Facet Joint or Herniated Disc? How to Tell (And Why It Matters Less Than You Think)
Back In Shape PodcastShow Notes
Is your back pain a disc or a facet joint? It's the question everyone chases — but the honest answer is that it rarely changes what you should actually do. If you've been told it's a herniated disc by one clinician and a facet joint problem by another — or you're trying to work out which one you've got at L5/S1 or L4/L5 — this session is for you. The tests people use to tell them apart cross over more than you'd think: bending forwards strains the disc but also stretches the facet joint capsule, and bending backwards can compress the facet joint or squeeze a herniated disc against the nerve. So a "positive" test for one is often a positive test for the other, and chasing the label sends you round in circles. 🎓 Join the Back In Shape Program: https://backinshapeprogram.com We work through why the disc-versus-facet distinction is so blurry, and why it matters less than you've been led to believe: in both cases, the pain comes from losing control of the segment and moving it in a way that provokes already-sensitive tissue. Reaching into a cupboard and arching, or bending into the dishwasher and rounding — different structures, same root failure, same fix. We explain why spine stability is the starting point whichever label you've been given, how to judge healing by load rather than by feel, why back belts and braces sit above the segment that's actually injured, and why walking, holds and stretching aren't the rehab you think they are. The thread throughout: you're not a disc or a facet joint — you're a person with an injured back, and the answer is to build control and capacity, not to perfect the diagnosis.
🔑 Key Topics Covered 🔀 Disc or facet joint? Why the tests blur together: bending forwards strains the disc and stretches the facet joint capsule; bending backwards can pinch either one. A positive test for one is often a positive test for the other — which is why the label so often changes depending on who you ask. 🎯 Why the label matters less than you think: in both cases the pain comes from losing control of the segment and provoking injured tissue. Reach up and arch, or bend down and round — different structure, same failure. And the fix is the same: learn to stabilise and control the spine. 🧱 You can't control L5/S1 — only the region: nobody can consciously steer a single segment. What you can control is the area between your lower ribcage and pelvis, by engaging the core and holding a neutral spine. That's what the six exercises teach. 📊 Judge healing by load, not by feeling: how the back feels isn't a measure of how healed it is — a child's broken arm stops hurting long before the cast comes off. What your squat and hip hinge can carry, aggravation-free, is the honest gauge of how much capacity you've rebuilt.
Chapters 00:00 Disc or facet joint — does it change anything? 01:21 Two kitchen injuries: the cupboard and the dishwasher 03:27 Why the tests cross over and confuse everyone 05:33 Chasing the label vs asking what to do 06:00 Why spine stability protects both 07:12 The six exercises, and what they actually train 09:12 What a disc bulge at L4/L5 feels like (or doesn't) 11:33 Reherniation after surgery: did you ever rehab? 15:48 The flexibility mistake — right work, wrong time 17:48 What to do in an acute flare (it isn't nothing) 23:00 A pars defect without the slip 25:18 "Being mindful" isn't a strategy 27:09 Why back belts and braces don't help 30:15 How do you know your disc is healing? Load it 33:24 Why you haven't earned a lifting belt 38:24 "I'll never lift heavy again" — what does heavy mean? 42:09 Why an MRI lying down can mislead 46:39 Why steady runners have healthier discs (and walking doesn't strengthen) 53:36 Getting back to running, football and sport safely 1:03:15 Aggravation-free doesn't mean pain-free
#HerniatedDisc #FacetJoint #BackInShape #Sciatica #SlippedDisc #LowerBackPain #BackPainRelief #SpinalRehab
More from Back In Shape Podcast
Sciatica isn't a diagnosis — it's a symptom description, and chasing the pain in your leg instead of the injury in your lower back is what keeps it coming back. If you've been told you have sciatica, a trapped nerve or a pinched nerve, this session explains why that description is incomplete. The pain running down your buttock, thigh, calf or foot is generated by an injury higher up — usually a herniated disc, a disc bulge or spondylolisthesis irritating the nerve roots where they leave the spine — so stretching, massaging or icing the leg itself never touches the actual problem. 🎓 Join the Back In Shape Program: https://backinshapeprogram.com We explain why thinking in terms of "sciatic-type pain" rather than one strict diagnosis helps you trace symptoms back to their real source, why piriformis syndrome is usually muscle guarding rather than the cause, and why relief from an injection, a nerve block or nerve flossing is never the same as healing. We cover why going by how you feel day to day keeps people stuck in the same loop, why sitting can put more strain through an injured lower back than a careful, controlled squat, and why exercises like elephant walks, nerve glides and generic mobility routines are not rehabilitation. The common thread throughout: build the capacity of the injured lower back itself, rather than chasing the symptoms it's sending down your leg.
Your lower back rehabilitation works in three distinct stages, and the first one — protecting the injury — can start working within minutes, not months. Whether you're dealing with a slipped disc, a disc bulge, spondylolisthesis or sciatica, the exact term on your scan matters far less than you've been told. This session breaks down the three stages your rehabilitation has to go through to heal a lower back injury, using a real case from the comments to show why the same disc bulge can be a bigger problem for one person than another.
Walking feels like exercise for your lower back, but if you're relying on it to rehabilitate a herniated disc or recover from surgery, it's doing far less than you think.
Lower back pain at night from a disc bulge, herniated disc or stenosis often comes down to congestion building while you're still, which is why getting up and walking around can settle it.
A herniated disc doesn't mean you have to stop going to the gym, and being told to stop is often what keeps people struggling for months or years. If you've got a slipped disc (a herniated disc), a disc bulge, degenerative disc disease, sciatica or spondylolisthesis from training, or you're getting back to the gym after lower back surgery, this session is for you. It's for people who've been cleared of emergency symptoms and want to rebuild properly, rather than rest, avoid and lose the strength that protects the lumbar spine. 🎓 Join the Back In Shape Program: https://backinshapeprogram.com We explain why most people with a back injury don't have much strength to lose (over 90% of adults in the UK do no significant strengthening work), and why the squat and hip hinge are the safest way to progressively load the lumbar spine. We cover the two technique errors that catch out experienced lifters, the butt wink at the bottom of the squat and driving through the top of the hip hinge, plus how to standardise your depth with a block, what "aggravation-free" really means when you still have some tingling, and why changing depth and load together leaves you unable to tell what went wrong. We also look at muscle memory outpacing the spine, hip mobility, back belts, massage guns, and why the piriformis label and the figure-four stretch so often miss a lower back problem.