Is pelvic floor dysfunction associated with development of transient low back pain during prolonged standing?

None listed

Prolonged standing has been associated with an increased prevalence of back pain in both laboratory and epidemiologic studies (Andersen et al 2007) and is recognised as a potential workplace hazard for employees who may stand for up to 75% of their work time such as, retail staff, assembly line workers, and healthcare personnel, among others (“Standing Problem,” 2005; Parent-Thirion et al., 2012). Recent research indicates that prolonged standing might lead to transient LBP in workers without previous history of back injury (Gallagher et al 2014; Marshall et al 2011; Nelson-Wong et al, 2010). Those individuals who developed pain during standing work usually experience first symptoms within 15 to 45 min, in conjunction with significant muscle co-activation anomalies, such as high co-activation of the gluteus medius, compared to non-pain developers. Transient back pain by definition exists solely during the exposure time and dissipates quickly once the standing ceased. However, Nelson-Wong and Callaghan (2014) found that transient LBP developers were 3 times more likely to experience chronic LBP over the next 24 months, seek medical care within 3 years of their participation, and report multiple episodes of chronic LBP. Although LBP during the 2-hour standing protocol is transient in nature, it has been shown to be a positive predictor for future chronic and recurrent LBP (Callaghan et al., 2015; Nelson-Wong & Callaghan, 2014). LBP is more prevalent in women than men (Schneider, Randoll, & Buchner, 2006). Further, many recent studies have highlighted an association between LBP and urinary incontinence (UI) (Arab, Behbahani, Lorestani, & Azari, 2010; Bush et al., 2013; Cassidy et al., 2017; Eliasson, Elfving, Nordgren, & Mattsson, 2008). In fact, women with UI are more than twice as likely to experience frequent back pain as those without UI (Smith, Russell, & Hodges, 2009). Additionally, women with greater severity of UI also report an increased severity and greater disability related to their back pain (Kim et al., 2011). The function of the pelvic floor muscles in supporting continence is well known (Dumoulin, 2010; Price, Dawood, & Jackson, 2010). However, the pelvic floor muscles play important roles in spinal stability as they naturally coactivate with other trunk muscles such as the transvers abdominis (Hodges, Sapsford, & Pengel, 2007). Given the pelvic floor muscles’ dual roles, it is logical to hypothesize a relationship between pelvic floor function, continence status and the development of lower back pain. The primary objective of this research is to improve work-related health outcomes for women by elucidating significant predictors of LBP during prolonged standing. The main purpose of the study is to determine whether co-activation patterns between the pelvic floor and trunk muscles during a 2-hour prolonged standing task can predict transient low back pain in healthy women with and without pelvic floor dysfunction.