Does Back Pain Improve Without Physiotherapy Treatment?


Back pain can be a painful and debilitating problem and whilst some people seek physiotherapy treatment, others choose to wait and see if their back pain will go all on its own. Whilst you might think that our professional opinion can help answer this question, to avoid any element of bias we prefer to to use an evidence based approach and review the scientific literature to help provide you with an informed answer to this question.

Episodes of low back pain (LBP)  are normally  classified as acute (<6 days), subacute (7 days to 6 weeks) or chronic (>6 weeks) (CSAG, 1994). Many research studies continue to use these cut-off points, although the epidemiological evidence suggests that the frequency or number of episodes over long periods of time, rather than current episode length, better describes the problem of LBP (Croft et al, 1997).

A systematic review of predictive factors for the course of LBP has shown that 75%-90% of acute episodes presenting in General Practice improve within 6 weeks (Pengel et al, 2003). However, although after 6 weeks most patients ceased to consult their doctor and had returned to work, the majority continued to experience ongoing LBP and therefore had not got better!

Croft et al (1998) conducted a prospective study and found that 75% of patients had ongoing persistent LBP even after a year. Burton et al (2004) also found that during a four year follow-up study of adults attending an Osteopathic practice, recurrence was reported by 78% of respondents, with half seeking further care.

The research also shows that a small proportion of individuals develop persistent and chronic LBP leading to disability. Time is known to be of fundamental importance to the development of chronic back pain and disability (Waddell et al, 2003) and the point at which patients start to develop a ‘chronic’ problem is widely recognised  as 12 weeks after symptom onset. The team at PhysioDoc are trained to assess, identify and treat the factors that cause and aggravate low back pain, helping you to recover in the shortest possible time, but also reduce the risk of future episodes of back pain.

Therefore, the answer to the question is as follow: (a) without physiotherapy treatment your symptoms are more likely to persist or recur, (b) there is a possibility that your symptoms might worsen and become ‘chronic’ over time, and (c) getting an assessment sooner rather than later can help to reduce the risk of developing ongoing pain and loss of function.

Dr Jamie Bell


Burton, A. K., Balague, F., Cardon, G., Eriksen, H. R., Henrotin, Y., Lahad, A., Leclerc, A., Muller, G. and Van Der Beek, A. J. (2004). European Guidelines for Prevention in Low Back Pain. European Commission Research Directorate General: 1-54.

Croft, P. R., Macfarlene G. J., Papageorgiou, A. C., Thomas, E. and Silman, A. J. (1998). Outcome of low back pain in general practice: A prospective study. British Medical Journal 316(7141): 1356-1359.

CSAG (1994). Report of a Clinical Standards Advisory Group on Back Pain. London, Clinical Standards Advisory Group.

Spitzer, W. O., Le Blanc, F. E. and Dupuis, M. (1987). Quebec Task Force Report: Spinal Disorders. Spine 12(7): S8-S59.

Waddell, G., Burton, A. K. and Main, C. J. (2003). Screening to identify people at risk of long term incapacity for work: A conceptual and scientific review. Department for Work and Pensions. London, Royal Society of Medicine Press Ltd.