Pelvic Floor Dysfunction Is Linked To Back Pain

What is the pelvic floor?

The pelvic floor musculature is a group of muscles that sits like a sling within the pelvis and plays a vital role in providing stability, support and daily function. The pelvic floor works to provide support for pelvic organs, stability to the low back, hip and pelvis, and controls bladder, bowel and sexual function.

Pelvic floor dysfunction is the inability to control the muscles of your pelvic floor. Coordinated contracting and relaxing of the pelvic floor muscles control bowel and bladder functions – the pelvic floor must relax to allow for urination, bowel movements, and, in women, sexual intercourse. Pelvic floor dysfunction occurs when there is either too much tension on the pelvic floor muscles (high tone) or not enough (low tone) contributing to urinary incontinence, constipation, pain during intercourse or pain in the lower back. It’s also something that can be mistaken for back pain or bring about pelvic and lower back pain.

What’s the link between pelvic floor and back pain?

Research has found correlations between the presence of low back pain and pelvic floor dysfunction. A 2018 study of 182 participants showed that 95% of those who were experiencing lumbopelvic pain also had pelvic floor dysfunction. If the pelvic floor component of low back pain is missed or untreated, there is a chance the back pain will continue. It has also shown that individuals with low back pain have lower pelvic floor muscle function compared to individuals without low back pain. Therefore, it is not always clear which comes first.

Most people think of their core as consisting only of the abdominals.  However, the core system is made up of the abdominal muscles, back muscles, diaphragm, and pelvic floor muscles. This system is responsible for managing pressure within the body and creating stability from our centre 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.

A major role of the pelvic floor is to help stabilize the core and lower back, so when the back is in pain, the pelvic floor muscles may tighten to try and protect the sensitive area. This can overwork the pelvic floor and create additional symptoms. In other cases, the pelvic floor dysfunction may have come first and altered the spine’s mobility and stability, thus triggering low back pain. Either way, there is a feedback loop where low back pain and pelvic floor dysfunction reinforce each other. Both must be addressed for full resolution of symptoms.

Sophie O'Flaherty

About Sophie O'Flaherty

Sophie completed a Bachelor of Physiotherapy at the University College of Dublin and relocated to Sydney from Dublin in 2023. She uses a combination of manual therapy and exercise-based rehabilitation to get the optimal results for her patients, while encouraging them to take an active role in their recovery. Sophie is committed to staying up-to-date with the latest advancements in the field of physiotherapy and brings a wealth of knowledge and expertise to every treatment session. Sophie has an interest in Women’s Health, including pregnancy and pelvic floor dysfunction and has recently completed further study in this area. Sophie has completed clinical Pilates training and uses these skills and exercise-based techniques in both group classes and one to one rehabilitation.

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