Have you ever experienced low back pain? If not, you probably know someone who has. Low back pain is a major cause of disability, affecting people of all ages. What you may not know is that research shows a connection between low back pain and pelvic floor dysfunction, particularly in women.
What Is The Pelvic Floor?
The pelvic floor is a group of muscles and soft tissue running from the pubic bone to the base of the spine, like a hammock. They interact together to serve as sphincters (controlling the opening of the urethra, vagina and anus), allow sexual intimacy, promote venous and lymphatic flow, provide support to the lumbo-pelvic complex, and support internal organs. That’s a big task for a part of our body most of us don’t even think about!
Why Does This Matter for Your Low Back?
During functional movements throughout the day, your pelvic floor is responsible for managing intra-abdominal pressure changes and the transfer of weight or loads throughout your body. When the pelvic floor cannot properly contract or relax, it may no longer be in a position to serve its usual functions and this may lead to low back pain.
What To Look Out For:
One of the most notable findings in recent research on low back pain and pelvic floor dysfunction is that a very high percentage of individuals with back pain experienced pelvic floor tenderness on palpation. This tenderness is associated with a lesser ability to relax the pelvic floor which may present as painful intercourse, discomfort with tampon insertion, or urinary urgency (as a few examples). Interestingly, the second most notable finding was the presence of pelvic floor weakness. This may present as urinary incontinence (leakage), fecal incontinence, or pelvic organ prolapse (as a few examples). Does this mean the answer is doing regular kegels? Not necessarily. In many individuals, pelvic floor weakness occurs because the muscles have higher resting tension, thus impairing their ability to provide full strength. The following is a list of symptoms that may indicate pelvic floor dysfunction:
- Stress and urge incontinence (urinary leakage)
- Frequency (peeing more than 5-8 times a day)
- Fecal incontinence
- Dyspareunia (painful sex)
- Pelvic organ prolapse
- Post-partum recovery
- Pregnancy related pelvic girdle pain
- Chronic pelvic conditions such as endometriosis, bladder pain syndrome, and interstitial cystitis
- Rectus diastasis (abdominal separation)
- Tailbone pain
What Can You Do:
First and foremost, an awareness that your pelvic floor may contribute to your low back pain is important. If you experience any of the symptoms listed above, an in-person, or virtual assessment with a certified pelvic floor physiotherapist is a great place to start.
Strategies to learn different breathing techniques and awareness exercises to properly relax and engage your pelvic floor may be important tools to better manage your low back pain and your pelvic health.
Don’t let persistent back pain get you down! Take the time to learn why you are struggling and let us help you reach your goals.
Arab, A., Behbahani, R., Lorestani, L., Azari, A., 2010. Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound. Man. Ther. 15 (3), 235–239.
Dufour, S., Vandyken, B., Forget, M., & Vandyken, C. (2019). Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study.
Pelvic Health Solutions (n.d.). Facts about urinary incontinence. Retrieved from http://pelvichealthsolutions.ca/for-the-patient/facts-about-urinary-incontinence/
Written By: Clair Harris