It may also offer short-term pain relief and functional improvement for those with long-term (chronic) and subacute lower pack pain, but this benefit does not appear to be sustained after six months of treatment. There do not appear to be any serious adverse effects associated with massage. Acupuncture may provide some relief for back pain. However, further research with stronger evidence is needed. Spinal manipulation appears similar to other recommended treatments. "Back school" is an intervention that consists of both education and physical exercises. There is no strong evidence supporting the use of back school for treating acute, subacute, or chronic non-specific back pain. Insoles appear to be an ineffective treatment intervention. While traction for back pain is often used in combination with other approaches, there appears to be little or no impact on pain intensity, functional status, global improvement or return to work. Medication
If nonpharmacological measures are ineffective, medication may be administered. Non-steroidal anti-inflammatory drugs (NSAIDs) are typically attempted first. NSAIDs have been proven more effective than placebo, and are usually more effective than paracetamol (acetaminophen). Long-term use of opioids has not been tested to determine whether it is effective or safe for treating chronic lower back pain. For severe back pain not relieved by NSAIDs or acetaminophen, opioids may be used. Opioids may not be better than NSAIDs or antidepressants for chronic back pain with regard to pain relief and gain of function. Skeletal muscle relaxers may also be used. Their short-term use has been proven effective in the relief of acute back pain.
Syringomas are benign eccrine sweat duct tumors, typically found clustered on eyelids, although they may also be found in the armpits, abdomen, chest, neck, scalp, or groin area, including genitals, in a symmetric pattern. : 663   They are skin-colored or yellowish firm, rounded bumps, 1–3 mm in diameter, and may be confused with xanthoma, milia, hidrocystoma, trichoepithelioma, and xanthelasma. They are more common in women and are most commonly found in middle-aged Asian women. While they can present at any time in life, they typically present during adolescence. They are usually not associated with any other symptoms, although can sometimes cause itchiness or irritation. Types
The eruptive form typically presents on the anterior chest, abdomen, neck, and arms. It presents in successive crops with periods of relief in between times of active rash. The milia-like  type of syringoma is typically smaller lesions that have a milky white center that can look like milia. The plaque type is more commonly associated with itchiness and chronic scratching that leads to epidermal thickening similar to lichen planus. The familial form, in some cases of syringoma, exhibits a familial pattern in an autosomal-dominant pattern of inheritance. Chromosome 16q22 has been shown to be involved in the genetic links of syringoma. Presentation
Associated syndromes
Syringomas can be found in association with other symptoms as part of a syndrome.