Low back pain: when to see a physiotherapist, and when a doctor first
Almost every working adult has had low back pain. Most of it settles in 2–6 weeks; some needs treatment; and a few signs mean a doctor first. This helps you tell the three apart.
Signs that need a doctor first
Numbness or weakness in a leg; pain radiating below the knee; loss of bladder or bowel control or numbness around the seat; pain after an accident or fall; night pain that wakes you and does not change with position; fever; unintended weight loss; a first episode over 50; or a history of cancer or osteoporosis. These need a cause found, not symptoms treated.
When physiotherapy is the answer
Pain tied to posture or use — long sitting, lifting, a bad training movement — with none of the signs above, that has not improved after two weeks of moving normally. A physiotherapist assesses how you move, finds which muscles are tight or weak, and gives you specific exercises. Machines (ultrasound, heat, electrical stimulation) ease pain in the short term; what keeps it from coming back is the exercise programme you continue at home.
The first two weeks: what to do yourself
Keep moving; do not rest in bed — more than a day lying still slows recovery. Take short, frequent walks and change position every 30 minutes. Heat relaxes the muscles. Over-the-counter painkillers are fine short-term as labelled. Avoid heavy lifting and fast twisting. If two weeks pass with no change, or this is the third episode in a year, that is the time to book a physiotherapist.
