The Hidden Connection: How Your Pelvic Floor Could Be the Root Cause of Your Chronic Lower Back Pain

For millions of women suffering from persistent lower back pain, the answer to their discomfort may lie in an unexpected place: the pelvic floor. This group of muscles, often overlooked in traditional back pain treatment, plays a crucial role in spinal stability and core function. Understanding this connection could be the key to finally finding relief from chronic pain that hasn’t responded to conventional treatments.

Understanding the Pelvic Floor-Lower Back Connection

The pelvic floor works in tandem with the abdominal and back muscles to stabilize the spine, forming part of the core system made up of the abdominal muscles, back muscles, diaphragm, and pelvic floor muscles. The pelvic floor is essentially the bottom of the core, yet many people don’t realize how integral these muscles are to back health.

Current evidence shows that individuals with low back pain have a significant decrease in pelvic floor function compared to individuals without low back pain. This relationship is particularly pronounced in women, where pelvic floor dysfunction is commonly linked to lower back pain.

Why Women Are More Susceptible

Women make up the majority of cases, since pelvic floor dysfunction can result from pregnancy, childbirth, and endometriosis. The connection becomes even more significant as women age. The odds of developing pelvic floor-related back pain increase for women as they get older due to factors such as diminished estrogen and childbirth-related pelvic floor damage, as estrogen levels decline, so does muscle mass.

Childbirth-related pelvic floor damage can also reveal itself decades later as muscles, ligaments, and other tissues sag, fueling back pain. The more babies you had, the more likely this will happen. Statistics show that upwards of 70% of women who attended physical therapy for low back pain also reported urinary incontinence.

How Pelvic Floor Dysfunction Contributes to Back Pain

The mechanism behind this connection involves several pathways:

• Structural Connection: The tailbone is a structural connection point between the pelvic floor muscles and the lower back. Since the tailbone acts as a connecting point between the pelvic floor and low back, if there are mobility restrictions in any of the muscles this can result in changes in mobility in the low back.
• Pain Referral: Tender points in the pelvic floor due to overuse or excessive tension can create patterns of pain that travel elsewhere in the body, including the lower back, tailbone, hips, abdomen, legs, and pelvic organs.
• Core System Dysfunction: The core system is responsible for managing pressure within the body and creating stability from our center to support movement. If a component of this system is not working properly, or the entire system does not work well together, it can result in altered movements and pain.
• Postural Changes: Pelvic floor dysfunction can cause changes in pelvic alignment, which affects the entire lower body. Misalignment of the pelvis places stress on the lumbar spine and can alter your gait, further aggravating back pain.

Recognizing the Signs

If conventional approaches such as regular stretching or physical therapy don’t make a dent, that’s a major clue that your pelvic floor may be involved. Additional warning signs include:

• Bladder symptoms – incontinence, needing to rush to the bathroom, or trouble urinating
• Bowel symptoms – incontinence, constipation or needing to strain to have a bowel movement
• Other pain symptoms – painful intercourse or other pelvic pain
• Pelvic-organ prolapse symptoms – the feeling of heaviness or something ‘falling out’ of the vagina or feeling a bulge at the vaginal opening

The Treatment Approach

A growing body of evidence tells us there is a need for clinicians to differentiate between patients with low back pain who have pelvic floor muscle weakness versus tightness. If patients have pelvic floor muscles that are always overworking (tight), their lower back pain and/or incontinence will usually continue to be a problem until they learn to lengthen and relax their pelvic floor muscles.

Physical therapy treatment modalities include pelvic floor training, manual therapy, biofeedback, movement patterning and behavioral modifications. Manual therapy and biofeedback are used to increase awareness of the pelvic floor and improve the patient’s ability to contract and relax the muscle in addition to strengthening it.

Finding Expert Care in Grand Rapids

For women in the Grand Rapids area dealing with persistent back pain, seeking comprehensive chiropractic care that addresses the whole person is essential. Lower Back Pain Grand Rapids residents can find relief through practitioners who understand the complex relationships between different body systems.

Chiropractic First, located at 403 44th Street SE in Grand Rapids, takes a holistic approach to wellness under the care of Dr. James Heath. His goal is not to hide the symptoms of pain but to understand their cause so that patients can live a healthier, more fulfilling life. Dr. Heath believes in a whole person focus to wellness and doesn’t treat symptoms but works to cure the underlying problem. This comprehensive approach is particularly valuable for women experiencing the complex interplay between pelvic floor dysfunction and lower back pain.

Moving Forward

It is important for physical therapists to consider pelvic floor dysfunction when evaluating and treating patients with lower back pain. Although recent research has made many gains in relating lower back pain and pelvic floor dysfunction, much more progress is needed to definitively establish the relationship between the two conditions and identify successful intervention techniques.

For women who have been struggling with chronic lower back pain without success, exploring the pelvic floor connection could provide the breakthrough they’ve been seeking. By working with healthcare providers who understand this relationship and take a comprehensive approach to treatment, it’s possible to address the root cause of pain rather than just managing symptoms.

Don’t let hidden muscle dysfunction continue to impact your quality of life. If you’re experiencing persistent lower back pain, especially when accompanied by other pelvic floor symptoms, consider seeking evaluation from a practitioner who understands the intricate connections within your body’s core system.