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The Connection Between Low Back Pain and the Pelvic Floor


Low back pain is something many of us are all too familiar with, but did you know it tends to affect women more frequently than men? Studies show that nearly 60-80% of women will deal with low back pain at some point in their lives. If you’re one of those women who have tried everything under the sun to get rid of that nagging pain with limited success, it might be time to look beyond just your low back—specifically to your pelvic floor and core.


Understanding the Pelvic Floor, Low Back and Core

Let's take a moment to refresh our memory about what the pelvic floor is and how it functions. The pelvic floor is a group of muscles at the base of your pelvis that supports your bladder, bowel, and for women, the uterus. These muscles are crucial for maintaining urinary and fecal continence, supporting pelvic organs, and contributing to sexual function.

Now, when we talk about the core, we’re talking about more than just those elusive six-pack abs. Your core includes the diaphragm, the muscles of your back, abdominal muscles, and yes, the pelvic floor. These muscles work together in a wonderful synergy to keep your spine and pelvis stable and strong during movement.


Medical illustration of a human spine and core muscles, provided by Pelvic Global, pelvicglobal.com.
Here you can see the relationship between the muscles of the abdomen and back in the front and back. At the top and bottom the thin red lines represent with diaphragm and pelvic floor. The coordination of this system is integral in avoiding low back pain. Image used with permission from Pelvic Guru®, LLC as a member of the Global Pelvic Health Alliance Membership (GPHAM)

The Holistic Approach to Pelvic Floor Therapy for Low Back Pain

So, how exactly do the pelvic floor and core muscles tie into low back pain? Here's where things get interesting:

  1. Pelvic Floor Dysfunction and Low Back Pain: When the pelvic floor muscles are either too tight or too weak, they can’t function properly. This dysfunction can lead to instability in the pelvic area and the lower back, causing pain. Chronic low back pain might actually be a sign of underlying pelvic floor issues that have gone unnoticed or without the obvious symptoms like leakage, pain with intimacy, or constipation.

  2. Core Weakness and Spinal Instability: A weak core means that the muscles supporting your spine aren't doing their job effectively. This can lead to poor posture, increased load on the lower back, and, ultimately, pain. Strengthening the core, including the pelvic floor, provides the necessary support for your spine and can significantly reduce pain. However, we do want to make sure before we start an aggressive core strengthening program that we are't actually dealing with a lot of muscle tension and stiffness.

  3. Managing Pressure: The core and pelvic floor muscles play a crucial role in managing intra-abdominal pressure, which helps stabilize the spine. Whenever you lift, bend, or even breathe, your core muscles—including the diaphragm and pelvic floor—work together to create pressure within the abdomen that supports and stabilizes your spine. If these muscles aren’t functioning correctly, this balance is disrupted, placing extra stress on the lower back and leading to pain.

  4. Misdiagnosis and Overlooked Symptoms: Often, healthcare providers might overlook the pelvic floor when diagnosing and treating low back pain. This oversight can lead to treatments that don’t address the root cause, leaving you in continued pain despite interventions. A thorough assessment by a pelvic floor physical therapist can identify if pelvic floor dysfunction is contributing to your low back pain.


Understanding these connections is the first step in addressing your pain more effectively. Let's look at how pelvic floor physical therapy can help.


A pelvic floor physical therapist treating a women with low back pain and pelvic floor dysfunction by doing leg stretches on a table. The room is bright with a white, modern window shade. Calm mood. Holistic women's health care.
Holistic pelvic floor therapy includes treating and educating you about the connection between the low back and pelvic floor as well as treating the body both from inside and outside the pelvis. HERE you can learn more about GAIA's approach.

How Pelvic Floor Physical Therapy Can Help Get Rid of Your Low Back Pain

Pelvic floor physical therapy is a specialized approach that focuses on evaluating and treating the pelvic floor muscles through a variety of techniques. Pelvic floor therapists are great at treating orthopedic conditions like low back pain because they have additional training and a speacial eye to understand how the pelvic floor affects other parts of the body. Often times, the pelvic floor is overlooked in traditional physical therapy treatments. Here’s how it can make a difference in managing your low back pain:

  • Customized Exercise Programs: We create tailored exercise programs that target both the core and pelvic floor muscles. These exercises help improve muscle coordination and strength, providing better support for your lower back and reducing pain.

  • Manual Therapy: Our therapists use hands-on techniques to release tight muscles, improve tissue mobility, and enhance function. This can directly alleviate pain and improve your overall mobility.

  • Education and Awareness: Knowledge is power! We’ll educate you about the connection between your pelvic floor and low back pain, empowering you to take control of your symptoms. You'll learn practices that support your recovery and prevent future pain.

  • Retraining Functional Movements: We help you retrain functional movements to ensure you’re using proper strategies in everyday activities. Whether it's lifting your child, bending to pick something up, or performing tasks at work, we’ll teach you techniques to protect your back and support your pelvic floor.


If you’ve been struggling with chronic low back pain and traditional treatments haven’t provided relief, it’s time to consider the role of your pelvic floor and core. Pelvic floor physical therapy at GAIA Women's PT offers a comprehensive approach that addresses underlying issues contributing to your pain. Call or click to book an evaluation with one of our skilled therapists to learn more about how strengthening your core and pelvic floor can help you live a pain-free life. Don’t let low back pain control your life—take the first step towards recovery today!




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