Have you ever wondered why your low back pain hasn’t improved or gone away, despite many efforts with therapy, massage or chiropractic adjustments? It could be that often much of the treatment has focused on the spine or hips alone. There is typically no attention paid to a very important structure, which happens to be the tailbone! There are muscles that attach to and support your pelvis and tailbone including back muscles, abdominal muscles, other hip muscles, as well as a very important set of muscles at the base called your pelvic floor muscles. Many therapists are missing an important piece of the puzzle, some would say the missing link, if they are not treating the pelvic floor muscles.
So how does this get treated, you ask? Good question!
Pelvic floor physical therapists understand that there is a close relationship with pelvic floor tension and back pain. Some patients may first have symptoms associated with sciatic pain. Often, they don’t realize it might be related to their pelvic floor until their initial evaluation. Recent research has shown this is even more prevalent that we realized.
Of women with low back pain, more than 95% had pelvic floor dysfunction as well!
It can be difficult to understand which come first, the tension in the pelvic floor or the back pain. One of the roles 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 inured area. This can be a problem as it can create overuse or over clenching of the pelvic floor.
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 cycle where low back pain and pelvic floor dysfunction reinforce each other. It is important that both areas are addressed.
Therapists who are trained in pelvic floor treatment will address both the internal and external causes. With traditional orthopedic physical therapy, low back pain is typically treated with general stretching and strengthening exercises for the low back. Often time pelvic floor tension is never even mentioned. The back pain may improve some but tends to pull back into dysfunction and then the pain returns.
The same issues occur when the focus is only on the internal pelvic floor muscles. With the reduction in the muscle tension of the pelvic floor, it is important to stabilize the back with appropriate exercises. For true healing to occur, both the pelvic floor and low back must be addressed together.
We believe that complex low back and pelvic floor patients benefit from an hour of hands-on treatment with physical therapists trained in pelvic floor and myofascial release who can address both the internal and external aspects of the issue. We have created the space to be able to provide this type of treatment for our patients. We provide the time needed to address both the pelvic floor and low back together as they are so closely related. This allows for a complete whole-body approach to treating the patient.
For sustained relief of lower back pain, often both the pelvic floor and lower back must be looked at together.
For more information about low back pain and pelvic floor, feel free to give us a call at 513-549-6693 to chat or set up an appointment.
Lauren Cadman, PT