What if physiotherapy does not relieve lower back pain?

Lower back pain can persist when the current exercises do not match the movement pattern, when activity is progressing too quickly, or when muscle guarding and poor sleep are keeping symptoms active. Pain travelling into a leg, tingling, numbness, or weakness may point to nerve irritation and needs a focused assessment. Persistent pain does not identify one diagnosis on its own.

Notice whether symptoms change with sitting, standing, walking, bending, or coughing. Record any leg symptoms and whether they affect balance or strength, then share this information at review.

Tell your physiotherapist or doctor exactly which activities help, aggravate, or fail to change the pain. They may alter the exercise selection, frequency, posture advice, pacing, or goals, and decide whether another examination is needed. Keep gently active within your agreed limits when possible; avoid prolonged bed rest and do not force movements that produce sharp or spreading pain.

Bring details of any fall, lifting incident, previous back problem, medicines, and changes in bladder or bowel function. Read about [Lower Back Pain](/symptoms/lower-back-pain/) and [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/).

Seek urgent care for new loss of bladder or bowel control, numbness around the inner thighs or genital area, or rapidly worsening weakness in a leg. Prompt assessment is also needed for severe pain after trauma, fever with back pain, or feeling very unwell. Do not wait for a routine therapy appointment when these signs appear.

Ask: Do my symptoms suggest nerve irritation? Which movements are safe while pain continues? Do I need another examination? What changes in strength, sensation, or bladder and bowel function require urgent help?