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Chronic Back and Hip Pain? The Surprising Link to Pelvic Floor Dysfunction


woman with back and hip pain

Chronic back and hip pain are common complaints that can significantly affect your quality of life. If you've tried everything—stretching, strength training, even pain medications—but still find yourself in discomfort, there may be an underlying issue you're not addressing: pelvic floor dysfunction. This often-overlooked condition can be a key contributor to persistent back and hip pain, but the good news is that targeted physical therapy (PT) can offer effective relief.


Understanding the Pelvic Floor

The pelvic floor is a group of muscles that span the bottom of your pelvis, supporting your bladder, bowel, and, in women, the uterus. These muscles are crucial for controlling urinary and bowel functions, supporting sexual health, and stabilizing your core. When functioning correctly, the pelvic floor works in harmony with other muscles in the body, particularly the deep abdominal muscles, lower back muscles, and hip muscles.


However, when the pelvic floor is not functioning properly—whether due to weakness, tightness, or poor coordination—it can create a ripple effect of problems throughout the body. This dysfunction can manifest as pain in the lower back and hips, often confusing patients and healthcare providers alike.


The Connection Between Pelvic Floor Dysfunction and Back/Hip Pain

The connection between pelvic floor dysfunction and back or hip pain lies in the interconnectedness of the body’s muscular system. The pelvic floor muscles are part of the "core," which includes the diaphragm, deep abdominal muscles, and spinal muscles. When the pelvic floor is not functioning properly, it can lead to imbalances in this core system.

For example, if the pelvic floor muscles are too tight, they can pull on the surrounding muscles and joints, leading to pain in the lower back and hips. Alternatively, if these muscles are weak or uncoordinated, other muscles in the body may overcompensate, leading to strain and discomfort in the back and hip areas.


Furthermore, chronic pain can alter the way you move, causing you to adopt compensatory movement patterns that only worsen the issue. This cycle of pain and dysfunction can be challenging to break without targeted intervention.


How Physical Therapy Can Help

Physical therapy is an effective treatment for both pelvic floor dysfunction and the related chronic back and hip pain. A skilled physical therapist can assess your pelvic floor function and determine whether it is contributing to your pain. Here’s how PT can help:


  1. Pelvic Floor Muscle Training:

    • If your pelvic floor muscles are weak, targeted exercises can help strengthen them. Conversely, if your pelvic floor muscles are too tight or overactive, relaxation techniques and stretches can help ease tension.

  2. Manual Therapy:

    • Physical therapists may use hands-on techniques to release tight muscles, improve joint mobility, and reduce pain in the pelvic floor, lower back, and hips.

  3. Posture and Alignment:

    • Improving your posture and body mechanics can alleviate strain on your pelvic floor and surrounding muscles, helping to reduce pain and prevent future issues.

  4. Core Stability:

    • Strengthening the entire core, including the pelvic floor, can improve overall stability, reducing the likelihood of back and hip pain.

  5. Education and Lifestyle Modifications:

    • A physical therapist can provide you with strategies to manage your symptoms, including advice on activities to avoid and techniques to improve your daily movements.

Why You Shouldn’t Ignore Pelvic Floor Dysfunction

Many people endure chronic back and hip pain without ever considering that their pelvic floor might be involved. However, ignoring this potential cause can lead to continued discomfort and frustration. By addressing pelvic floor dysfunction through targeted physical therapy, you can alleviate your pain, improve your quality of life, and get back to doing the activities you love.


If you’re experiencing persistent back or hip pain that hasn’t responded to traditional treatments, it might be time to consider the role your pelvic floor is playing. Contact Nashville Physical Therapy & Performance to schedule an assessment and learn more about how we can help you find relief and get back on track.


References

  • Fitzgerald, C. M., & Kotarinos, R. K. (2003). Pelvic floor physical therapy for pain: A descriptive study. Obstetrics & Gynecology, 101(5), 1051-1057.

  • Hodges, P. W., Sapsford, R., & Pengel, L. H. M. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and Urodynamics: Official Journal of the International Continence Society, 26(3), 362-371.

  • Smith, M. D., Russell, A., & Hodges, P. W. (2006). Do incontinence, breathing difficulties, and gastrointestinal symptoms increase the risk of future back pain? Journal of Pain, 7(4), 227-233.

  • Whittaker, J. L., & Stokes, M. J. (2011). Pelvic floor muscle training in elite athletes: An observational study of pelvic floor symptoms, dysfunction, and training. Physical Therapy in Sport, 12(4), 179-189.


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