Back and neck

Start with the change you have noticed

Back or neck symptoms can affect sleep, desk work, lifting, driving and ordinary movement. At an appointment, explain where you feel the problem, when it started and whether it followed an injury or a change in activity.

It also helps to describe what is different from your usual day. This may be difficulty looking over your shoulder, sitting through a meeting, getting out of bed or carrying something comfortably.

What the assessment may explore

A physiotherapy assessment can include questions about your symptoms, medical history, work, activity and previous treatment. The physiotherapist may look at relevant movement, strength, balance and how a task is performed.

The assessment is individual. A scan is not automatically required for every episode, and a website cannot tell you what is causing your symptoms.

• When the symptoms started and how they have changed
• Movements or positions that alter the symptoms
• Any symptoms in an arm or leg
• Previous injuries, surgery, treatment or reports
• The daily activities you want to return to

How physiotherapy may help

Depending on the assessment, a plan may include advice about activity, exercises for movement or strength, manual therapy and ways to manage symptoms. The useful combination depends on the person, the findings and the goal.

You should understand what each part of the plan is intended to address, how to perform any home exercise and when the plan will be reviewed.

Work, sleep and everyday context matter

Symptoms do not happen in isolation. Long periods in one position, a demanding workday, sleep, stress and a sudden change in activity can all be useful context for the assessment.

Bring the real task into the conversation. If desk work is difficult, explain how long it takes before symptoms change. If lifting is the concern, describe the object and the movement rather than simply saying that the back hurts.

Reviewing progress

Progress can be discussed in terms of the activities that matter to you, not only a pain score. A review might compare movement, strength, confidence with a task and how consistently the home plan fits your routine.

Recovery does not always change at the same rate each week. Tell the physiotherapist about setbacks, new symptoms and parts of the plan that are difficult to follow so the next step can be adjusted.

When routine physiotherapy is not the next step

Seek urgent medical help for severe symptoms after a major accident, chest pain, new loss of bladder or bowel control, numbness around the genitals or buttocks, or weakness and numbness affecting both legs. These are not symptoms to hold for a routine appointment.

For neck symptoms, seek medical advice if you also develop pins and needles, a cold arm or symptoms that worry you. Do not drive or cycle when restricted neck movement makes it unsafe.

Preparing for your appointment

Bring relevant reports you already have, a list of medicines and any instructions from another treating clinician. You do not need to arrive with a diagnosis.

Write down two or three questions and one activity you want to discuss. That gives the assessment a practical starting point.