Physiotherapy for Back Pain and Neck Pain at Megazee.com, Manchester

Almost every enquiry about back or neck pain arrives with a scan attached. Either you have had one and the report used a word you did not like, or you want one because nobody has explained what is going on. It is a fair instinct, and most of the time it is the wrong first move.

This page is about the treatment rather than the problem: how spinal pain is examined at Megazee.com, what happens in the room, when imaging changes anything, who we refer you to when physiotherapy is not the answer, and how care is staged. It sits alongside the other physiotherapy services at our Manchester clinic, and is usually combined with at least one of them.

Do I need a scan first?

Usually not, and the reason is not cost. NICE guideline NG59 advises against routinely imaging low back pain and sciatica outside specialist settings, because the picture rarely changes what the treatment should be.

There is a second reason, and day to day it matters more. Spinal imaging reports are written for surgeons, in the vocabulary of tissue: degeneration, desiccation, bulge, wear. Read at a kitchen table those words sound like a verdict, and people stop moving because of them. Such findings are commonly seen on scans of people with no pain at all.

A scan earns its place when the result would change the plan: neurological signs that are worsening, something raised at screening that needs excluding, a surgical or injection decision genuinely under consideration. Then we say so and get the referral moving rather than treating around it.

What a spinal assessment at Megazee.com involves

We start with what you can no longer do, not with where it hurts. Reversing off the drive. The first ten steps out of bed. Forty minutes at a desk before you have to stand up. One of those becomes the measure we retest against for the rest of your care.

• Watching you move. Bending, leaning back, rotating each way, sometimes repeatedly: a spine often behaves differently on the tenth repetition than the first.
• A neurological screen where it is indicated. Reflexes at the knee and ankle, big-toe strength pushed against our thumb, heel and toe walking, light touch compared side to side. For necks we add grip, and a question about buttons, keys and handwriting.
• Hands on the spine, level by level. Comparing each segment with the one above it, to find which joints have genuinely lost movement rather than which patch feels sore.
• The hips and the mid-back. A thoracic spine that will not rotate and a hip that will not extend both hand their workload downwards.
• A retest before you leave the room. Same movement, same measure. If nothing changed, you should know on the day rather than after four appointments.

Wear something you can move in. You can decline any part of the examination, and a chaperone is available on request.

The questions we ask before we treat anything

Early on you will be asked about bladder and bowel control, numbness around the saddle area, unexplained weight loss, fever, night pain that no position eases, cancer history, long-term steroid use and recent falls. When your problem is a stiff neck from a bad week at a desk, that can feel disproportionate.

We ask because the serious causes of spinal pain are uncommon rather than rare, and because they are the situations where physiotherapy is the wrong thing that day. You will be asked again, briefly, later on: a question answered once in March is not a safety net in May.

What treatment actually feels like

Hands-on work and exercise happen in the same appointment, not in separate courses. Graded joint mobilisation is firm, rhythmic pressure held for thirty to sixty seconds at a time. It should feel like pressure you could hold a conversation through, never sharp. In some techniques you do half the work, pushing against our hand before the joint is taken further.

You leave with two or three exercises, not twelve. Each is demonstrated back to us before you go, with the repetitions written down, because “little and often” is the instruction people most reliably forget. Where a spine needs supervision to load properly, that continues in supervised spinal exercise classes rather than alone in a kitchen. The NHS summary of what physiotherapy involves describes the same mix of movement, exercise and hands-on work.

How Megazee.com stages spinal care across appointments

Appointment one is the assessment, an explanation you can repeat to someone at home, the first treatment and your starting exercises.

Appointment two is usually seven to ten days later. We are looking for carry-over: how long the change from the first session lasted. Two days is information. Nothing at all is also information.

By the third or fourth we review in earnest. If the measure we chose has moved and you can feel it, appointments spread out: a fortnight, then three weeks, then discharge with a written plan for flare-ups. If it has not moved, a fifth identical session is not a plan, and we change the approach or refer you on.

Nerve-related and long-standing problems need more review points than a stiff mechanical back. You get an honest range after the assessment, not over the phone. Spinal care at Megazee.com is planned around those review points and never sold as a block of sessions in advance. What we charge and how insurance works is published in full.

When we refer you on, and where to

Physiotherapy is not the right answer for every spine. Part of what you are paying for at Megazee.com is somebody who will tell you that early.

• Back to your GP, by letter that week and with your consent, when screening raises something needing medical assessment or when imaging is warranted. We do not refer directly for scans; that goes through your GP or consultant.
• To an NHS spinal or MSK service where a surgical opinion may be needed, progressing neurological signs being the clearest reason.
• To rheumatology, via your GP, where the pattern looks inflammatory rather than mechanical.
• Alongside your existing team. If you are already under a consultant or waiting for an appointment, we work within what they have advised and write to them, not around them.

When to get medical help instead of booking physiotherapy

Some symptoms need a doctor today, not a physiotherapist.

• A&E the same day, or 999: loss of bladder or bowel control, difficulty starting to pass urine, numbness around the back passage, genitals or inner thighs, or new weakness or numbness in both legs.
• 999: dizziness, slurred speech, double or blurred vision, difficulty swallowing or facial numbness alongside neck pain. Also any sudden, severe, worst-ever headache.
• A&E before physiotherapy, after a collision or fall: midline bony tenderness in the neck, inability to turn the head roughly 45 degrees each way, or numbness, tingling or weakness in the arms or legs.
• An urgent GP appointment: fever alongside spinal pain, a history of cancer, unexplained weight loss, night pain unrelieved by any position, spinal pain after a fall in someone with osteoporosis or on long-term steroids, or weakness that is worsening.

That list is not exhaustive. If you are unsure, call NHS 111. Our medical disclaimer sets out the limits of anything written here.

Booking spinal physiotherapy at Megazee.com

No GP referral is needed to book privately. Every physiotherapist at Megazee.com is registered with the Health and Care Professions Council and chartered with the Chartered Society of Physiotherapy.

If you would rather read about your own problem than the pathway, we have written separately on lower back pain, leg pain and sciatica and neck pain, whiplash and related headaches. Timeframes and self-management live there.

Otherwise, book a spinal assessment and bring the movement you cannot do. If you would sooner speak to a physiotherapist before committing, ring and describe it. Five minutes usually settles whether this is the right place to start.