Physio, GP, NHS 111 or A&E: where to go for muscle and joint pain
For most muscle and joint pain, start with self-care. See a physio or a GP if it has not improved after a few weeks, and in many areas you can refer yourself to NHS physiotherapy without seeing a GP first.
Call 999 or go to A&E for serious injuries and life-threatening emergencies. Use NHS 111 when you need medical help now but it is not an emergency, or you are not sure where to go: 111 can tell you. The signs for each part of the body are listed below, in the same words our check uses.
Where to go, at a glance
| Where | When (NHS) | How |
|---|---|---|
| 999 or A&E | Life-threatening emergencies and serious injuries, such as a serious road accident, a stroke or a heart attack. | Call 999, or go to A&E. Do not drive yourself to A&E: ask someone to drive you, or call 999 for an ambulance. From the NHS: When to call 999, When to go to A&E |
| Urgent treatment centre | Urgent help that is not life-threatening, including sprains and strains, suspected broken bones and injuries. They can often do an X-ray. | Walk in, or use 111 online, which may be able to give you an arrival time. You do not need to be registered with a GP. From the NHS: When to go to an urgent treatment centre (UTC) |
| NHS 111 | You think you need medical help now, your GP surgery is closed or cannot see you, or you are not sure whether to call 999 or go to A&E. | Call 111, or use 111 online or the NHS App. 111 tells you where to go, which might be an urgent treatment centre, an out-of-hours GP or a pharmacist. From the NHS: When to use NHS 111 online or call 111 |
| Your GP | Pain that has not improved after a few weeks of self-care, keeps coming back, or stops you doing day-to-day things, and any of the GP signs listed for each area below. | Contact your GP surgery. Some surgeries have first contact physiotherapists who can assess bone and joint problems. From the NHS: Back pain, Physiotherapy |
| A physio | Muscle, joint and back pain with none of the warning signs, that is not settling, keeps coming back, or gets in the way of work, sleep or getting about. | In many areas you can refer yourself to NHS physiotherapy without a GP, but waits can be long and it does not offer urgent help. You can also pay privately: check the physio is registered with the HCPC. From the NHS: Get NHS help for back or joint problems, Physiotherapy |
| A pharmacist, and self-care | Everyday aches, sprains and strains in the first days, and questions about painkillers. | Ask at any pharmacy, no appointment needed. Most NHS pages for these areas start with self-care: keep moving gently, and use ice or heat. From the NHS: How pharmacies can help, Sprains and strains |
Our check suggests starting with self-care for pain you have had for less than 2 weeks, and a physio assessment after that. That is our own rule of thumb, drawn from the NHS pages above, not an NHS rule. Any warning sign comes first.
Whatever hurts
Our check asks everyone these, whichever part of the body hurts.
Call 999 or go to A&E
If you have pain anywhere and:
- Sudden pain, pressure or tightness in your chest that does not go awayIncluding chest pain that spreads to your arm, neck, jaw or back, or comes with sweating, feeling sick, light-headed or short of breath.
Get help from NHS 111, or ask for an urgent GP appointment
If you have pain anywhere and:
- You feel hot, cold or shivery, or generally unwell, as well as the pain
See a GP
If you have pain anywhere and:
- You have lost weight without trying to
Signs to act on, area by area
Open the part of the body that hurts. Each list is word for word what our check asks, taken from the NHS page for that area. Every area also has its own guide.
Neck pain
When a physio helpsShow the warning signs 6
Call 999 or go to A&E
If you have neck pain and:
- Your face has dropped on one side, you cannot lift both arms, or your speech is slurredEven if it has stopped. These are signs of a stroke.
- New weakness or numbness down one side, loss of sight, trouble finding words, or dizziness with falling over
- A headache that started suddenly and is extremely painful
- A very high temperature with a stiff neck, or bright light hurts your eyes
Get help from NHS 111, or ask for an urgent GP appointment
If you have neck pain and:
- Tingling or pins and needles on one or both sides of your body, or weak hands, arms or legsOr trouble walking or sitting upright, or a sudden electric-shock feeling in your neck and back.
See a GP
If you have neck pain and:
- Pins and needles in your arm, or an arm that feels cold
Shoulder pain
When a physio helpsShow the warning signs 5
Get help from NHS 111, or ask for an urgent GP appointment
If you have shoulder pain and:
- You cannot move your arm, or your arm or shoulder has changed shape or is badly swollen
- Sudden or very bad shoulder pain, or severe pain in both shoulders
- No feeling in your arm or shoulder, pins and needles that do not go away, or it feels hot or cold to touch
- The shoulder pain started after an injury or accident, like a fall
- The joint is hot and swollen, or the skin around it has changed colour
Upper back pain
When a physio helpsShow the warning signs 6
Call 999 or go to A&E
If you have upper back pain and:
- The back pain started after a serious accident, such as a car crash
Get help from NHS 111, or ask for an urgent GP appointment
If you have upper back pain and:
- Severe back pain that started suddenly, or is getting worse quickly
See a GP
If you have upper back pain and:
- A lump or swelling in your back, or your back has changed shape
- Back pain that does not ease when you rest, or is worse at night
- Back pain that is worse when you sneeze, cough or poo
- Pain at the top of the back, between the shoulders
Lower back pain
When a physio helpsShow the warning signs 9
Call 999 or go to A&E
If you have lower back pain and:
- Pain, tingling, weakness or numbness in both legs
- Loss of feeling around your genitals or your bottom (anus)
- Changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself
- Changes in how your genitals feel during sex, or new trouble getting an erection or reaching orgasm
- The back pain started after a serious accident, such as a car crash
Get help from NHS 111, or ask for an urgent GP appointment
If you have lower back pain and:
- Severe back pain that started suddenly, or is getting worse quickly
See a GP
If you have lower back pain and:
- A lump or swelling in your back, or your back has changed shape
- Back pain that does not ease when you rest, or is worse at night
- Back pain that is worse when you sneeze, cough or poo
Elbow pain
When a physio helpsShow the warning signs 5
Go to an urgent treatment centre or A&E
If you have elbow pain and:
- You hurt your arm and heard a snap, or your arm has changed shape
- Severe pain in your arm, and it is difficult to move
- Your arm tingles or feels numb
Get help from NHS 111, or ask for an urgent GP appointment
If you have elbow pain and:
- Your arm hurts when you exercise, but the pain goes away when you rest
- The joint is hot and swollen, or the skin around it has changed colour
Wrist and hand pain
When a physio helpsShow the warning signs 8
Get help from NHS 111, or ask for an urgent GP appointment
If you have wrist and hand pain and:
- The joint is hot and swollen, or the skin around it has changed colour
- You heard a snap, grinding or popping noise when you hurt it
- Severe pain, or the pain makes you feel faint, dizzy or sick
- You cannot move your wrist or hold things, or it has changed shape or colour
- You have lost the feeling in part or all of your hand
- A lump on your wrist that is very painful, hot or red
See a GP
If you have wrist and hand pain and:
- You have diabetesHand and foot problems can be more serious with diabetes.
- Tingling, or less feeling than usual, in your hand or wrist
Hip pain
When a physio helpsShow the warning signs 5
Call 999 or go to A&E
If you have hip pain and:
- Severe hip pain after a fall or injury
- You cannot walk or put weight on your leg
- Tingling or loss of feeling in your hip or leg after an injury
Get help from NHS 111, or ask for an urgent GP appointment
If you have hip pain and:
- The joint is hot and swollen, or the skin around it has changed colour
- Severe hip pain that started suddenly, without a fall or injury
Knee pain
When a physio helpsShow the warning signs 5
Get help from NHS 111, or ask for an urgent GP appointment
If you have knee pain and:
- The joint is hot and swollen, or the skin around it has changed colour
- Your knee is very painful
- You cannot move your knee or put any weight on it
- Your knee is badly swollen or has changed shape
- Your knee locks, gives way or clicks painfullyClicking that does not hurt is normal.
Ankle and foot pain
When a physio helpsShow the warning signs 7
Get help from NHS 111, or ask for an urgent GP appointment
If you have ankle and foot pain and:
- The joint is hot and swollen, or the skin around it has changed colour
- You heard a snap, grinding or popping noise when you hurt it
- Severe pain, or the pain makes you feel faint, dizzy or sick
- Your ankle or foot has changed shape or is at an odd angle
- You are not able to walk
See a GP
If you have ankle and foot pain and:
- You have diabetesHand and foot problems can be more serious with diabetes.
- Tingling or loss of feeling in your foot
Questions people ask
Should I see a physio or a GP first?
For muscle, joint or back pain with none of the warning signs on this page, you can go straight to a physio. In many areas you can refer yourself to NHS physiotherapy, or you can pay privately. See a GP first if you have any of the GP signs listed for your area, or if you are worried about the pain.
Do I need a GP referral to see a physio?
Often not. The NHS says most adults in England can refer themselves to community musculoskeletal (MSK) services, including physiotherapy, without a GP referral, although in some areas you still need to contact your GP surgery. You can also pay to see a physio privately.
When should I go to A&E with back or joint pain?
Only for a serious injury or a life-threatening emergency, or for the 999 and A&E signs listed for your area on this page. The NHS says A&E is for serious injuries and life-threatening emergencies. If you are not sure, NHS 111 can check your symptoms and tell you where to go.
Can a physio see me in an emergency?
No. A physio is not an emergency service, and NHS self-referral physiotherapy says it does not offer urgent or emergency help. For the 999 signs on this page, call 999. For the 111 signs, contact NHS 111. A physio can help later, once you have been checked.
What is an urgent treatment centre?
Urgent treatment centres give urgent medical help when it is not a life-threatening emergency. The NHS says they can help with sprains and strains, suspected broken bones and injuries, and can often do an X-ray. You do not need to be registered with a GP, and 111 online may be able to give you an arrival time.
Sources
- NHS: Back pain page reviewed
- NHS: Sciatica page reviewed
- NHS: Neck pain page reviewed
- NHS: Whiplash page reviewed
- NHS: Shoulder pain page reviewed
- NHS: Elbow and arm pain page reviewed
- NHS: Wrist pain page reviewed
- NHS: Hip pain in adults page reviewed
- NHS: Knee pain page reviewed
- NHS: Ankle pain page reviewed
- NHS: Heel pain page reviewed
- NHS: Chest pain page reviewed
- NHS: Headaches page reviewed
- NHS: Stroke: symptoms page reviewed
- NHS: Meningitis page reviewed
- NHS: Septic arthritis page reviewed
- NHS: Unintentional weight loss page reviewed
- NHS: Physiotherapy page reviewed
- NHS: Get NHS help for back or joint problems page reviewed
- NHS: When to call 999 page reviewed
- NHS: When to go to A&E page reviewed
- NHS: When to use NHS 111 online or call 111 page reviewed
- NHS: When to go to an urgent treatment centre (UTC) page reviewed
- NHS: How pharmacies can help page reviewed
This is general information, not medical advice or a diagnosis. A physio or GP can assess your own situation.