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  • 15 Signs Your Low Back Pain Might Involve Your Pelvic Floor

    When is Low Back Pain Not Just Low Back Pain?

    Did you know that roughly 65% of women and 45% of men who have chronic low back pain also have some sort of dysfunction in their pelvic floor muscles? I didn’t until I went to the San Diego Pain Summit last year. One of the presenters talked about the correlation and it was fascinating. So, when they offered a non-internal class on pelvic health this year I signed up immediately. And I’m so glad I did.

    illustration of pelvis and pelvic floor muscles

    These Signs Indicate You May Have a Pelvic Floor Component to Your Low Back Pain

    If you’re a male of a certain age, you may have been told that it’s normal to lose a couple drops of urine after you’ve buttoned yourself back up. Your doctor may even have said something witty like, “Welcome to your 40s (or 50s).”

    If you’re a female who’s had a baby or reached perimenopause you may have been told that losing a little urine when you cough, sneeze, or laugh is normal. Or maybe you were told that you have a small bladder and to just drink less if you have to go to the bathroom often.

    All of these things are common, but they’re not normal. The good news is: There’s help.

    So… If you have chronic low back pain that never fully resolves with physical therapy, chiropractic, or massage and you have one or more of the following symptoms, all of your low back pain may not be stemming from your low back:

    1. Need to urinate more than 8 times a day (especially if your fluid intake is low to normal levels)
    2. Difficulty starting your urine stream
    3. Burning sensation with urination (that’s not due to an active infection)
    4. Feeling that your bladder isn’t empty immediately after urination
    5. You can’t hold it long enough to get to the bathroom once the urge to urinate hits
    6. You pee a little when coughing, sneezing, laughing, jumping, etc
    7. Feeling of pelvic pressure
    8. You have less than 1 bowel movement every 3 days
    9. You have to strain to initiate a bowel movement
    10. Your stool is routinely lumpy or has cracks in it
    11. Pain during or after bowel movements
    12. Painful intercourse
    13. Pelvic pain (vaginal, rectal, penile, testicular, perineal, pelvic)
    14. Pelvic pain with sitting
    15. You’ve been diagnosed with:
      • vulvodynia
      • vestibulodynia
      • vaginismus
      • dyspareunia
      • interstitial cystitis
      • chronic prostatitis
      • endometriosis
      • pudendal neuralgia
      • chronic pelvic pain
      • levator ani syndrome
      • piriformis syndrome
      • coccydynia
      • poctalgia fugax
      • urethral syndrome
      • bladder sphincter dysenergia

    If you have any of these symptoms, see your doctor for a referral to a pelvic floor PT. If your state allows direct access to physical therapy, another healthcare provider may be able, and more willing, to offer a referral as well. Most PTs don’t do this work, so it’s important that it be a PT who specializes in the pelvic floor work.

    I’m not gonna lie, most of the pelvic floor muscles can’t be accessed from the exterior of the body so it will most likely involve some internal work. This means they will be working the muscles through the same procedure that they also check the ovaries, uterus, and prostate just more in depth. That may be a deal breaker for you or it may not.

    If you’re on the fence, just ask yourself if you would rather live with the low back pain and other symptoms or have some uncomfortable treatments in order to live the rest of your life without them. I don’t say that to pressure you into it… I’ve got no skin in the PT game. I’m simply saying that now you know you have a choice of either getting rid of the symptoms and pain or living with them. What you choose is up to you.