Is there anything that gut health doesn’t seem to influence? Apparently not. “We know that gut health has an impact on inflammation within the body,” Joshi explains. “Inflammation makes you experience more pain, so I’ll often ask patients about their diet and suggest they try to eat more whole grains, less processed goods and things like that – because it does have a big impact on the pain you experience.”

In Heal Your Back, Joshi flags that various gut conditions are directly associated with back pain, including IBS, constipation and acid reflux. It’s estimated that up to 81% of people with back pain will experience IBS at some point and while the cause of that hasn’t been properly researched yet, it’s thought that that might be down to referred pain from the stomach to the back as the muscles tighten. Constipation causes inflammation in the digestive tract, which studies show can cause referred pain in the lower back and limbs. Acid reflux might be felt mainly in the throat, but it’s thought that it can also refer pain lower down the chain.

But it’s not just about inflammation (although Joshi is a big advocate for following an anti-inflammatory diet). The gut-brain connection also plays a role in pain management. Why? Well, most of our serotonin is made in the gut and that helps us to sleep better, feel calmer and enjoy a better mood. And all of those things can help us deal with and manage pain better. For people with IBD conditions like Crohn’s and ulcerative colitis, back pain can be yet another difficult symptom to live with. IBDs change your gut microbiome, and that may be linked to the increase in other pain conditions like fibromyalgia, headaches and back pain.

IBD might not be curable, but there’s plenty of evidence to suggest that diet can help with symptoms. Joshi recommends we all try to follow an anti-inflammatory diet that includes plenty of omega-3 fatty acids (oily fish, chia seeds, etc.), antioxidant-rich berries, leafy green vegetables, nuts and turmeric.

“I’m an osteopath and these are the 5 surprising lifestyle tweaks that will stop back pain from ruining your life”