How Pelvic Physical Therapy Relieves Low Back and SI Joint Pain

Did you know that up to 80% of adults experience low back pain at some point in their lives? If you're one of them, you understand how disruptive and frustrating it can be. But what if I told you pelvic physical therapy could be the key componenet to relieving your low back and SI joint pain? As a Doctor of Physical Therapy and dual board-certified pelvic health specialist, I’m here to share how pelvic PT offers a unique perspective on treating back pain that you may not have considered.

Understanding Low Back and SI Joint Pain

Low back pain and sacroiliac (SI) joint dysfunction are common conditions that range from mild stiffness to sharp, debilitating pain. Many people attribute these issues to weak core muscles, poor posture, or the wear and tear of aging. However, research shows that back pain is rarely due to structural abnormalities. Instead, it often stems from hypersensitivity and systemic inflammation. This may explain why traditional treatments like core strengthening or massage sometimes only provide temporary relief.

The Pelvic Connection

Emerging research highlights a strong connection between back pain and pelvic floor dysfunction. When pelvic floor issues go unassessed or untreated, a critical component of back pain management is missed. Interestingly, both back pain and pelvic floor dysfunction are linked to tissue hypersensitivity, meaning their treatment strategies often overlap.

How Pelvic Physical Therapy Can Help

Pelvic physical therapy focuses on assessing and treating the muscles, ligaments, and connective tissues of the pelvic region in relation to the rest of the body. Unlike many traditional approaches, pelvic PT takes a holistic view, addressing physical, social, and psychological factors. This whole-person perspective is essential for managing both pelvic floor dysfunction and low back pain.

What to Expect in Pelvic Physical Therapy

If pelvic PT feels intimidating—especially if you expected treatment to focus solely on your back—you can rest assured, it's not as daunting as it seems. During your first visit, we’ll discuss your symptoms and medical history, followed by a comprehensive assessment of your back, hips, and pelvic floor muscles.

Here are some common techniques we may use to address low back and SI joint pain:

• Pelvic Floor Exercises: These exercises help to improve pelvic floor function, offering better support for the back and SI joint. Spoiler: these might not be the traditional kegels you’re thinking of either

• Education and Lifestyle Modifications: You’ll get guidance on ergonomics, body mechanics, activity adjustments, sleep improvement, and dietary strategies to reduce inflammation and enhance bowel function.

• Muscle Strengthening and Flexibility: Restoring balance in the hips, core, and pelvis can help to reduce sensitivity and pain.

• Manual Therapy Techniques: Hands-on treatments will help to release muscle tension and improve mobility.

• Movement Re-education: Training movements to help you move with confidence and ease, reducing fear and encouraging physical activity, which is critical for recovery.

• Relaxation Strategies: Stress management techniques will help to support healing and promote pain-free movement.

Self-Care Tips and Strategies

While professional therapy is essential, there are steps you can take at home to support your recovery:

• Stay Active: Movement and exercise are the crucial in improving back pain. Try starting with gentle movements like walking or stretching.

• Use Heat or Cold Therapy: Apply heat to relax muscles or cold to reduce inflammation.

• Mindful Breathing: Incorporate deep breathing exercises to reduce muscle tension and hypersensitivity in the nervous system which further drives pain.

Conclusion

You don’t have to let back pain control your life. Understanding the connection between low back pain, SI joint pain, and the pelvic floor is the first step toward lasting relief. If pelvic floor treatment isn’t part of your plan, you may be missing a crucial opportunity for improvement. Ready to take the next step? Schedule an appointment today, and let’s work together to help you return to the activities you love.

Written by:

Dr. Jana Richardson, PT, DPT, WCS, PRPC, CIDN
Dual Board Certified Pelvic Floor Therapist and Owner of Chicago Pelvic Health

Dr. Jana Richardson is a highly accomplished pelvic floor therapist with dual board certifications and extensive experience in treating complex pelvic floor dysfunctions. As the owner of Chicago Pelvic Health, Dr. Richardson is dedicated to providing personalized and effective care for her patients. With a Doctorate in Physical Therapy, and specialized certifications in Women’s Health and Pelvic Rehabilitation, Dr. Richardson is a leading expert in her field. She is also certified in Integrative Dry Needling, further enhancing her ability to offer comprehensive treatment plans. Dr. Richardson’s commitment to patient-centered care and her passion for helping individuals achieve optimal pelvic health make her an invaluable asset to the community.

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References:

O'Sullivan PB, Caneiro J, O'Sullivan K, et al Back to basics: 10 facts every person should know about back pain British Journal of Sports Medicine 2020;54:698-699.

Keizer A, Vandyken B, Vandyken C, Yardley D, Macedo L, Kuspinar A, Fagahani N, Forget MJ, Dufour S. Predictors of Pelvic Floor Muscle Dysfunction Among Women With Lumbopelvic Pain. Phys Ther. 2019 Dec 16;99(12):1703-1711. doi: 10.1093/ptj/pzz124. PMID: 31504926.

Dufour S, Vandyken B, Forget MJ, Vandyken C. Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study. Musculoskelet Sci Pract. 2018 Apr;34:47-53. doi: 10.1016/j.msksp.2017.12.001. Epub 2017 Dec 9. PMID: 29268147.