Nobody can tell you honestly how many visits you will need before they have examined you. A number quoted over the phone, before anyone has looked at you, is a guess. What can be said in advance is how the plan gets set, what is reviewed when you come back, and what would change it.
Why the answer depends on the examination
What moves the picture is ordinary enough to write down.
- How long it has been there. Something that started last week and something that has been building quietly for years are not the same problem, even when they hurt in the same place.
- What is feeding it between appointments: the hours you sit, the way you lift, the sleep you are not getting, the deadline that is not moving.
- Your age, your work, your health history, and anything else you are already being treated for.
- What you are trying to get back to. Getting through a desk day without an afternoon ache and getting back under a loaded barbell are different targets, and they ask for different work.
Two people who describe the same sore lower back in the same words can turn out to need quite different things. That is why the plan is set at the first assessment, once there is something real to set it against, and why it is written to be changed.
What the first visit actually settles
A plan needs something to be set against, and the first appointment is where that is found: how the thing behaves, what it is stopping you doing, and what the screening questions turn up. When you want to start, you can request an appointment.
Dr Laith Musallam, chiropractor, goes through the findings with you the same day and sets out the plan before you leave: what happens here, what you do between appointments, and how we will know whether it is working.
The imaging conversation here is not this clinic’s invention. For low back pain, the Australian Commission on Safety and Quality in Health Care’s Low Back Pain Clinical Care Standard (2022) puts expectations of imaging, and its limited role in diagnosing low back pain, among the things discussed with the patient.
Imaging here is suggested when clinically indicated, and not as a matter of routine. A report is read next to your story and your examination rather than in place of them, and it is gone through with you that way. There is more on what an image adds, and when it genuinely changes the plan, in our guide on whether you need a scan first.
What gets reviewed when you come back
A plan is a first move with a check attached, and the check is the part that matters. At the next appointment we go back over what changed: the movements that were sore, the things you could not do, how the week actually went, and what happened when you tried what you were given.
If something changed, that points the direction and the work carries on in it. If nothing changed, that tells us something too, and the answer is to adjust rather than to repeat. Care that is doing nothing does not become useful by being given more times.
If things settle, the balance shifts. Hands-on time comes down, movement and the ordinary habits around it take over, and appointments spread out with that. Some people finish there. Others come back if something flares, and that is a decision made at the time, with a reason for it, rather than booked ahead in the hope of it.
The part that happens when you are not here
The hands-on part is one half of the work and it is the half that is meant to step back first. You leave with a few things to do between appointments, minutes rather than a program you have to plan your week around, and they change as the plan is reviewed with you. That half runs between appointments, and it needs you as much as it needs the clinic.
For low back pain, one guideline outside Australia ties the two together. Recommendation 1.2.7 of the National Institute for Health and Care Excellence in the United Kingdom, in Low back pain and sciatica in over 16s: assessment and management (NG59), amended in 2026, considers manual therapy, meaning spinal manipulation, mobilisation or soft tissue techniques such as massage, for managing low back pain with or without sciatica, but only as part of a treatment package that includes exercise. The exercise half is not homework attached to the real appointment. It is part of what the guideline is describing.
For an acute low back episode, the Australian advice for what to do with yourself in the meantime is plainer still. The Royal Australian College of General Practitioners’ Handbook of Non-Drug Interventions entry, Advice to stay active for people with acute low back pain (2019), recommends staying active instead of resting in bed for an acute episode of low back pain, and is specific about what staying active means: carrying on with normal daily activities as much as possible, including going to work.
What we say instead of a number
What you get instead of a number is a plan with a reason attached and a review each time you come in. We do not swap the number for a date, because a date is a promise about a body that has not responded yet. An honest expectation is worth more than a flattering one, even when the honest one is harder to hear.
When to get it looked at
Go to a hospital emergency department straight away if you have numbness or altered feeling around the saddle area, meaning the groin, the inner thighs, the buttocks or the genitals; a loss of normal sensation in the genitals, including during sex; trouble starting to pass urine, or any new change in your bladder or bowel control; weakness in both legs, particularly if it is getting worse; new or worsening pain running down both legs; weakness in one leg that is severe or getting worse, or a foot that has started to catch or drag when you walk; or numbness in a leg that is spreading or getting worse quickly. Go to a hospital emergency department straight away for back or neck pain after a serious fall or a high-impact accident, such as a car accident; back or neck pain with a fever or feeling generally unwell; or new back or neck pain if your immune system is weakened, for instance by long-term steroids or chemotherapy, if you inject drugs, or if you have recently had a spinal injection, spinal surgery or a dental procedure. Go to a hospital emergency department straight away if you have weakness in one arm that is severe or getting worse, or numbness in an arm that is spreading or getting worse quickly. Go to a hospital emergency department the same day if you have new clumsiness in both hands, or new unsteadiness on your feet. Each of those means the hospital, rather than booking an appointment anywhere.
Call an ambulance if there is any confusion, sudden weakness or numbness in the face, arm or leg on one side, facial drooping, slurred speech, sudden trouble speaking, seeing or understanding, loss of vision, a seizure, or a sudden loss of balance or coordination. Call an ambulance or go to a hospital emergency department straight away if a headache comes on suddenly and severely (the worst you have ever had), if a headache arrives with fever, a stiff neck or a rash, or if a headache follows a knock to the head.
The back signs above go to an emergency department because the Australian guidance on low back pain puts them there: the Australian Commission on Safety and Quality in Health Care’s Low Back Pain Clinical Care Standard (2022) and the Royal Australian College of General Practitioners’ First do no harm: A guide to choosing wisely in general practice. For GPs: Imaging in adults with acute low back pain (2022) both send suspected cauda equina syndrome, suspected spinal infection, a fracture after a high-impact injury and severe or rapidly worsening nerve weakness for emergency assessment.
See your GP promptly, before booking here, if you have a history of cancer, unexplained weight loss, pain at night that will not settle in any position, known osteoporosis with new severe pain, numbness that is spreading or getting worse slowly, new, unexplained back pain as an older adult, or pins and needles, numbness or weakness in an arm or hand. Screening for that short list is built into every assessment here.
See your GP first if you have a brand-new type of headache, if your usual headache has changed its pattern, if your first bad headaches have started after the age of 50, if they are worse lying down or when you cough or strain, if you are taking pain relief for headaches more than a couple of days most weeks, or if you think you may have migraine and have never been assessed.
The other reason to get something looked at has nothing to do with how bad it is. If it has been going on long enough that you have stopped mentioning it, or you have started organising your week around it, that is a reason to have it assessed, and if the examination turns up nothing that needs treating, we will tell you that as well.