Low Back Pain — Physiotherapy in Central London

In most cases, no. NICE guidance specifically advises against routine imaging for non-specific low back pain because it rarely changes management and frequently shows incidental findings (disc bulges, mild degenerative change) that are present in pain-free people too. Imaging is appropriate when there are red flags — significant trauma, suspected fracture, neurological deficit, or pain pattern suggesting a specific cause.

Seek urgent medical attention (A&E or 111) if you experience: loss of bladder or bowel control, numbness around the saddle/perineal area, progressive leg weakness, or back pain after significant trauma. These can indicate cauda equina syndrome or fracture and require imaging within hours, not days. Routine physiotherapy is not appropriate in these cases.

Stay as active as the pain allows. Bed rest beyond 24–48 hours actually slows recovery from low back pain and increases the risk of chronic problems. Walking, gentle movement, and continuing your normal routine where possible are recommended even during an acute flare. Your physiotherapist will guide what to modify and what to keep doing.

For an acute first episode, most people are substantially better within 3–6 sessions over 4–8 weeks. Recurrent or chronic low back pain responds more slowly — expect 6–12 sessions over 8–16 weeks for meaningful change. The goal is not just symptom relief; it is restoring strength, capacity, and confidence in your back so flares become less frequent and less severe.