When Back Pain Needs More Than Rest and Physiotherapy
Most back pain resolves within 4-8 weeks with appropriate conservative management. This is well-established in spine medicine — and it means that the vast majority of patients who follow basic advice about rest, gentle movement, and short courses of anti-inflammatory medication will improve without specialist intervention. But a meaningful minority of back pain patients do not improve. Their pain stays the same or gets progressively worse. Standard treatments provide no lasting relief. And somewhere in that group are patients whose back pain has an underlying cause that physiotherapy and painkillers will never address — including spinal tuberculosis. The Specific Triggers That Should Change Your Approach When any of the following features accompany back pain that is not improving, the clinical picture changes significantly and demands a different response: Pain duration beyond 6 weeks with no meaningful improvement despite treatment Any systemic symptoms — fever, night sweats, un...