Activity-related pain
Symptoms that appear with specific movements or postures — bending, sitting, lifting, standing for long periods — and settle with change of position. Typically a load-tolerance problem rather than a structural one.
Online physiotherapy
Online physiotherapy for back pain.
Most low back pain is mechanical, responds to graded loading, and does not require imaging. That makes it one of the presentations best suited to a well-run online consultation — provided the assessment is thorough and the warning signs are ruled out first.
Presentations
What is usually behind it.
Back pain is a symptom, not a diagnosis. The assessment is about identifying the pattern.
Recurring episodes
Repeated flare-ups with good periods in between. The useful clinical question is what changes in the weeks before a flare: sleep, training load, workload, stress, or a drop in general activity.
Persistent pain
Symptoms lasting beyond the expected healing period. Management shifts toward graded exposure, capacity building and confidence with movement, rather than continued searching for a structure to blame.
Post-surgical or post-injury
Rehabilitation following a defined event or procedure, progressed against milestones and in step with any restrictions set by your surgical or medical team.
The assessment
What a video consultation actually covers.
History
Onset, duration, behaviour through the day, aggravating and easing factors, previous episodes, prior treatment and response, relevant medical history, work and activity demands, and specific screening questions for the presentations that need urgent in-person care.
Guided movement
You are asked to perform a defined sequence of movements in front of the camera — forward and backward bending, side bending, rotation, sit-to-stand, single-leg balance, and where appropriate a controlled loading task — while range, quality, control and symptom behaviour are observed.
Your goal
The plan is anchored to something specific and meaningful: sitting through a working day, lifting a child, returning to running, sleeping without waking. Vague goals produce vague plans.
The plan
What treatment involves.
Exercise, progressed
A short, specific set of exercises with defined sets, repetitions, frequency and — crucially — the criteria for making them harder. Progression is what separates rehabilitation from stretching, and it is the part that self-directed exercise almost always omits.
Load and activity management
Practical guidance on how much to do and when: what to keep doing, what to modify temporarily, and how to reintroduce what has been avoided. Prolonged rest and complete avoidance both tend to make back pain worse, not better.
Understanding the problem
What the symptoms mean and, equally important, what they do not mean. Fear of movement is one of the strongest predictors of persistent back pain, and it is directly modifiable through explanation.
Review and adjustment
Follow-up consultations check technique, review response and adjust difficulty. A plan that is never revisited is a guess that was made once.
Safety
When to seek in-person care instead.
These are not reasons to worry about every backache — they are specific, and they are uncommon. They do need acting on.
Seek urgent local assessment
Loss of bladder or bowel control, numbness around the groin or inner thighs, progressive weakness in the legs, or a sudden severe change after significant trauma. Contact your local emergency service rather than booking an online session.
Arrange in-person review
Unexplained weight loss with night pain, fever alongside back pain, a history of cancer, or symptoms that do not vary at all with position or activity. These warrant in-person examination and possibly investigation before rehabilitation proceeds.
Questions
Frequently asked.
Can back pain really be treated online?
For mechanical low back pain, yes. The components that drive recovery — accurate assessment, an appropriate graded exercise plan, load management and progression — all transfer to video. Presentations needing hands-on examination or urgent investigation are identified during screening and referred appropriately.
Do I need an MRI before starting physiotherapy for back pain?
Usually not. Imaging changes are common in people with no symptoms at all, and routine scanning of ordinary low back pain does not improve outcomes. Imaging is indicated when specific clinical findings suggest it, which is part of what screening is for.
How long does back pain take to improve?
It varies with presentation, duration, general health and consistency. No responsible clinician can promise a timeline for an individual, and any service that does should be treated with caution. Progress is reviewed against your own starting point at each follow-up.
What if my back pain gets worse during the exercises?
Some increase in symptoms during rehabilitation can be expected and acceptable; a sharp, sustained or spreading increase is not. The plan sets out what is normal and what is a signal to stop, and follow-up exists precisely so it can be adjusted.
Next step
Book an online consultation.
A 30-minute video consultation with Dr. Varun Soni (PT). Appointments are shown in your own local timezone.