Struggling with back pain, stiffness, and pelvic incontinence ?
Dr Daniela Moise, DPT, Advance Core Physical Therapy and Wellness
Low back pain is one of the most common complaints in healthcare, but not all back pain is caused by a disc herniation or true sciatica. Many patients are misled into believing they have a serious nerve issue when, in reality, their pain stems from lumbar facet joint irritation, myofascial tension, and postural imbalances.
Why the Confusion?
When patients experience radiating pain, stiffness, or difficulty walking, they often assume—or are told—that they have a herniated disc pressing on a nerve. However, other structures in the lower back and pelvis can mimic these symptoms.
Lifting heavy objects or making a sudden, brisk movement can affect the spine’s facet joints, ligaments, and fascia, while also increasing pressure in the abdomen and bladder. This can lead to digestive issues, constipation, or urinary incontinence, contributing to pain and discomfort.At Advance Core Physical Therapy, we specialize in differentiating true nerve pain from mechanical dysfunction and helping patients avoid unnecessary treatments. If your low back pain persists despite conventional treatments, it’s time for a deeper assessment of:
- Facet joint irritation at L2-L4 can develop from poor posture, excessive sitting, or movement restrictions, causing deep, aching pain that mimics nerve compression.
- Myofascial tension in muscles like the quadratus lumborum, hamstrings, and hip adductors creates pulling forces that restrict movement and cause pain referral patterns similar to nerve pain.
- Postural imbalances, including forward head posture, rounded shoulders, and hip misalignment, place excessive stress on the lumbar spine and pelvis, leading to compensatory pain patterns.
- Pelvic Floor muscle function
Common Causes of Muscle, Ligament, and Fascial Tension
Prolonged sitting, improper lifting, and poor posture while working at a computer or using a phone all contribute to muscular, ligament, and fascial tension that can provoke pain. These issues are often mistaken for a structural spine problem, but in reality, medication or surgery will not fix them. Treating the underlying movement dysfunction and postural habits is key to lasting relief.
How to Tell the Difference
Disc herniations and nerve compression often cause sharp, shooting pain down the leg, especially with forward bending, coughing, or prolonged sitting. Facet joint and myofascial pain, on the other hand, tend to be more localized, radiating into the hip or pelvis, and often improve with mobility and manual therapy.
If you’ve been diagnosed with sciatica or a disc herniation but treatments haven’t worked, it’s time to consider whether your pain is actually coming from facet joint irritation, myofascial restrictions, or postural dysfunction. Manual therapy, postural corrections, and targeted exercises can restore proper movement patterns, relieve tension, and prevent further aggravation.
At Advance Core Physical Therapy, we focus on strengthening the core, restoring pelvic function, and using regenerative technology, including TEAR therapy, to support long-term tissue healing and functional recovery. By improving posture, correcting muscle imbalances, and enhancing tissue repair, we help you move better and feel stronger.
