Pelvic and Lower Back Pain in Females: Are They Linked?
Lower Back Pain and the Role of the Pelvic Floor
Low back pain (LBP) is the most common musculoskeletal complaint affecting up to 90% of the population for at least one episode in their lifetime.
This type of pain occurs in all socio-economic levels and all age groups.
People with physically demanding tasks, physical and mental comorbidities, smokers, and obese individuals are at a higher risk of reporting low back pain.
Acute LBP most often occurs due to the insufficient motor control of deep local stabilizers of the trunk such as the abdominals, multifidus, and, most recently connected, the pelvic floor musculature (PFM).
The pelvic floor muscles have multiple functions including bowel and bladder continence, organ support, sexual function as well as playing an important role in generating, maintaining, and increasing intra-abdominal pressure in functional tasks.
The pelvic floor is involved in actions such as laughing, lifting, and coughing and is the only transverse muscle group in the body that bears load. PFM supports the abdominal-pelvic organs and is accepted as part of the trunk stability mechanism.
Many people experience stubborn low back pain that just won’t go away, even after trying things like physical therapy, exercise, chiropractic care, massage, acupuncture, meds, injections, or even surgery.
If that sounds familiar, it might be worth looking into your pelvic floor muscles. They could be the key to easing the pain and getting back to your normal routine.
Are Pelvic and Low Back Pain Linked?
Most studies looking at the link between low back pain and pelvic floor issues have focused on women, and many have found a connection.
For example, a 2018 study with 182 participants found that 95% of those with lumbopelvic pain also had pelvic floor dysfunction. If the pelvic floor aspect of back pain isn’t addressed, it could mean the pain sticks around longer.
Plus, there’s a ton of research showing that imaging tests like X-rays often don’t line up well with pain levels. Many people with things like degenerative disc disease or arthritis don’t feel any pain at all.
This suggests that typical age-related changes in the spine might not be the main cause of discomfort. So, it’s really important to look at other factors, like the pelvic floor muscles, that could be contributing to ongoing pain.
The pelvic floor plays a big role in lower back symptoms in a few key ways:
Tailbone Attachment: All the pelvic floor muscles connect to the tailbone, which means any issues here can affect movement and cause pain in the lower back. So, the tailbone acts as a link between the pelvic floor and the back.
Pain Referrals: If the pelvic floor muscles are tight or overworked, it can create pain that spreads to other areas, including the lower back, tailbone, hips, abdomen, legs, and pelvic organs like the bladder and uterus.
Trunk Stability System: Many people think of their core as just the abs, but it actually includes the back muscles, diaphragm, and pelvic floor. This whole system helps manage pressure and provides stability for movement. If any part of this system isn’t functioning well, it can lead to awkward movements and pain.
Bowel Function: A healthy pelvic floor is crucial for normal bathroom habits. If these muscles struggle to relax during a bowel movement, or if we often hold it in, it can lead to constipation, which is linked to increased lower back pain.
How Do You Know if Your Pelvic Floor Could be a Factor?
If you are experiencing ongoing low back pain, it’s worth considering whether you have any other symptoms that might point to pelvic floor issues.
Here are some signs to look out for:
Bladder Symptoms: This includes things like incontinence, feeling the urge to rush to the bathroom, or having trouble urinating.
Bowel Symptoms: If you’re experiencing incontinence, constipation, or have to strain to have a bowel movement, these could be red flags.
Other Pain Symptoms: Painful intercourse or any other pelvic pain can also be a sign.
Pelvic-Organ Prolapse Symptoms: This might feel like a heaviness or a sensation of something “falling out” of the vagina, or feeling a bulge at the vaginal opening.
If you notice any of these symptoms, it’s a good idea to find a pelvic floor physical therapist to help you assess your pelvic floor muscles and determine if they are contributing to your back pain.
Looking for pelvic health physical therapy in Jacksonville Beach, FL?
If you’re looking for personalized, one-on-one sessions to address your pelvic floor concerns, we provide pelvic health physical therapy services to women in the Jacksonville Beach area.
If you’re looking for providers who will listen to you and help you get to the root cause of your back pain or pelvic floor concerns, we’ve got you. We’re here to help you if you’re experiencing pain, heaviness, leaking, or are pregnant/postpartum and want to continue safely working out/running/lifting during your pregnancy and get back to your sport after birth.
Get started today by booking a discovery call.
Resources:
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020 Mar;8(6):299. doi: 10.21037/atm.2020.02.175. PMID: 32355743; PMCID: PMC7186678.
Dufour S, Vandyken B, Forget MJ, Vandyken C. Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study. Musculoskelet Sci Pract. 2018 Apr;34:47-53. doi: 10.1016/j.msksp.2017.12.001. Epub 2017 Dec 9. PMID: 29268147.
Arab, A. M., Behbahani, R. B., Lorestani, L., & Azari, A. (2010). Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound. Manual Therapy, 15(3), 235–239. https://doi.org/10.1016/j.math.2009.12.005
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