Back Pain in the UK: Physiotherapy and Where to Get Help

The NHS says back pain often improves on its own within a few weeks. Its advice is to:

• stay active and carry on with your daily activities as far as you can, and do not stay in bed for long periods
• try exercises and stretches for back pain (stop and see a GP if the pain gets worse); walking, swimming, yoga and pilates may also help
• use an ice pack or a heat pack wrapped in a tea towel for pain, swelling, stiffness or muscle spasm
• ask a pharmacist or GP which painkiller is suitable for you: the NHS says anti-inflammatory medicine such as ibuprofen may help but is not suitable for everyone, and that paracetamol on its own is not recommended for back pain

The NHS page links to a physiotherapist's back stretches video and to Chartered Society of Physiotherapy video exercises.

The NHS says to see a GP if your back pain does not improve after treating it at home for a few weeks, is stopping you doing your day-to-day activities, or is worrying you or making it hard to cope. It also lists these signs: you have lost weight without trying to; there is a lump or swelling in your back or your back has changed shape; the pain does not improve after resting or is worse at night; it is worse when sneezing, coughing or pooing; or it comes from the top of your back, between your shoulders, rather than your lower back.

The NHS says that most adults in England who are registered with a GP can refer themselves to community musculoskeletal (MSK) services without a GP referral. You do not need a diagnosis. These services help with back, knee, shoulder or neck pain, arthritis, sciatica, carpal tunnel syndrome, plantar fasciitis, tennis elbow and recovery after an injury or surgery. Depending on what is available locally, you may be offered an assessment, treatment or support such as physiotherapy, pain management and occupational therapy, and a further referral for tests such as an MRI or CT scan if needed.

You use the NHS service finder to choose a service for your GP surgery's area and then start the referral on that service's website. The NHS says a health professional reviews your referral and the service will tell you what happens next, including waiting times. These services do not offer urgent or emergency help, and in some parts of England you may not be able to refer yourself and may need to contact your GP surgery. Source: NHS: get help for back or joint problems from community MSK services.

The NHS says other treatments may be recommended if your back pain does not get better after a few weeks:

• group exercise sessions and physiotherapy
• manual therapy, where a trained therapist massages and moves the muscles, bones and joints in your back
• cognitive behavioural therapy (CBT) to help you cope with the pain
• a procedure to seal off some of the nerves in your back (only for long-term lower back pain)

If a medical condition such as a slipped disc is causing the pain and other treatments have not helped, surgery may be an option. Decisions about medicines and procedures are for you and your doctor. If pain has lasted more than 12 weeks, see our guide to living with long-term pain.

• Physiotherapists assess movement and pain and offer exercise programmes and manual therapy; see how to find a physiotherapist and sports injury physiotherapy.
• Occupational therapists can help you adapt tasks, equipment and routines at home and work when pain limits what you do (the NHS lists occupational therapy among MSK service support).
• CBT therapists, practitioner psychologists and counsellors can help you cope when pain affects your mood, sleep or confidence; see physiotherapy for pain and mental health.

The Chartered Society of Physiotherapy runs a find a physiotherapist directory of its members, and you can check anyone on the HCPC register whether or not they are in a directory.

Whoever you choose, check their register: physiotherapists must be on the HCPC register (HCPC: check the register). Ask about fees, session length and what progress will look like. See questions to ask a private allied health professional. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.