Is Diastasis Recti Abdominis Associated With Low Back Pain? A Systematic Review

Abstract

Background: Low back pain (LBP) is a common cause of disability worldwide; multiple causes and risk factors have been proposed in the genesis of back pain. Some studies reported an association between diastasis recti abdominis (DRA), a surrogate for decreased core strength muscle, and low back pain. We aimed to investigate the relationship between DRA and LBP through a systematic review.

Methods: A systematic review of the literature of clinical studies in English literature was conducted. PubMed, Cochrane, and Embase databases were used to conduct the search up to January 2022. The strategy included the following keywords: "Lower Back Pain" AND "Diastasis Recti" OR "Rectus abdominis" OR "abdominal wall" OR "paraspinal musculature".

Results: From 207 records initially found, 34 were suitable for full review. Thirteen studies were finally included in this review, with a total of 2,820 patients. Five studies found a positive association between DRA and LBP (5 of 13 = 38.5%) whereas 8 studies did not find any association between DRA and LBP (8 of 13 = 61.5%).

Conclusions: Of the studies included in this systematic review, 61.5% did not find an association between DRA and LBP whereas a positive correlation was observed in 38.5% of studies included. Based on the quality of the studies included in our review, better studies are warranted to understand the association between DRA and LBP.

Keywords: Diastasis recti abdominis; Linea alba; Low back pain.