The Link Between Pelvic Floor Dysfunction and Back Pain

Back pain is one of the most common complaints among adults, but did you know your pelvic floor could be playing a role? Many people don’t realize that the pelvic floor muscles are deeply connected to the muscles supporting the lower back. When the pelvic floor isn’t functioning properly, it can contribute to ongoing discomfort, instability, and pain in the lumbar spine.

The pelvic floor is a group of muscles that sit at the base of the pelvis, supporting the bladder, bowel, and reproductive organs. These muscles work in harmony with the deep core muscles, including:

The diaphragm (for breathing)
The transverse abdominis (a deep abdominal muscle providing stability)
The multifidus (small spinal muscles that help control movement)
Together, these structures create what’s often referred to as the “core” When one part of this system is dysfunctional—such as the pelvic floor being too weak or too tight—it can lead to compensations that strain the lower back.

If you have persistent back pain that doesn’t improve with traditional treatments, it may be worth considering your pelvic floor. Some signs that the pelvic floor could be a factor include:

Chronic lower back or sacroiliac (SI) joint pain
A feeling of instability in the lower back
Urinary urgency, leakage, or incomplete bladder emptying
Constipation or difficulty with bowel movements
Pelvic pain or pressure
Pain during or after sex
Many people assume pelvic floor problems only stem from weakness, but tightness (hypertonicity) is just as common. When the pelvic floor muscles are overactive, they can create excessive tension, pulling on the lower back and causing pain. This is especially true if you experience faulty breathing patterns or postural imbalances.
If you suspect your pelvic floor is contributing to your back pain, here are some steps you can take:

Breathe better – Proper diaphragmatic breathing helps regulate intra-abdominal pressure and relaxes tight muscles.
Improve posture – Poor alignment can lead to excessive strain on both the pelvic floor and the lower back.
Release tightness – Techniques like fascia release, stretching, and pelvic floor relaxation exercises can help.
Strengthen wisely – If weakness is an issue, targeted exercises can build strength without overloading the back.