and morphine that made the brain forget about the pain.

We are lucky in Britain, in that we are still allowed to prescribe them. Drug abusers in other countries have led to their being outlawed even for proper medical use. But none of these treatments, effective as they often are, make a difference to the causes of the pains.

And it's only in the last few years that doctors have turned pain care into a speciality, so that every large hospital has a department, usually serviced by anaesthetists, with the specific aim of treating the types of chronic pains that we GPs can't handle satisfactorily.

The research done by these doctors has solved a lot of problems - and has given GPs like myself much-needed new approaches to pain.

For example, the National Back Pain Association (NBPA) found that 8 in every 10 schoolchildren are carrying too much weight in their schoolbags, and doing so in the wrong way - slung over one shoulder.

So the Association has designed a schoolbag that reduces strain on the spine and encourages good posture.

Schools that don't know about this can contact the NBPA at 16 Elmtree Road, Teddington, Middlesex TW11 8ST (0181 977 5474).

It's essential to recognise the "triggers" that set off your pain, and to try to avoid them. Liz Macleod, physio in the pain management programme at the Astley Ainsley Hospital in Edinburgh, related the case of a grandmother who always had pain a day after after babysitting.

It turned out to be due to the awkward position she was in while feeding the child. The answer was to rearrange her position and to share the feeding with granddad.

Liz stresses that pain can come on a whole day after the action that causes it - so when you are trying to find out the cause, go over the previous day in detail.

Once the pain flares up, it's not enough just to rest and take drugs. You may find a heat pad or a warm bath, or even a trip to the local jacuzzi, will help.

The commonest cause of pain is cramps in muscles, and if you rest for too long, you may just make the muscles stiffer and even more painful. Learning to relax properly also helps - your local physio will help you on that.

It's important to realise that if a muscle hurts you, do not damage it by using it - in fact working on improving its flexibility and strength can prevent attacks of pain. That's why all doctors have been asked to provide active exercises for people with chronic back pain, rather than bed rest.

Then there's a technique called distraction. It's possible to distract your mind from a persistent pain by concentrating on some other subject. Liz recommends counting the numbers of doors in a street that are painted black, or trying to make a word from car licence plate letters.

If you pooh-pooh that, then consider my interview with Odette Churchill in 1980, when I was researching a book on human potential. A British spy captured by the Germans in occupied France, the Gestapo were pulling her fingernails and toenails out one by one to make her give them the names of her colleagues.

She drew down in front of her eyes an imaginary cinema screen, and made her brain project on it scenes from her happy childhood. She stuck it out for 24 hours, by which time her friends had got the message that she was captured and escaped.

She thought nothing of it - and modestly told me that anyone in the same circumstances would have done the same. I wonder...

Converted for the new archive on 30 June 2000. Some images and formatting may have been lost in the conversion.