Explore symptoms, assessment and rehabilitation considerations for back pain.
Lower back pain can affect sitting, walking and everyday work. An exercise plan should reflect your symptoms and what you need to do, rather than assume that everyone needs the same stretches or core routine. Here are movement options, activity adjustments and assessment questions to consider.
Back pain symptoms needing immediate care
Seek emergency medical care for back pain with new bladder or bowel problems, loss of feeling around the genitals or bottom, or pain, weakness or numbness in both legs. Back pain with chest pain or after a serious accident also needs emergency assessment. Do not wait for an online physiotherapy appointment.
Severe pain that begins suddenly or worsens quickly, or back pain with fever or feeling unwell, needs urgent medical advice. See the NHS back pain guidance for the distinction between urgent and routine care.
Understanding lower back pain
Often there is no single structure that can be identified as the cause. This is called non-specific low back pain. Leg pain with tingling or numbness may need assessment for nerve involvement.
Guy's and St Thomas' explains that movement, general fitness, sleep and emotional wellbeing can contribute to the experience of back pain. There is no one perfect posture, and a scan is not routinely helpful for most low back pain.
Gentle back exercises to discuss with a physiotherapist
A healthcare professional can help you choose movements that fit your symptoms. The Chartered Society of Physiotherapy exercise demonstrations include these options:
Pelvic tilt
Lie on your back with your knees bent. Gently tilt your pelvis so your lower back moves towards the floor, then return towards a comfortable resting position. Keep breathing and avoid forcing the movement.
Single knee towards the chest
Start on your back with both knees bent and feet on the floor. Support one thigh with your hands and gently bring that knee towards you, then lower it again. Keep the range comfortable.
Heel slide
Lie with your knees bent and your back in a comfortable neutral position. Gently engage your abdominal muscles while sliding one heel away and back, keeping your breathing steady and avoiding a change in your back position.
Stop if exercises worsen your pain and seek medical advice. These examples do not provide a rehabilitation plan for a recent operation or a specific spinal diagnosis.
Stay active without doing too much at once
Prolonged bed rest is generally unhelpful for back pain. Continue manageable everyday activity, adapting tasks that aggravate symptoms. For desk work, changing position can be more useful than trying to hold one rigid posture all day.
Guy's and St Thomas' recommends pacing activity: start from what you can currently manage, break larger tasks into smaller parts and build up gradually. A physiotherapist can help you plan progression when flare-ups make this difficult.
What online physiotherapy can cover
A video consultation can be used to discuss symptoms, observe suitable movements and agree on home exercises. Your history and symptoms determine whether you also need an examination in person or medical investigations.
Our lower back pain physiotherapy guide explains assessment, rehabilitation and preparation. Bring your questions about work, sleep, movement and previous treatment so the consultation addresses your own priorities.
Frequently asked questions about back pain rehabilitation
Do I need an MRI before physiotherapy?
Not routinely. A clinician decides whether imaging is likely to change your care, based on your history and examination.
Is there one best exercise for lower back pain?
No single exercise suits everyone. A plan can combine movement, strength and general activity according to your preferences and abilities.
What if pain keeps returning?
Arrange an assessment to discuss the pattern, its effect on daily life and whether your plan needs adjusting. Recovery varies, and an exercise schedule should not promise a fixed completion date.
Sources and further reading
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Explore our treatment options for this topic: Online Physiotherapy for Back & Hip Pain.
A physiotherapist can help you choose exercises and adjust activity to your circumstances. Explore our physiotherapy services, see how our treatment process works, or explore more practical guides in our blog library.
