Back pain is common, and many new episodes improve with time, sensible movement and a gradual return to normal activity. But it is not always obvious when to keep self-managing, when to book a physiotherapy assessment and when to seek urgent medical care.
This guide gives you a practical starting point. It cannot diagnose the cause of your pain or replace an individual assessment.
Seek urgent medical help first if you have red-flag symptoms
Call 000 or seek urgent medical care if back pain is accompanied by loss of bladder or bowel control, loss of feeling around the genitals or saddle area, or sudden loss of movement or marked weakness in a limb.
Prompt medical assessment is also important when back pain follows major trauma or occurs with fever, a recent significant infection, a history of cancer, unexplained weight loss, rapidly worsening weakness or severe unremitting night pain. These features do not automatically mean something serious is present, but they should not be assessed only as a routine physiotherapy problem.
When a physiotherapy assessment may be useful
A physiotherapist can be a useful first contact when there are no urgent warning signs and:
• pain is limiting sleep, work, walking, lifting, sport or normal daily activities;
• symptoms are not settling as expected or are getting harder to manage;
• the same problem keeps returning;
• pain travels into the buttock or leg, or you notice tingling that needs assessment;
• you are unsure which movements are safe; or
• you want a graded plan for returning to work, training or running.
You do not need to wait until pain is severe. An early assessment can help clarify what is likely to be safe, identify factors that may be slowing recovery and give you a plan that matches your current capacity.
What does a back-pain physiotherapy assessment involve?
A good assessment starts with your story: when the pain began, how it behaves, what makes it better or worse, your health history and what you need to get back to doing. Depending on your symptoms, the physical assessment may include movement, strength, sensation, reflexes, balance and functional tasks.
The aim is not simply to find one sore structure. It is to screen for features that need medical referral, explain the findings in plain language and build a plan around your goals. Management may include advice about activity, individually selected exercise, pacing and strategies for gradually restoring confidence and capacity.
Do you need a scan before seeing a physiotherapist?
Usually, no. Australia's Low Back Pain Clinical Care Standard recommends selective rather than routine imaging for a new episode of low back pain. Scans are useful when the assessment suggests a specific serious cause or when the result is likely to change management, but routine imaging can identify common age-related findings that are not necessarily the cause of pain.
A physiotherapist or GP can advise if imaging or another referral is appropriate after assessing your symptoms.
What can you do while waiting for an appointment?
If you have no red flags, try to remain gently active rather than staying in bed. Short walks, changing position regularly and temporarily modifying the most aggravating tasks are often more useful than complete rest. Avoid repeatedly testing a movement that sharply worsens symptoms, and seek review if you are deteriorating.
At My Therapist Group in Frankston, Ash Samarakoon provides one-to-one physiotherapy assessment and care. Private patients do not need a GP referral.
Learn more about back-pain physiotherapy
Book a physiotherapy appointment
Sources and further reading
Australian Commission on Safety and Quality in Health Care — Low Back Pain Clinical Care Standard