Lumbo-pelvic Pain: Coming from inside?

by Mia Thomas, PT, DPT


Based on the most current evidence, physical therapy is the first line of treatment for low back pain. This is why if you walk into most physical therapy offices, you will find that a majority of the patients being seen are coming for low back or hip pain.

Unfortunately, no matter how often patients with these conditions are seen some pertinent screening questions continue to fall through the cracks. For example, out of two hundred women who reported low back pain 156 also had incontinence. When one is unable to fully activate their pelvic floor to control their urine retention, they are also unable to fully activate their deep core muscles, which help stabilize their low back. So, it is important as a patient to advocate for yourself and report any urinary symptoms you might be having.

Others who present with hip or buttock pain, maybe sciatica or pain surrounding the sacroiliac or SI joint, may also have underlying pelvic floor dysfunctions that are contributing to their pain; some common pelvic floor dysfunctions associated with hip or buttock pain are pain with intercourse, painful bowel movements, and difficulty with urination.

While your therapist might not have the knowledge to incorporate all aspects of pelvic floor rehabilitation into your plan of care, they will be able to recognize when they can no longer help and a pelvic floor physical therapist might be more beneficial. So, do not be afraid to speak up and tell your physical therapist about any pain or difficulties with urination, bowel movements, or intercourse!