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Does a Weak Pelvic Floor Cause Lower-Back Pain?

We Asked 4 Experts If a Weak Pelvic Floor Can Cause Back Pain, and It Was a Unanimous Yes

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Pelvic-floor function might not be spoken about as often as, say, getting sculpted abs, but we're here to tell you that it's very important. In fact, if you regularly suffer from lower-back pain, it may be caused by pelvic-floor dysfunction.

But what is the pelvic floor? Dr. Helen Bernie, a urologist at Indiana University Health, told POPSUGAR that "the pelvic floor consists of all the muscles, ligaments, connective tissues, and nerves that support our pelvic organs and helps them function". She explained that the pelvic floor acts like a hammock to support the bladder, bowels, rectum, uterus, vagina, and prostate. "We use our pelvic floor every day in the way we walk, move, sit, go to the bathroom, engage in sexual activity, and more." The pelvic floor is extremely hard working and important for good abdominal health, and honestly, it deserves a lot more credit.

Of the four experts I spoke to about the pelvic floor — a combination of gynaecologists, urogynaecologists, and physical therapists — they all agreed that pelvic floor dysfunction can cause lower-back pain which, as we all know, can be a debilitating condition. There's a logical reason for this, according to Dr. Sarah Collins, urogynaecologist at Northwestern Medicine Central DuPage Hospital in Illinois. "The pelvic floor is part of the all-powerful core, which is made up of the abdominal muscles, back muscles, pelvic-floor muscles, and the diaphragm," she said. "When there is a problem with one part of the core, all other parts are affected."

Dr. Bernie agreed, explaining that many people who have lower-back pain, also have pelvic-floor dysfunction, and vice versa. "Back pain and pelvic-floor dysfunction are closely related because all the muscles that support and protect the spine must also work to support the pelvic floor," she said. "They are all interrelated and impact our core stability, gait, movements, and bodily functions." In practical terms, it means that "if someone has chronic back pain, they might compensate by unconsciously altering the way they stand or walk, which can affect the balance of the pelvic muscles, said Dr. Karyn Eilber, MD, a urologist at Cedars-Sinai Medical Centre in California. "Also, if someone has lower lumbar or sacral spinal disease like spinal stenosis or a spine surgery, the nerves that go to the pelvis can be affected and pain and/or dysfunction can ensue," added Dr. Eilber.

When I asked Jenna Walton, physical therapist at UCHealth Steadman Hawkins Clinic in Denver, whether she believes there's a link between back pain and a weak pelvic floor, she answered, "Absolutely!." "In fact, there was a recent research study done in Canada that found 95.3 percent of nonpregnant women in their sample with chief complaints of low-back pain also had undiagnosed, underlying pelvic-floor dysfunction," she said. "In this study in particular, the most common pelvic floor impairment was weakness."

This isn't all to say that you should immediately start doing kegel exercises everyday to strengthen your pelvic floor — in fact, if performed incorrectly (or unnecessarily), it can lead to more troubles. "When the pelvic floor muscles are in an overly contractile or 'tightened' state, they become weak," said Dr. Bernie. "When we think of strengthening our pelvic floor, oftentimes we associate that with 'tightening' our pelvic floor muscles. As with any muscle, you want to contract or tighten the muscles, as well as teach them how to relax and elongate." Just like all medical problems, it's recommended that you see your general practitioner (GP), who can refer you to a specialist who's trained in pelvic-floor health for treatment.

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