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Up to 95% of Women with Low Back Pain have Pelvic Floor Dysfunction

Low Back Pain... Relieve Symptoms and Causes

Association Between Low Back Pain & Pelvic Floor Dysfunction

Low back pain is the number one reason people visit their primary healthcare provider; and it is the number one cause of global disability. Clinically, physical therapists (PTs) trained to treat pelvic floor dysfunction have long noted a link between their orthopedic low back pain patients and concurrent pelvic floor dysfunction, but only more recently has this link been empirically evaluated. A common and often necessary component of pelvic floor physical therapy is an internal digital exam of the pelvic floor musculature. Dufour et al. noted that no studies had previously considered the link between low back pain and pelvic floor dysfunction through manual, digital muscle testing. In a group of 85 women (mean age 43.4 years old) referred to physical therapy for low back pain:

  • 95.3% had some form of pelvic floor dysfunction on digital examination
  • 70.6% had pelvic floor tenderness
  • 65.9% had pelvic floor weakness
  • 41.2% had pelvic organ prolapse
  • 83.5% reported conditions relating to pelvic floor dysfunction

The authors issued a note of caution for patients with concurrent low back pain and pelvic floor weakness. Because the majority of their sample presented with both pelvic tenderness and weakness, the authors note that weakness from overactivity (i.e., higher resting tone) is different than frank weakness. When conventional PTs assume an underlying weakness and emphasize strengthening, they may actually be making the pelvic floor symptoms worse.

“...Bowel and bladder functional questions as they pertain to Stress urinary Incontinence (SUI), Urge Urinary Incontinence (UUI), Pelvic Organ Prolapse (POP), Dyspareunia and Chronic Constipation are rarely considered [by conventional orthopedic PTs] and our findings suggest that they should be.” p.51

All PTs are trained to treat orthopedic concerns like low back pain, but only PTs trained in pelvic floor dysfunction can treat your patients with low back pain holistically, get them out of pain, and help them return to the activities they love. 

 

Submitted by Dr. Lauren Collier Peterson, PT, DPT

Clinical Director FYZICAL Therapy & Balance Centers of Oklahoma City

Dr. Peterson and her staff provide Physical Therapy for patients with pelvic floor dysfunction, imbalance and falls risk, & orthopedic injuries in OKC.

She has treated hundreds of men and women with pelvic floor issues ranging from incontinence and constipation to pain and prolapse. While she has a particular clinical interest in pelvic pain disorders, she wants everyone to enjoy good pelvic health and to know that “Leaks are not normal!”

 

 

Dufour, S., et al. (2018). Association between lumbopelvic pain and pelvic floor dysfunction in women:A cross sectional study. Musculoskeletal Science and Practice, 34, 47-53.