Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
Can pelvic organ prolapse cause back pain?
Some women with pelvic organ prolapse notice low back pain or a dragging feeling, especially later in the day or after standing for a while. “POP-related low backache” is actually a recognized symptom category in the international medical terminology for prolapse.
Prolapse is not the most common cause of back pain. But the two can be connected, and I see it fairly often in clinic.
How prolapse can cause back pain
The uterosacral ligaments connect your uterus and upper vagina to the lower part of your spine, near the sacrum (around the S2 to S4 vertebrae). When prolapse stretches these ligaments, you may feel an aching or pulling in your lower back. This tends to center around the lower sacrum and gets worse with standing or activity.
Prolapse can also lead to back discomfort in other ways:
- Postural changes. You may shift how you stand or move without realizing it, which puts extra strain on your back.
- Pelvic floor and core connection. Your pelvic floor muscles work closely with your core, hips, and back. When the pelvic floor is not working well, your back muscles may pick up the slack.
Back pain from prolapse usually feels like a dull ache or dragging in the low back. It tends to get worse as the day goes on and better when you lie down. That pattern matches how most prolapse symptoms behave.
When to bring it up
If you have low back pain along with pelvic pressure, a vaginal bulge, or changes in bladder or bowel habits, it is worth mentioning to your doctor. These symptoms together suggest prolapse may be part of the picture.
I ask about back pain when I evaluate prolapse. One way to test the connection is with a pessary, a removable device that supports the prolapsed organs from inside the vagina. If a pessary eases your back pain, that tells us the two are likely related.
Pelvic floor physical therapy can also help. A pelvic floor PT works on more than just Kegels. They address strength, coordination, your core, hips, and posture, all of which can affect both prolapse and back pain. We have pelvic floor PTs in our office and can also refer to therapists in the community.
When we treat the prolapse, whether with a pessary, physical therapy, or surgery, many women tell me their back pain gets better too.
References
- Haylen BT, Maher CF, Barber MD, et al. An IUGA/ICS joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35(2):137-168. doi:10.1002/nau.22922
- Haylen BT, Vu D. Surgical anatomy of the vaginal vault. Neurourol Urodyn. 2022;41(5):1148-1164. doi:10.1002/nau.24963
- Hilton P, Dolan LM. Pathophysiology of urinary incontinence and pelvic organ prolapse. BJOG. 2004;111(Suppl 1):5-9. doi:10.1111/j.1471-0528.2004.00505.x
- Carberry CL, Tulikangas PK, Ridgeway BM, Collins SA, Adam RA. AUGS best practice statement: evaluation and counseling of patients with pelvic organ prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796-806. doi:10.1016/S0140-6736(13)61977-7
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