The pelvis is the home of pelvic organs, and the Pelvic floor muscles (PFM) are an essential component of that home. The PFM is one of the main parts of the local stabilizing system, which is connected with deep abdominal and multifidus muscles, and plays an essential part in lumbopelvic stability. If the PFM is not appropriately strengthened (too weak or too tight), it becomes harder to control, and the lower back muscles do not get strengthened. PFM may be the primary source of back pain.

Methods: Between 2002 and 2025, studies published including women diagnosed with PFM disorders and LBP were examined in “the Web of Science, Cochrane Library, Scopus, and PubMed databases”. Keywords and search terms used (PFM, LBP, urinary incontinence, sacroiliac pain, levator ani, obturator internus pain, and sexual dysfunction). Exclusion criteria included studies with no outcomes or inadequate data, as well as procedures, recommendations, and letters to editors, animal research, and articles written in languages other than English.
Conclusion: Traditional LBP rehabilitation programs have long stressed the significance of strengthening the abdominal muscles, gluteals, and spinal extensors. However, current advances in physical therapy and rehabilitation science highlight the importance of taking a more comprehensive approach, one that incorporates the PFM as a critical component of core function. This paper investigates why PFMs should no longer be an afterthought, but rather a top focus in complete musculoskeletal rehabilitation.