Advice guide
Back Pain: When to Wait, When to Book, and When to Worry
Most episodes of low back pain improve substantially within four to six weeks without any treatment at all. That is genuinely good news, and it means rushing to a scan is rarely the answer. The useful question is which episodes are the exception — and there are clear signposts.
The first week: what helps
Keep moving within comfort, avoid prolonged bed rest, use heat if it feels good, and stay at work if you can, adapting tasks rather than stopping entirely. Complete rest is one of the few things that reliably makes early back pain worse and longer.
Signs you should book physiotherapy
Book if any of the following describe your situation rather than waiting the full six weeks.
- Pain that is not clearly improving after two weeks
- Pain travelling below the knee, or pins and needles in the leg or foot
- This is the third or more episode — recurrence means something is unresolved
- You are avoiding normal activity, sleep is disturbed, or you feel anxious about moving
- You need to return to a physical job, a season or an event on a timeline
Symptoms that need urgent medical attention, not physio
A small number of symptoms indicate a medical emergency. Do not book a physiotherapy appointment for these — go to A&E or contact your GP the same day.
- Loss of bladder or bowel control, or numbness around the saddle or groin area
- Sudden significant weakness in a leg or foot, such as foot drop
- Back pain with unexplained weight loss, fever or night sweats
- Significant back pain following a fall or accident, particularly with osteoporosis
Why scans are usually not the first step
Imaging findings such as disc bulges and degenerative change are extremely common in people with no pain at all, so a scan often creates worry without changing the plan. Guidelines put assessment and active rehabilitation first, with imaging reserved for cases where it will genuinely alter management.
Common questions
Should I rest or keep moving?
Keep moving within tolerance. Gentle, frequent movement beats both complete rest and pushing through severe pain.
Is it a slipped disc?
Discs do not slip out. They can bulge and irritate a nerve, which we can usually identify from symptoms and examination without a scan.
Can I still go to the gym?
Usually yes, with modifications. We will tell you what to keep, what to reduce and what to park for a fortnight.
How quickly can I be seen?
Most patients get an appointment within days. Check live availability in the booking system.