Paula Clayburg, chief counsellor at a pain clinic in Liverpool, gives a radio talk on back pain. She covers how common it is, who suffers most, why the back heals badly, and which everyday changes and products actually help.
All answers come from Paula's talk, in order. Questions 31-36 follow the first half: figures, women patients, the clinic's treatment, why backs heal badly, bed rest and weight. The line 'what can WE do to help?' starts the advice section that carries Questions 37-40.
Answer key and self-check
Type what you wrote and hit mark. Hide the key first if you haven't done the part yet. Every question number jumps to its explanation.
How to attack this block: Paula mentions almost every option, but usually to dismiss it or to say it matters less. Listen for her own opinion markers: 'I personally believe', 'at our clinic', 'in our experience'. Those point to the key.
Question 31
Answer: AEarly on, right after the famous people with bad backs
Which daily figure for people with back pain does the speaker give?
The most recent available figures show that about a quarter of a million people are incapacitated with back pain every day.
Question says → You hear
UK daily figurespeople are incapacitated with back pain every day
Why: A quarter of a million is 250,000, so the matching column is A. You have to do the conversion yourself while listening.
The trap: B, 500,000, catches people who hear 'million' and guess a bigger bar. Only one figure is ever given.
Question 32
Answer: BWhen Paula says most of the clinic's patients are women
What does the speaker think mainly causes back pain in women?
They are especially vulnerable because of pregnancy but also because of osteoporosis, which I personally believe to be the major cause of problems for women.
Question says → You hear
the main causethe major cause of problems for women
Why: Both pregnancy and osteoporosis are named, but 'which I personally believe to be the major cause' is attached to osteoporosis. That makes B the answer.
The trap: Pregnancy is said first and is a real factor, but it isn't called the main cause. Giving up exercise comes next, as a result of the pain, not its cause.
Question 33
Answer: BAfter 'that starts up a vicious circle'
What treatment does the clinic mainly favour?
although there are many excellent drugs on the market, at our clinic we are beginning to realise the unique benefits of relaxation therapy
Question says → You hear
the Clinic mainly recommendsat our clinic we are beginning to realise the unique benefits
Why: 'At our clinic' plus 'unique benefits' marks relaxation therapy as the clinic's choice, so B.
The trap: Exercise is backed by 'other specialists', but Paula says it is easily mishandled and can do more harm than good. Pain killers are only a 'traditional response'.
Question 34
Answer: CWhen Paula asks why back pain is becoming such a menace
How is the back different from the rest of the body?
In general, the body is pretty good at self-repair. … But the body's response to back injury can be very counter- productive.
Question says → You hear
its response to injurythe body's response to back injury
results in more damagecan be very counter- productive
Why: Counter-productive means it makes things worse. She then explains how: we hold the back still, the muscles tense and go into spasm. That's C.
The trap: A takes 'self-repair' from the sentence about the body in general. The 'But' that follows tells you the back is the exception.
Question 35
Answer: AWhen Paula describes 'the second mistake' people make
What advice does the clinic give about bed rest?
Although at the clinic we recognise that a short rest in bed can be helpful ... up to two days . . . any longer makes our back muscles become weaker
Question says → You hear
for a maximum of two daysa short rest in bed can be helpful … up to two days
Why: 'Up to two days' is a maximum, and anything longer weakens the muscles. That's A.
The trap: Extreme pain is said just before, but only to describe when people make the mistake. C reverses the advice: more than two days is exactly what to avoid.
Question 36
Answer: BWhen Paula says 'Another problem is being overweight'
What effect does being overweight have?
though it won't actually set it off in the first place, the weight will increase the strain and make things worse
Question says → You hear
worsens existing back painwho already has back pain … make things worse
Why: The weight doesn't start the pain but makes existing pain worse, so B.
The trap: A is the tempting one, because weight sounds like a cause. Paula says directly that it won't 'set it off in the first place'.
Matching (A-C)
Questions 37-40
How to attack this block: You have three levels of recommendation. 'But' and 'though' clauses usually mean 'only in certain circumstances' (B); praise like 'a real find' means strongly recommended (A); 'better spent on' something else means not recommended (C). The products come in the same order as the list.
Question 37
Answer: BAfter the point about sitting in a slouched position
How strongly does the speaker recommend special orthopaedic chairs?
It can be useful to get special orthopaedic chairs, but remember the most important improvement should be in OUR posture.
Question says → You hear
Buy special orthopaedic chairsIt can be useful to get special orthopaedic chairs
Why: 'Can be useful' is a mild yes, and the 'but' shifts the weight onto posture. That's a conditional recommendation: B.
The trap: C is tempting because she says the problem isn't the design of chairs. She still says the chairs can help, so they aren't rejected.
Question 38
Answer: AWhen Paula explains 'heel strike'
How strongly does the speaker recommend shock-absorbing inserts?
A real find for our patients has been the shock-absorbing shoe insert. A cheap but very effective solution.
Why: 'A real find' and 'very effective' are unqualified praise, so this is strongly recommended: A.
The trap: 'Cheap' might sound like a weakness, but here it's part of the praise. The heels advice that follows is a separate point.
Question 39
Answer: BRight after the advice about heel height
How does the speaker rate wearing flat shoes?
Though absolutely flat shoes can be a solution for some, others find their posture suffers.
Question says → You hear
Wear flat shoesabsolutely flat shoes can be a solution for some
Why: Good for some people, bad for others: that's 'recommended in certain circumstances', B.
The trap: C is tempting because of 'posture suffers', but she only says that happens to some people.
Question 40
Answer: CThe very end, after 'Finally a word about'
How does the speaker rate the TENS machine?
Finally a word about the state-of-the-art relief - the TENS machine … Our experience indicates that your money is better spent on the more old-fashioned remedies.
Question says → You hear
Buy TENS machineyour money is better spent on the more old-fashioned remedies
Why: If your money is better spent elsewhere, she is advising against buying it. That's C.
The trap: 'State-of-the-art' sounds like praise, and that can push people to A. It only describes the machine; the verdict comes in the last sentence.
Option A copies the phrase 'good at self-repair', but Paula says that about the body in general. The back is the opposite: its response to injury makes things worse.
Words from this recording worth keeping
chronic(Introduction)
lasting a long time or keeps coming back
incapacitated(How common back pain is)
unable to work or live normally
vulnerable(Women patients)
more likely to be hurt or affected
vicious circle(Women patients)
a problem that causes another problem, which makes the first worse
self-repair(Why the back is different)
the body's ability to heal itself
counter-productive(Why the back is different)
having the opposite effect to the one you want
posture(Advice on chairs)
the way you hold your body when sitting or standing
state-of-the-art(TENS machine)
the newest and most advanced
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The full Cambridge 3 Test 1 listening paper with the real audio: all four parts, played once, marked the moment you finish. Already done it? Take it again and listen for the traps this page showed you.
Cambridge IELTS 3, Test 1, Listening Part 4. The recording, transcript and questions belong to Cambridge University Press and are not reproduced here. We quote short extracts of the transcript only as evidence for our own commentary, and the answers are published for self-marking. Get the book for the full material, or sit the test on Langujet.
