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Pain in the right upper abdomen radiating to the back or right shoulder, especially with fever or yellowing of the skin/eyes (jaundice)this may indicate gallbladder disease Fever, chills, or signs of systemic infection Sudden onset of bowel or bladder dysfunction, which may suggest cauda equina syndrome Progressive leg weakness or numbness, indicating potential neurological compromise Chest pain, breathlessness, or cardiovascular symptoms Contact your GP or prescribing clinician within 2448 hours if you experience: Back pain that persists beyond two weeks despite simple analgesia Pain that progressively worsens rather than improves Back pain accompanied by unexplained weight loss (beyond expected treatment effects), night sweats, or general malaise Significant functional impairment affecting daily activities New or worsening pain following a change in medication dosage Signs of dehydration (dark urine, dizziness, reduced urine output) with persistent vomiting Routine review may be appropriate for mild, intermittent back pain that: Responds to over-the-counter analgesia and self-care measures Appears related to postural changes or increased physical activity Improves with rest and does not significantly impact quality of life According to NICE guidance on low back pain (NG59), most episodes of non-specific back pain improve within six weeks with conservative management