Lower Back Pain That Radiates to the Front Pelvic Area
Lower back pain is hard enough to deal with, but when it radiates to the front of the pelvis, it can cause discomfort everywhere across the lower region of your torso. The pain might also be felt in the hips, buttocks, or even the legs.
This can make it hard to find the underlying issue that’s causing the pain. Physical therapists are highly educated health care professionals who can help identify structural abnormalities or potential injuries that are linked to lower back and pelvic pain.
Common Causes of Lower Back Pain That Radiates to the Front Pelvic Area
As lower back pain may cause referred pain in other parts of the body, including the front of the pelvis, it’s common to be misdiagnosed—especially if you’re not seen by health care professionals who specialize in spinal-related issues.
Low back and front pelvic pain can come from many sources including:
- Bulging discs and nerve root irritation
- Sacroiliac joint injuries and pelvic dysfunction
- Physiological changes during pregnancy
- Generalized low back pain and facet joint injuries
A thorough examination can be used to figure out whether an individual's pain is due to a problem with the spine, nerves, muscles, or sacroiliac joint. Physical therapists are well-versed in anatomy, biology, physiology, and kinesiology (body movement). This allows them to pinpoint areas of concern when symptoms are reported, such as lower back pain that radiates into the pelvis.
Bulging Discs and Nerve Root Irritation
A bulging disc is a common, age-related issue that may lead to nerve irritation. This type of disc injury may occur with or without nerve root irritation at any level along the spine.
Keep in mind that a mild form of broad-based disc bulging is a normal part of the aging process. Thankfully, many adults undergo this degenerative change without experiencing any significant pain.
However, moderate to severe bulging that is localized, particularly in the lumbar region, may lead to inflammation that puts excess pressure on the nerve roots. When this happens, lower back pain and referred pain often cause difficulty during weight bearing movements. Altered sensations in other parts of the body may develop, such as pelvic pain and tingling or numbness in the limbs.
Another health issue linked to nerve root irritation is spinal stenosis. This condition is characterized by the narrowing of the spinal elements that enclose nerve roots (foraminal stenosis) or nerve irritation that occurs as pressure is placed on the spinal cord due to the narrowing of the spinal canal (canal stenosis).
Although this issue generally develops in the lumbar region (lower back), the pain may gradually radiate towards the front of the pelvis. You may notice lower back and pelvic pain gets worse while walking or standing. This is because being in an upright position decreases spinal space and increases pressure on the spinal cord and nerve roots.
Sacroiliac Joint Injuries and Pelvic Dysfunction
Sacroiliac joint injuries occur when the joints that connect the lower (lumbar) region of the spine to the hip bones undergo abnormal structural changes—allowing spinal bones to rub together. In this case, the joint may become stiff and cause lower back and pelvic pain as well as coordination problems. On the other hand, the ligaments within the joint may gradually loosen due to hormonal changes (e.g., pregnancy), causing pelvic or back pain during movement.
Experiencing a hard fall on one side of the body can also lead to sacroiliac joint misalignment that results in persistent pain. This kind of injury may cause inflammation that leads to constant aches in the lower back, pelvis, buttocks, or even the upper thighs. Stiffness, looseness, or misalignment of the sacroiliac joint is often linked to pelvic dysfunction.
Pain associated with pelvic dysfunction may be felt while sitting, standing, or walking. It can also affect bladder control if it’s not properly addressed. Over time, sacroiliac joint issues and pelvic dysfunction can alter core muscle activation, making it hard to carry out normal daily activities.
Physiological Changes During Pregnancy
The body undergoes a wide range of physiological and postural changes during pregnancy. Hormonal changes in particular influence the start and progression of a pregnancy. Certain hormones may also cause ligaments in the sacroiliac region to relax or loosen.
The loosening of ligaments is needed to accommodate the many changes that occur during pregnancy, but it also places stress on the sacroiliac joint, resulting in pain. The pain may be felt in the lower back, abdomen, and pelvis. This issue typically resolves after giving birth, but some women experience long-term discomfort due to sacroiliac joint changes.
Weight gain during pregnancy can also strain muscles in the lower back and hips, resulting in lower back pain that extends toward the front pelvic area. Then there are uterine contractions—these may radiate through the back, pelvis, and lower abdomen, especially if they're strong.
It’s also true that pregnant people tend to experience abdominal, pelvic, and upper stomach discomfort, particularly during late stages of pregnancy when the uterus starts to compress different organs.
Generalized Lower Back Pain and Facet Joint Injuries
Low back pain that radiates to the front of the pelvis can have many underlying sources. If you’re experiencing this type of pain, you probably find it hard to accurately explain where the pain is coming from. Also, structural abnormalities can be tricky to detect through scans or x-rays.
This form of generalized lower back pain is often due to muscle strains or tight back muscles that limit the way spinal joints move. A serious strain, poor posture, or improper activation of core muscles can also affect nerve root joints that extend toward the front pelvic area—causing chronic discomfort.
Degenerative (age-related) changes that develop at facet joints are another common issue linked to generalized lower back and pelvic pain. Facet joints are small bony structures that help stabilize spinal bones (vertebrae). These two small joints look like bony knobs located between the vertebrae.
Facet joints connect spinal bones together in a chain-like manner to facilitate the movement of the spine in different directions. As individuals age, gradual wear and tear, certain repetitive movements (e.g., heavy lifting), or stress fractures of the facet joints might happen. These types of injuries can lead to acute inflammation that causes pain during movement.
Degeneration of or damage to the facet joints can also lead to the onset of a condition called facet joint syndrome. Facet joint pain typically develops in the area where the affected joint is located.
Common signs of facet joint syndrome include pain in the lower back and referred pain in the front of the pelvis, the buttocks, upper thighs, or legs. There have also been reports of muscle weakness, a loss of spinal flexibility, and pain or tenderness in the inflamed region.
In some cases, injuries that a person considers minor, such as twisting or lifting something the wrong way, may trigger the onset of facet join pain. If left untreated, the injury may also affect nerve roots that extend toward the front of the pelvis.
Overall, ongoing lower back or pelvic pain related to a disc injury (e.g., bulging disc), nerve problems, sacroiliac joint issues, pelvic dysfunction, or changes during pregnancy that linger for extended periods of time may require professional pain management.
Physical therapy is typically recommended because it combines manual tissue manipulation with therapeutic exercises that:
- Relax overactive muscles
- Enhance nerve function
- Promote core and lumbo-pelvic muscle retraining
- Help individuals regain full body movement
These strategies help restore strength and mobility by targeting nerve root irritation and reducing the incidence of re-injury.
Treatment for Lower Back That Radiates to the Pelvis
Physical therapists generally perform extensive physical and diagnostic exams to make sure that the most beneficial treatment or therapy is recommended. The proper approach can help relieve acute pain in a short period of time. Of course, making an effort to adhere to the therapeutic plan will better help you overcome your pain and discomfort.
Individuals suffering from chronic lower back pain accompanied by discomfort in the front pelvic area may see dramatic improvement from physical therapy. This form of therapy is one of the most successful forms of pain management.
As a non-surgical approach, Physical Therapy is initially recommended for about 4-6 weeks to determine whether progress is being made or if a more invasive form of treatment, such as surgery, is needed. For some people, a longer physical therapy regimen results in long-term benefits.
The main goal of this type of therapy is to reduce inflammation, increase mobility, improve range of motion, restore muscle and vertebral function, and reduce or relieve back pain, which should target the pelvic pain at the same time. It is also important to target inflammation and irritation that may be affecting nerve roots in the lower back or pelvic region.
In addition, most physical therapy regimens are tailored to each individual’s specific case to promote progress as quickly as possible. The process also involves teaching maintenance techniques that can be used at the workplace or at home to lower the risk of recurring lumbo-pelvic issues.
For people who are experiencing sacroiliac joint issues or pelvic dysfunction, physical therapy is optimal—health care professionals in this field are experts at assessing and treating pelvic dysfunction. This generally involves a combination of manual therapy, muscle and nerve release strategies, and specific therapeutic exercises that promote rehabilitation as well as the restoration of lumbo-pelvic muscle control.
For people who have generalized pain in the back or front pelvic area due to facet joint issues, the physical therapy regimen may be specifically geared towards easing pressure on the irritated facet joint. This approach decreases inflammation and reactivates the muscles that support the joint during movement.
Physical therapists may even suggest the use of certain devices such as support belts, which offer extra support for the pelvis and lower back. A support belt helps reduce pain by stabilizing the sacroiliac joint as it easily wraps around the pelvis and hips.
Support belts are safe to use during pregnancy and provide gentle lumbar (lower back) compression, providing symptom relief for some people who use it. The use of this type of device is designed to accommodate the anatomy of the lower torso, which makes it beneficial for targeting pain, delaying the progression of certain problems, and promoting recovery.
With the appropriate form of treatment and muscle training, the majority of people suffering from lower back and front pelvic pain improve quickly. Therefore, it is important to work with practitioners, such as physical therapists, who have an in-depth knowledge of how to properly assess the pelvis and lumbar spine (lower back), as well as the surrounding nerves and muscles.
By working closely with a physical therapist, you can also learn self-care strategies, such as strength-training exercises, to promote long-term pain relief and help prevent future injuries.
Summary
Lower back pain may radiate toward the front of the pelvis for a number of reasons. Some of the most common sources of this type of pain include spinal injuries, bulging discs, nerve root irritation, and changes that occur during pregnancy.
In some cases, the issue gradually resolves by resting the back, engaging in more careful movements, or using pain relievers for short periods of time. Other individuals may require professional pain management due to more serious underlying problems that are contributing to the lower back and pelvic pain.
If you are experiencing back pain that radiates to the front pelvic area, contact FYZICAL today. Our physical therapists have the education and expertise to properly assess the cause of chronic lower back or pelvic pain. After completing a thorough examination, a physical therapist can recommend a specific pain management regimen that will help provide pain relief and start the path to recovery. Most individuals experience long-term improvement by adhering closely to their physical therapy plans.
FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!
To learn more about how FYZICAL Therapy & Balance Centers can help you, download our free e-book.