When Your Low Back Pain Isn’t Really A “Back Problem” After All…
Pain in the lower back can actually be referred from other areas. In other words, some dysfunction/tightness in another area of the body is being perceived by your brain as being pain in the lower back. Therefore you conclude you have a “back problem.” Tightness or tender points in other muscles can all be referred to the lower back including:
Pelvic floor muscles (muscles between our pubic bone and tailbone)
Hip flexors (front of the hips)
Abdominals
Internal organs can also refer pain to the lower back. In other words, if there is a problem with one of these internal organs, your brain may perceive it as being low back pain:
Uterus
Kidneys
Bladder
If you have seen a provider for low back pain and they have not assessed the muscles surrounding that area, or have not asked questions to rule out internal organ issues - we could be missing important pieces of the puzzle!
There is a very strong association between low back pain and urinary incontinence (involuntary leakage of urine). This isn’t just a coincidence! In fact, in one study it was found that 78% of women with low back pain experienced urinary incontinence (Eliasson, Elfving, Nordgren, Mattsson-2008 Science Direct) - and these were women who hadn’t even experienced childbirth!! So, what’s going on with that?
Well, if we look at our mid-section (trunk) like a soda can, there are distinct top/bottom/sides. At the top of our trunk we have our breathing diaphragm muscle which helps our lungs to inflate/deflate with each breath we take. At the bottom of the trunk are the pelvic floor muscles (which mimic the breathing diaphragm perfectly) that control our urinary and bowel functions, and are involved in sexual function. The sides of the can are the abdominals and back muscles. Between the abdominal muscles and back muscles we are talking about over ten groups of muscles. All of these muscles need to work in combination with each other to keep us upright against gravity, manage pressures in the abdominal cavity when we do something like lifting heavy items, or even just with basic daily movements such as reaching into the cupboard.
When one of these areas of the soda can is not working properly, it can create pain or dysfunction in one or more of these sides/top/bottom. Sometimes the problem area is not the same as the pain area!
If you’ve been trying to fix your low back pain by treating your back and you’re not seeing the results you want- it’s time to reach out to a pelvic floor physical therapist to evaluate your symptoms. People can absolutely have “back problems” but we also need to be treating the back as part of the bigger picture! At Shift Physical Therapy, we are pelvic floor physical therapists who will look at the big picture of your symptoms and help to get you answers.
Make the SHIFT today by calling Shift Physical Therapy and Wellness at (763) 645 -1113.
Written by: Renee Hancock, Physical Therapist
