Low back assessment at Elevate Health Care covers the lumbar spine, the pelvis and sacroiliac joints, the hips, and the fascial system that transfers load between them. Conditions commonly assessed include lumbar disc problems, lumbar facet syndrome, sacroiliac joint pain, myofascial pain, piriformis syndrome and cluneal neuralgia. Treatment combines Fascial Manipulation by Stecco with movement rehabilitation.
Is it a disc?
It's the first thing most people want ruled in or out, and the honest answer is that a scan alone rarely settles it. Disc bulges and degenerative changes are extremely common in people with no back pain at all, which means finding one doesn't prove it's the cause.
The patterns are more useful than the picture. Disc-related pain tends to be worse with sitting, bending and first thing in the morning, and can travel below the knee. Facet and sacroiliac pain more often bite with standing, extension, or rolling over in bed. Deep gluteal pain that mimics sciatica may be coming from the piriformis or the cluneal nerves rather than the disc at all.
Those patterns overlap enough that the label often changes from one practitioner to the next — which is a large part of why people arrive here having been told three different things. Others arrive with no clear label at all — a scan that showed nothing, or a diagnosis of “non-specific low back pain”, which classifies the presentation rather than identifying a cause. Our assessment is aimed at how the region is being loaded, because that's what determines whether a structure stays irritated, whatever it's called.
→ Lumbar Disc Problems — what bulges and herniations actually mean
→ The fascial approach to lower back pain — the full explanation, with references
Why core exercises don't always help
Core strengthening assumes the problem is weakness. Often it isn't.
The low back doesn't work as a set of individual muscles — it transfers load through a connected system: the thoracolumbar fascia across the back, the abdominal canister that pressurises the trunk, and the slings that link the trunk diagonally to the hips and shoulders. When that system shares load poorly, the same structures keep taking more than their share, and strengthening one muscle harder doesn't change the distribution.
That's why people who have diligently done their core work for months still find the pain returns. It usually isn't that they did it wrong — it’s that the limitation was somewhere the exercise never addressed. One common version of this is pain that only shows up when you stand still for a while — a queue, a school assembly, a long conversation on your feet.
→ Why core exercises don't always fix low back pain — the lateral raphe and load transfer
→ The myofascial slings — how force actually reaches the low back
What we assess
- The lumbar spine — segmental movement, which directions provoke and which relieve, and how it behaves under load
- The pelvis and sacroiliac joints — load transfer between spine and legs
- The hips — range and control, because a hip that doesn't move well leaves the low back making up the difference
- The fascial system — densification through the thoracolumbar fascia and the sling attachments, using Fascial Manipulation by Stecco
- Nerve involvement — where symptoms travel down the leg, and whether strength, reflexes or sensation are affected
- Your load — sitting, lifting, training, sleep position, and what changed before it started
Lower back conditions we commonly assess and treat
Lumbar Disc Problems
Bulges, herniations, and the biomechanical context that determines whether they become symptomatic.
Learn more →Lumbar Facet Syndrome
Facet joint pain and the fascial loading patterns that perpetuate it.
Learn more →SIJ Syndrome
Sacroiliac joint pain and its relationship to the posterior oblique sling.
Learn more →Myofascial Pain Syndrome
Trigger points, referred pain, and the fascial environment in which they develop.
Learn more →Piriformis Syndrome
Deep gluteal pain, sciatic-like symptoms, and the hip–spine interface.
Learn more →Cluneal Neuralgia
Entrapment of the cluneal nerves — an underdiagnosed cause of low back and gluteal pain.
Learn more →When back pain isn't musculoskeletal
Most low back pain is musculoskeletal. A small number of presentations need urgent medical assessment rather than ours.
Seek urgent medical care if back pain comes with:
- Numbness around the groin, inner thighs or back passage, difficulty passing urine, or loss of bladder or bowel control — this combination needs emergency assessment the same day
- Progressive weakness in one or both legs, as distinct from pain or pins and needles
- Significant trauma — a fall or accident, particularly with osteoporosis or long-term steroid use
- Fever, unexplained weight loss, a history of cancer, or night pain that is unrelenting and unrelated to position
- Severe, sudden abdominal or back pain with feeling faint, particularly in older adults
If you're unsure, call your GP or present to an emergency department. This page is general information, not advice about your situation.
Some back pain needs a blood test, not a treatment table
Back pain that began gradually before the age of 45, is worse after rest and better with movement, wakes you in the second half of the night, and comes with prolonged morning stiffness can point to an inflammatory cause rather than a mechanical one. That pattern is diagnosed with blood tests and imaging and is managed medically, and it is often recognised late. If your history looks like that, we'll say so and send you to your GP.
Your first visit
A 60-minute initial consultation: history, physical assessment of the lumbar spine, pelvis and hips, a neurological screen where your symptoms call for it, an explanation of what we've found, and treatment starting the same visit where appropriate.
No referral is required. If imaging is needed, we'll arrange it. If someone else is better placed to help, we'll say so.
Not ready to book? Start with the free program
Four exercises across two weeks that train the back as a system — the canister, the thoracolumbar fascia and the slings — with enough of the why to keep going on your own.
It isn't a substitute for an assessment, and it won't tell you which structure is involved. But if you've been doing core work without change, it addresses the part that work usually misses.
- Why Most Programs Miss the Point
- Load Management & What to Avoid
- Phase 1 — Restoring the Canister (Days 1–7)
- Phase 2 — Loading the Slings (Days 7–14)
- Full Schedule & the Long Game
Frequently Asked Questions
Please note: The information on this page describes our general clinical approach and is intended for educational purposes only. Individual presentations vary, and your assessment and management will be tailored specifically to you. Nothing on this page constitutes clinical advice for your individual situation. Please consult a registered health practitioner for advice about your specific condition.