Online physiotherapy for lower back pain
If your lower back pain fits, a video appointment lets your physiotherapist ask about your pain, watch how you bend and move, and set up an exercise and advice plan you follow at home. Call 999 or go to A&E, instead of booking, if you have weakness or numbness in both legs, numbness around your genitals or anus, or bladder or bowel changes. See the full list below.
If you’re in the Glasgow area, you can book a home visit instead of a video call.
How online physiotherapy works for lower back pain
Lower back pain is a good example of a problem where the story matters as much as any hands-on test. On video we spend the first part of the appointment on how it started, what the pain does through the day, what it stops you doing and what you are worried about. Then we ask you to show us the movements that bother you, from bending to pick something up to getting out of a chair.
Because you are at home, we can look at the real setting. Your bed, your desk chair, the car seat you sit in for the commute and the way you lift a laundry basket are all things we can talk through with you in the room where they happen. Our advice is built around that, so it is easier to carry out the next morning.
NICE guidance on low back pain and sciatica encourages people to continue with normal activities, and lists exercise among its recommended non-invasive options. It also says imaging should not routinely be offered in a non-specialist setting. In our plans that means a scan is not a starting requirement, and movement and graded exercise sit at the centre of what we ask you to do.
If your leg pain is the main problem rather than the back itself, our page on online physiotherapy for sciatica covers that separately. Here we stay with pain that is mostly in the back.
A video call has limits. We cannot feel the muscles or joints of your spine, and NICE says manual therapy should only be given as part of a package that includes exercise. If your picture does not fit what we can safely assess by video, we will say so and point you to the right in-person care.
What the video assessment checks
- When the pain began, whether it followed a particular movement or came on gradually, and how it has changed since.
- How far you can bend forward, lean back and to each side, and whether any direction feels easier or harder than the other.
- How you move from sitting to standing, get on and off the floor, and walk across the room, to see how freely your back and hips are working.
- What makes the pain worse and what eases it across a normal day, including sitting, standing, lying and work tasks.
- How the pain affects sleep, work, exercise and mood, and what you have already tried.
- The red flag questions listed below, which we ask before anything else, because they decide whether a video appointment is the right place for you to be.
What treatment usually involves
Most plans begin with a short explanation of what is going on, advice on staying active, and a few simple movements chosen after we have watched how your back moves. From there we add strengthening for the trunk, hips and legs, and a walking or activity routine that you build up at your own pace.
We do not set a number of sessions for lower back pain in advance. It depends on your condition; your physiotherapist will give you an estimate after your assessment. The first is a 60-minute video assessment at £40, and follow-ups are 30 minutes at £30. We review progress with you at each follow-up instead of booking a block up front.
NICE recommends that manual therapy is not given on its own, and that it should be part of a package that includes exercise. Because a video appointment has no hands-on element at all, exercise and advice are the whole of our approach. If you want a clinician to treat the area by hand, a video service will not be the right fit.
For questions about cost, referrals and insurance, our guide to private physiotherapy cost in the UK is a good place to start, and we cannot promise that any insurer will pay, so check with yours before you book.
How long recovery usually takes
The NHS says back pain often improves on its own within a few weeks and advises staying active. If yours is not improving after that, or it is getting worse, speak to a GP or book a review with us so that we can look again at what the plan should be.
When you need to be seen in person instead
A video appointment is not the right route for the situations below, and a home visit is not a substitute for urgent care.
- Call 999 or go to A&E if you have back pain and pain, tingling, weakness or numbness in both legs.
- Call 999 or go to A&E if you have a loss of feeling around your genitals or anus.
- Call 999 or go to A&E if you have changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself.
- Call 999 or go to A&E if you have back pain with chest pain, or changes in sexual feeling or function.
- Call 999 or go to A&E if your back pain started after a serious accident.
- Do not drive yourself to A&E for any of the above. Ask someone to drive you, or call 999.
- NICE guidance on low back pain asks clinicians to think about other causes first, such as cancer, infection, an injury or inflammatory disease. If you think your back pain could be linked to one of these, see your GP before you book with us.
Exercises and self-checks
Common questions
Can lower back pain be treated by video?
Our video appointments cover your history, how you move and a plan of exercise and advice, and NICE lists exercise among its recommended options for low back pain. We cannot examine you by hand, and if we think you need that, tests or a doctor, we will tell you plainly.
Will I need a scan first?
No. NICE advises that imaging is not routinely offered in a non-specialist setting for low back pain, and we do not ask for a scan before an assessment. If your symptoms suggest you need further tests, we will explain why and suggest you speak to your GP.
Should I stay in bed if my back is sore?
NICE encourages people to continue their normal activities, and the NHS advises staying active. We help you work out how much to do, what to ease off for now and how to build back up without setting the pain off again.
What if I have pain down my leg as well?
Leg pain with back pain is common and we ask about it at the start. We cover that picture on our sciatica page. Tell us if you notice weakness or numbness, because some patterns need urgent care in person.
Do I need a GP referral for physiotherapy?
You can book with us directly. Whether your insurer needs a GP referral depends on your policy, so check with them before booking. Our guide on GP referral for physiotherapy explains the options.
Further reading
This information is general and not a substitute for an assessment. Don't start a new exercise programme without advice from a physiotherapist or doctor who knows your condition. If an exercise causes pain that doesn't settle, stop and seek advice.
Sources
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A 60-minute video assessment with an HCPC-registered physiotherapist is £40.
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