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Urtication refers to the deliberate stinging of the skin with nettles. Throughout history urtication has been used for a range of different purposes. This case describes an interesting clinical encounter in which a patient with recurring low back pain reports using urtication to help with pain control. Some recent research into this previously more widespread pain-relieving strategy is also discussed.

Either through referral by a medical practitioner or self-referral many patients with musculoskeletal problems receive some form of physical therapy. There are several highly trained professional groups who deliver this treatment. Due to lack of regulation, however, there are also many untrained and unregistered therapists delivering treatments for musculoskeletal conditions. For a number of reasons firm evidence-based protocols on physical therapy management are limited. This combined with the aforementioned means that practice can vary markedly. It is thus important for general practitioners to be able to make some assessment of physical therapy quality. This paper aims to unveil some of the practices of physical therapists, discuss issues related to treatment and make suggestions on what constitutes quality physical therapy.