British GPs have come under pressure to stop handing out painkillers for people with lower back pain after American health chiefs said patients should be prescribed exercises first.

The American College of Physicians has changed its official advice, telling doctors to prescribe treatments such as massages, acupuncture, and heat therapy before considering drugs.

The shift of position comes in the same month a study by Sydney University found that over-the-counter painkillers made barely any difference for five out of six people with back pain.