Incontinence and low back pain: inseparable conditions ?

Innovative Physio Pilates team has a great focus on treating women with incontinence and low back pain. We know these conditions are prevalent. One in three who has had a baby has incontinence and 70-85% of people will experience low back pain at some time during their life.

Study from the University of Queensland using a database of 38,000 women showed that incontinence and low back pain are related.

They claim women with incontinence are significantly more likely to report back pain than women with no history of incontinence. It appears that incontinence increases the risk of getting low back pain and low back pain increases the risk of experiencing incontinence.
These inseparable conditions have a common link – At Innovative Physio/Pilates our clinical thoughts is the coordinated function of the pelvic floor muscles, abdominal muscles, deep back muscles (abdominal cylinder) and diaphragm. The studies suggest the altered activation of the pelvic floor and abdominal muscles contribute to incontinence and low back pain.

The pelvic floor muscles support the pelvic organs and when we cough or sneeze the pelvic floor muscles contract moving upwards in the pelvic cavity, assisting to press the urethra (wee tube) against the pubic bone making sure no urine escapes and keeping the pelvic organs well elevated in the pelvic cavity. The timing of these muscles is critical. We have learnt through research that the pelvic floor muscles work optimally with a stabile ‘neutral’ spine.  A neutral pelvic lumbar spine is achieved with coordinated activity of the pelvic floor muscles, lower abdominal muscles, diaphragm and deep lower back muscles. When neutral spine is achieved many people who have suffered low back pain find their symptoms reducing and some women can experience reduced symptoms of stress urinary incontinence.

This control and coordinated action between the pelvic floor muscles, abdominal cylinder, deep back muscles and diaphragm (‘core muscles’) is also critical to cure and prevent low back pain, and very important to stay dry and prevent pelvic organ prolapse.
Many of our women report their incontinence improving on teaching abdominal cylinder control for back care. The reverse occurs with reduction in back pain on improving pelvic floor control and coordination for incontinence treatment.

At Innovative Physio we realise the importance of a comprehensive assessment and design a program to improve control and coordination of the pelvic floor, abdominal cylinder muscles, deep lower back muscles and diaphragm to help cure and best managed these linked and distressing conditions.

Once these important movement patterns have been learnt many women then attend our pilates group classes to maintain these healthy and vital movement patterns. Please visit the section on Clinical Pilates in this website for more detailed information on our pilates program.
Researchers- University of Queensland Ms M Smith, Professor P Hodges, Ms A Russell, Dr M Coppieters