“It's not that bad really.” We hear this sentence a lot. Patients who have been living with pain for weeks, dragging themselves through everyday life — and thinking that's normal. Spoiler: it isn't.
At the same time, we don't want to panic anyone. Not every twinge in the back needs physiotherapy straight away. It's about the right balance: when is patience wise, and when is waiting dangerous?
We have put together five signs where you shouldn't hesitate any longer — and explained for each one what may be behind it.
1. Pain that lasts longer than 2–3 weeks
Acute pain is a warning signal from the body — and usually completely normal. A strained muscle, slight overload, a stiff neck after a bad night's sleep: these usually ease by themselves within 1–2 weeks.
But if pain persists for longer than 2–3 weeks — even if it is “bearable” — it's time for a professional assessment. Why?
- Chronic pain develops when acute pain doesn't heal — and the longer the system stays irritated, the harder it becomes to calm it down again
- Pain leads to guarded postures, guarded postures lead to tension, tension leads to new pain
- What starts as back pain can suddenly radiate into the leg after weeks — a sign that it is escalating
Rule of thumb: if it isn't better after 14 days of rest, we treat it.
2. Pain that radiates
Local pain is usually harmless. Pain that travels from one place to another — from the back into the leg, from the shoulder into the arm, from the neck into the back of the head — is a different matter.
Such radiating pain often points to nerve involvement: a trapped nerve, a disc pressing on something, or irritation from tense muscles. We should start early here, because nerve irritation “burns in” over time and becomes harder to reverse.
3. Functional limitations in everyday life
Sometimes the pain isn't the main problem, but what you suddenly can no longer do:
- You can no longer turn your head fully — looking over your shoulder when driving hurts
- You can no longer reach your feet when putting on socks
- You wake up at night with low back pain and can't find a comfortable position
- Getting up from the armchair takes two attempts
- Climbing stairs has hurt your knee for weeks
Such functional limitations are often an early signal — the body is still compensating, but its reserves are shrinking. The earlier we start, the less effort is needed.
4. Recurring complaints — the same thing again and again
“My back puts me out of action every few months.” If you've ever said this, it's a clear sign: there is a structural cause that keeps producing the same complaints.
Physiotherapy is then not (only) about resolving the acute episode, but about understanding the mechanism behind it. This can be:
- A muscular imbalance (e.g. weak trunk muscles)
- A movement habit (desk work, lifting, one-sided loading in sport)
- An old injury that never fully healed
- A movement restriction in a joint that the body compensates for
This is where physiotherapy has the greatest leverage — we can break the pattern instead of just calming the next episode.
5. After surgery, an accident or a diagnosis
Actually obvious: after knee surgery, a torn ligament, shoulder surgery, a bad fall or a diagnosis such as a slipped disc, osteoarthritis or dizziness, physiotherapy belongs in the treatment plan.
Still, many patients put it off — “let's wait and see if it goes away by itself”. Please don't. Especially in the first weeks after an operation or an acute event, the window for healing is at its largest:
- After surgery: controlling swelling, regaining mobility, activating muscles — all most effective in the first 6 weeks
- Slipped disc: conservative treatment works in 80–90% of cases. But only if you stick with it
- Osteoarthritis: movement is the most effective treatment — and it should be safely guided
- Dizziness: the earlier, the better. BPPV in particular can often be treated in 1–3 sessions
Do I need a prescription?
For treatment through statutory health insurance, yes — usually from your GP, sometimes from a specialist (orthopaedist, neurologist, ENT). Talk openly to your doctor: “I've had pain for … weeks. Which prescription would make sense?”
As a private or self-paying patient you can also come without a prescription. That makes sense if you want clarity quickly — or if your doctor says “wait a bit longer” but you feel yourself that something should be done.
How to find the right practice
You can recognise good physiotherapy by a few things:
- The first assessment takes at least 30 minutes — anything less is too little to really understand your body
- You get an explanation of what the therapist has found and why they are doing what they do
- You get homework — 80% of success happens between sessions
- Specialisms match your problem — for dizziness someone with IVRT certification, for TMD someone with jaw joint experience
- After 3–4 sessions you feel that things are moving forward — if not, say so or switch
Unsure whether physio is right for you?
Just give us a call. We'll listen briefly and tell you honestly whether we can help — or whether another path is better. Advice is always free.
Conclusion: better once too early than once too late
The sentence we hear most often at the end of a first session is: “I wish I'd done this sooner.” If you recognised yourself while reading — book the appointment. In the worst case we'll tell you after 30 minutes: “You don't need therapy at all.” In the best case we'll save you months or years of complaints.
