Lower Back Pain: When to See a Physio and Will ACC Cover It?

If you have lower back pain, two questions usually come up: should I see a physio yet, and will ACC cover it? The short answer is that you don't need to wait weeks before seeing a physiotherapist, and ACC covers lower back pain when it was caused by an accident, such as lifting, twisting, a fall or a sports injury. Back pain that came on gradually, with no specific incident, is usually not covered by ACC, but it can still be treated privately.

At AZ Physiotherapy Limited in Pakuranga, East Auckland, we assess and treat lower back pain for both ACC and private patients. This guide explains when to book, how ACC decides on back injuries, and which symptoms need a doctor instead.

When should you see a physio for lower back pain?

Consider seeing a physiotherapist if your lower back pain is:

• Affecting your work, sleep or ability to sit, stand or walk
• Making bending or lifting difficult
• Stopping you exercising or playing sport
• Getting worse rather than better, or not improving with self-management
• Coming back repeatedly after activity
• Spreading into your buttock or leg
• The result of a specific incident, such as lifting, twisting, a fall or a car accident

If your pain started after an accident, it is worth being assessed early. Your injury is documented while the details are clear, and the ACC claim can be lodged at the same visit.

Will ACC cover my lower back pain?

ACC covers personal injuries caused by an accident. For lower back pain, the key question is how it started.

ACC specifically lists unexplained back pain that gets worse over time among the things it generally doesn't cover. If you have had mild back discomfort for months that has slowly worsened without a particular incident, ACC is unlikely to cover it.

Every situation is different, though. ACC says your doctor, physiotherapist or other health provider can tell you whether an injury is likely to be covered and make the claim where appropriate.

Lower back pain from lifting

Lifting is one of the most common causes of acute back injuries we see, for example lifting at work, moving furniture, picking something up from the floor, gym training or gardening. If there was a clear moment when you felt your back go, it may meet ACC's injury criteria.

Lower back pain from sport

Back injuries happen in cricket, rugby, football, basketball, tennis, running, gym training and weightlifting. A sports-related back injury may be covered if it came from a specific incident. Rehabilitation usually includes progressive strengthening, mobility work, movement retraining and sport-specific exercises.

Can a physio lodge an ACC claim for a back injury?

Yes. You don't need to see your GP first. When you are injured you can go straight to a physiotherapist, and your physio can lodge the ACC claim on your behalf. If your symptoms need medical investigation, we will refer you to your GP.

Is ACC physio for back pain free?

Not necessarily. ACC contributes towards the cost of treatment for covered injuries, and you may pay part of each appointment. At AZ Physiotherapy, an ACC appointment costs $35 for a 45-minute first assessment and $30 for a 30-minute follow-up. Private appointments for back pain that isn't covered are $80 and $70. See our fees page, or read is ACC physio free? for how ACC costs work.

When is lower back pain an emergency?

Most lower back pain isn't serious. Seek urgent medical help (your GP, an urgent care clinic or the emergency department) if your back pain comes with:

• New loss of bladder or bowel control
• Numbness around the groin, genitals or inner thighs (saddle area)
• Weakness in the legs that is significant or getting worse quickly
• Pain after major trauma, such as a serious fall or car crash
• Fever, or feeling very unwell, with severe back pain

What if the pain goes into my leg?

Lower back pain sometimes comes with pain, tingling, numbness, pins and needles or weakness in the buttock or leg. This can happen when structures around the lower back irritate a nerve. A physiotherapist can check your nerve function and decide whether physiotherapy is right or whether you need medical review. Read more about sciatica.

How does a physio assess lower back pain?

We'll ask when and how your pain started, where you feel it, what makes it better or worse, your work and exercise, previous injuries, sleep and any leg symptoms. The physical assessment may include:

• How your lower back and hips move
• Strength and functional movement, such as bending, sitting to standing and walking
• A neurological screen if you have leg symptoms

Treatment depends on what we find. It usually combines exercise, strengthening and mobility work, hands-on treatment, education about pain and movement, and a plan for returning to work or sport. For causes and treatment in more detail, see lower back pain: causes and treatment.

Do I need an X-ray or MRI?

Usually not at first. Most lower back pain can be assessed without imaging, and scans often show changes that are common in people without pain. Your physio or doctor will recommend imaging when there is a specific clinical reason, such as red-flag symptoms or pain that isn't improving as expected.

How long does lower back pain take to get better?

It varies. Many acute back injuries improve over a few weeks, while others need a longer rehabilitation programme. Recovery depends on the type and severity of the injury, your general health, your work and sport demands, previous injuries, and sleep. If your pain isn't improving or is affecting your daily life, an assessment will help you work out the next step.

Lower back pain physio in East Auckland

AZ Physiotherapy Limited is at 7/45 Dale Crescent, Pakuranga, and sees people from Howick, Highland Park, Botany and across East Auckland. You'll see Abdullah Abdullah, our registered musculoskeletal physiotherapist, for ACC and private care.

If your back pain started with an accident, we'll assess it and help with the ACC claim. If it didn't, we'll still help you understand it and get moving again. Learn more about lower back pain treatment and ACC physio at AZ, or contact us to book.

Sources

• ACC: Injuries we cover
• ACC: Injuries we don't cover
• ACC: What to do if you're injured