MSK Rehabilitation, Patient Guide

When to see a physio for back pain, and what helps in the meantime

Written by Elliot Stubbs, BSc (Hons) Physiotherapy, 13 years in MSK practice. Updated 14 October 2026.

Most lower back pain isn't caused by serious damage and starts to ease within a few weeks, especially if you stay gently active. It's worth seeing a physio if your pain isn't easing after a couple of weeks, keeps coming back, is affecting your work, sleep or sport, or you've become wary of moving. A small number of symptoms, covered below, need a GP or urgent help instead.

Is my back pain serious?

Usually not. Most back pain is what clinicians call non-specific or mechanical back pain. That simply means it's coming from the muscles, joints and other tissues of the back, rather than from a disease or a specific injury that a scan would pick up. It can be very painful, but a high level of pain doesn't mean a high level of damage.

Common contributors include a sudden jump in lifting, gardening or training, long spells sitting or driving, poor sleep and stress. Words like "slipped disc" or "wear and tear" can sound alarming, but these changes show up on scans of plenty of people with no pain at all.

Should I rest or keep moving?

Keep moving, within reason. Bed rest tends to make backs stiffer and slower to recover. You don't need to push through severe pain, but gentle, regular movement is one of the most helpful things you can do.

Walk little and often. Short walks through the day are usually better tolerated than one long one.
Change position regularly. Get up from your desk or sofa every 20 to 30 minutes, even briefly.
Carry on with normal life where you can, including work.
Use simple pain relief if you need it. Ask a pharmacist what's suitable for you, and heat such as a warm bath or a heat pack can ease muscle tension.
Try gentle movements such as lying on your back and rocking your knees side to side, or pulling one knee towards your chest, if they feel comfortable.

Some discomfort while you move is normal and not a sign you're doing harm. As a rough guide, if an activity makes your pain flare and it's still worse the next morning, ease back a little rather than stopping completely.

When should I see a physio for back pain?

You don't have to wait for back pain to become long-standing before getting help. A physiotherapy assessment is worthwhile if:

your pain isn't clearly easing after a couple of weeks
you keep getting repeat episodes, perhaps every few months
it's affecting your work, your sleep or your sport
you've become worried about bending, lifting or exercising in case you make it worse
you have pain spreading into your leg, which may be sciatica

That last point matters: avoiding activity for too long can leave the back weaker and more sensitive.

What does physio for lower back pain involve?

The first session is a thorough assessment: how the pain started, what eases and aggravates it, a check for warning signs, then how you move, your strength and, where relevant, the nerves to your legs. You'll leave with an explanation of what's likely going on and a plan.

Treatment is usually a combination of:

Exercise and gradual loading. Building strength and confidence in bending, lifting and twisting, starting where you are now and progressing steadily.
Gym-based strength work. As things settle, exercises such as deadlift variations, carries and hip strengthening help the back cope with real-life demands.
Hands-on treatment. Manual therapy and soft tissue work can ease pain and stiffness in the short term, used alongside exercise rather than instead of it.
Activity changes. Practical tweaks to work, training or daily routines while things calm down, so you can keep going rather than stop.

Sessions take place in a fully equipped gym with 1:1 guided rehab, so you're coached through the exercises rather than given a sheet to take home. If you're weighing up different types of practitioner, our guide to physio vs osteopath may help.

How long does back pain take to get better?

It varies from person to person. Many acute episodes improve noticeably within a few days to a few weeks, and a lot of people are largely back to normal within about six weeks. Pain that has lasted longer than three months, or keeps returning, usually takes longer and tends to respond best to a structured exercise plan.

What about neck pain?

Much of the same advice applies to the neck. Most neck pain, including the stiff neck you wake up with, settles within days to weeks. Keep it moving gently, break up long spells at a screen, and use heat if it helps. A physio can help if it isn't easing after a couple of weeks, keeps coming back, or is causing headaches or pain down an arm. Strength work for the shoulders and upper back is often part of treatment.

When to see a GP or get urgent help

Go to A&E straight away or call 999 if you have back pain with any of these: numbness or tingling around your genitals, bottom or inner thighs; new difficulty passing urine, or wetting yourself without realising; loss of control of your bowels; new problems with sexual function; or sciatica in both legs, or legs that are getting weaker. These can be signs of cauda equina syndrome, where the nerves at the bottom of the spine are squashed. It's rare, but it needs emergency treatment the same day, so don't wait for a physio or GP appointment. Also call 999 if back or neck pain comes with chest pain or breathlessness.

See your GP soon if your back pain comes with a high temperature or you feel generally unwell, unexplained weight loss, a history of cancer, or it started after a significant fall or accident. The same applies if you're under 20 or over 50 and this is new back pain, if you have osteoporosis or have taken steroid tablets for a long time, or if the pain is constant and worse at night whatever position you're in. For neck pain, get urgent advice from 111 if it comes with dizziness, blurred or double vision, difficulty speaking or swallowing, clumsy hands or unsteady walking. In the uncommon cases where they're relevant, a GP or specialist can discuss other options such as injections or surgery.

Back pain physio in Wymondham and Norwich

If you're in Wymondham, Norwich or South Norfolk and your back or neck isn't settling, Elliot sees patients at Suggs Gym on Tuesday evenings. He also works full time in the NHS assessing complex musculoskeletal problems. No GP referral is needed, and you can check the assessment and follow-up prices before you book an assessment.

Frequently asked questions

Should I see a physio or a GP first for back pain?

For most back pain you can go straight to a physio, and you don't need a GP referral. See your GP first if you have any of the warning signs in this guide, such as a high temperature, unexplained weight loss or a history of cancer, and go to A&E for symptoms like numbness around your bottom or genitals or new bladder or bowel problems.

Do I need a scan for lower back pain?

Not usually. Most back pain can be assessed properly without imaging, and scans often show changes that are common in people without pain, so they can cause more worry than help. A scan is worth considering if your history or assessment suggests something that would change the treatment plan.

Is it OK to exercise with back pain?

Generally, yes. Gentle movement such as walking usually helps more than resting. You may need to reduce the weight, range or intensity of your usual training for a while. If an activity makes your pain clearly worse the next day, ease back rather than stopping altogether.

Can a physio help with neck pain too?

Yes. Neck pain is assessed and treated in a similar way to back pain, with advice, exercise and strength work for the neck, shoulders and upper back, plus hands-on treatment where it helps. Get urgent advice if neck pain comes with dizziness, vision changes, difficulty speaking or swallowing, or clumsy hands.

Will my back pain come back?

It can. Many people have more than one episode over the years. Staying active and keeping up some strength work, especially for the hips and back, is the best way to reduce how often it happens and how much it affects you.

This guide is general information written by a physiotherapist, not a substitute for individual assessment. If you're unsure about any of the warning signs above, seek medical advice rather than waiting for an appointment.