Pelvic Pressure and Lower Back Pain: The Relationship
Pelvic pressure can feel like heaviness, fullness, or discomfort in the pelvic area and may occur alongside lower back pain. This article explains possible connections, common causes, symptoms that may warrant evaluation, and how pelvic floor physical therapy can help identify contributing factors and support symptom management.
What Pelvic Pressure Can Feel Like
Pelvic pressure can feel like heaviness or discomfort in the groin area or the pelvic floor. It can sometimes cause achiness, dull discomfort or a sensation of something being in between the legs that should not be there. Pelvic pressure can also be described as fullness in the pelvis or a feeling of dragging at the end of the day. Patients also often describe pelvic pressure as “something there,” a tampon was “hanging out,” or as if something was going to fall out.
Generally, resting, sitting or lying down will improve the feeling, whereas being active and on your feet may make it worse. Activities such as prolonged standing, walking or lifting can increase pelvic pressure. Pelvic pressure will also often be worse at the end of the day due to increased time spent upright.
How Pelvic Pressure and Lower Back Pain Are Connected
Pelvic pressure and low back pain often occur simultaneously. Lower back pain can be caused by pelvic pressure since the pelvic muscles and ligaments all attach right at the lower back. Your lower back starts at the top of your pelvis or hips so the hip and pelvic floor muscles are all located in that general area. Any kind of problem in these muscles can contribute to pelvic pressure and therefore lower back pain. For this reason, there is a high correlation between pelvic floor conditions and lower back pain.
The Role of the Pelvic Floor
Often, the pelvic floor muscles or organs are the cause of pelvic pressure. Pelvic floor tension, for example, can cause a feeling of heaviness. On the other hand, pelvic organ prolapse, a quite common condition where one of the organs in the pelvis descends lower into the pelvic bowl, can also cause feelings of pressure and heaviness. A skilled pelvic floor physical therapy evaluation can help determine the cause of the pelvic pressure and if it is coming from pelvic organ descent or from pelvic floor muscle tension.
Common Causes of Pelvic Pressure and Back Pain
- Pelvic floor muscle tension- muscle tension can reproduce a type of pressure or heaviness feeling.
- Pelvic floor muscle weakness – weakness can result in decreased support to the pelvic organs.
- Pelvic organ prolapse- ligaments have stretched due to pregnancy or other conditions.
- Hormonal changes associated with pregnancy, postpartum, or menopause- decreased estrogen can lead to structural changes in ligaments.
- Chronic constipation – chronic straining can lead to pelvic pressure over time.
When Symptoms May Need Evaluation
Signs that you need to see a pelvic floor physical therapist for an evaluation include:
- Re-occurring pelvic pressure or heaviness that occurs more in the evening or more after prolonged standing, walking or lifting and that improves with rest or lying down
- Increase in lower back pain or pelvic achiness
- Leaking urine
- Difficulty with bowel movements or chronic straining
- Pain with intercourse
- Tailbone pain
- Increased urinary urgency or frequency
- Persistent hip pain
How Pelvic Floor Therapy Can Help
A skilled pelvic floor physical therapy evaluation can help determine what is causing pelvic pressure and low back pain. The pelvic floor physical therapist will perform an internal assessment, with patient’s enthusiastic consent, to determine pelvic floor muscle tone, coordination, strength, endurance, if there is pelvic organ prolapse present or not and more. The first visit will also include a discussion of your symptoms, lifestyle and any concerns you may have. Pelvic floor physical therapy extends beyond giving exercises and should include a comprehensive plan to help you reduce and manage symptoms.
What to Expect During Treatment
Pelvic floor physical therapy treatment will be customized to you and can include many different avenues:
1) Treatment to improve pelvic floor muscle tone and coordination. This can include manual therapy, exercises as well as the use of tools such as a pelvic floor wand or dilator therapy
2) Improving movement coordination such as the relationship between the pelvic floor and core canister. Patients may need help learning a new muscle coordination strategy for example if they are excessively bearing down into the pelvic floor.
3) Decreasing straining with lifting or using the bathroom
4) Improving constipation through nutrition, hydration, movement or more.
5) Improving hip and core strength. There is often a correlation between hip weakness and pelvic floor muscle dysfunction.
6) Evaluating gait and other functional movements such as squatting to determine the reason why certain activities may cause more symptoms than others.
7) Working on trunk rotation and mobility.
8) Considering a referral to a urogynecologist for a pessary fitting if needed.
9) And more!
If you have pelvic heaviness and low back pain symptoms…do not panic! Please know that pelvic floor physical therapists are highly trained and experienced to help you with these distressing symptoms.
Where to Find Pelvic Floor Physical Therapy For Pelvic Pressure And Lower Back Pain In Queens, NYC
If you are experiencing pelvic floor symptoms such as pelvic pressure and lower back pain, help is available! Pelvic floor physical therapy can be very helpful for improving and managing pelvic pressure and lower back pain. If you are in the Forest Hills, Queens, NYC area and you are looking for help today, reach out to us! We offer highly skilled pelvic floor physical therapy that is customized to your life and goals. Give us a call or fill out our contact form today!
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