Lower back pain, with or without leg pain or sciatica is very common and affects many adults.

It can be very painful and disabling.

People are prescribed a variety of pain killing medications to help them cope and perform their daily activities.

The MEDAL Study is investigating which medications, on their own or in combination with others, give the best pain relief.

We are inviting you to take part because you have contacted your GP about acute lower back pain or sciatica.

If you are interested, you can answer some questions on our website to check if the study is right for you.

If it is, you will complete the informed consent process with a research nurse and be randomly allocated your treatment at your GP appointment.

The treatment will be pain killing medications of increasing strength which also target pain in different ways.

These are taken in steps, called an analgesic ladder.

If the medication does not help, you move to the next step of the ladder, with the agreement of your GP.

There are no ‘new’ medications in this study. All the medications are already in routine use within the NHS.

The medication will be prescribed by your GP and supplied by your pharmacy.

The study lasts for 8 weeks.

Each day we’d like you to tell us how you feel, and how bad your pain is, using our study App. If you prefer paper questionnaires, this is also available.

If you deal with your pain in other ways, such as exercises or using a hot water bottle, please tell us using the daily questionnaires.

We will ask you to complete a more detailed set of questions at 4 weeks, 8 weeks and finally at 6 months.

If after the 8-week treatment period you still need help, your GP will see you outside the study. Taking part is voluntary and you can leave at any time.

If you decide not to take part, your normal care will not be affected.

We will offer you a £10 gift voucher for completing the baseline appointment with the nurse and a £15 gift voucher after completing the patient questionnaires at the end of week 8.