Back Pain and Incontinence: What Can I Do?

Medically reviewed by Deborah Weatherspoon, PhD, RN, CRNA, COI on February 22, 2017Written by Kimberly Holland

Is there a connection?

Urinary incontinence (UI) is often a symptom of a bigger problem. Treating that underlying problem may remedy your symptoms of incontinence, as well as other related side effects.

Incontinence can be caused by:

  • frequent urinary tract infections
  • constipation
  • pregnancy
  • childbirth
  • prostate cancer

Back pain has also been studied for its potential to cause incontinence. Researchers think the activation of muscles in your abdomen may trigger back pain. Those same muscles may impact your ability to properly hold or release urine.

Still, the research isn’t clear. More research is needed to determine whether back pain is actually a cause or even a symptom of incontinence.

Keep reading for more information about incontinence and its possible connection to back pain.

Is back pain a symptom of incontinence?

The connection between back pain and symptoms of UI is unclear. Occasionally, people experience back pain or pressure that can cause episodes of incontinence, but researchers haven’t yet pinpointed particular causes.

For the most part, symptoms of incontinence depend on the type of UI you have. The types and symptoms of incontinence include:

Stress incontinence: This type of UI is caused by sudden pressure on your bladder. This pressure may be from laughing, sneezing, exercising, or lifting heavy objects.

Urge incontinence: People with this type of UI experience a sudden, severe urge to urinate. Then, they’re unable to control the loss of urine. People with this type of incontinence may need to urinate frequently.

Overflow incontinence: When your bladder doesn’t empty fully, you may experience dribbling or dripping of urine.

Functional incontinence: A physical or mental impairment may affect your ability to reach a toilet in time to urinate.

Total incontinence: If you’re unable to hold urine or prevent passing urine, you may have total incontinence.

Mixed incontinence: When you are impacted by more than one type of UI, you may have mixed incontinence. For example, it’s not uncommon for a person to have both stress and urge incontinence.

What does the research have to say?

Researchers are studying how back pain or back issues may impact or cause incontinence. So far, the research isn’t clear. Still, a few studies shed some light into possible connections.

A Brazilian study published in 2015 explored the potential correlation between lower back pain and UI. However, this study was conducted in a population with an average age of 80. The results weren’t conclusive, and it’s possible the advanced age of study participants impacted their urinary health.

In a 2015 study of mothers one year after giving birth, researchers found that back pain and UI are common issues. This study showed that back pain is more common and more likely to interfere with a mother’s day-to-day life than UI.

Women who were obese, were an advanced maternal age, or had vaginal delivery during childbirth were more likely to experience symptoms and issues of UI. The study found no connection between women who experienced back pain and their episodes of UI.

More research is needed to truly determine whether there is a substantive link between the two symptoms.

What are the risk factors for back pain and incontinence?

Certain risk factors increase your chances for experiencing symptoms of both back pain and incontinence. This includes:

Obesity: Carrying extra weight causes extra pressure on your back. Extra weight also increases pressure on your bladder and nearby muscles. This may lead to stress incontinence, and over time, the extra stress may weaken your bladder muscles.

Age: Back pain becomes more common with age. Likewise, the muscles that impact bladder control lose strength as you grow older.

Other diseases: Some conditions, such as arthritis and diabetes, can cause both back pain and incontinence. Equally, people with certain psychological conditions, such as anxiety and depression, are more likely to experience back pain.

Can back pain and incontinence be the result of another condition?

Though rare, one disorder could cause back pain and UI: Cauda equina syndrome affects the bundle of nerve roots at the end of your spinal cord.

These nerve roots send and receive signals from your brain. These nerves control the lower half of your body and your pelvic organs. When the nerve roots are compressed, the pressure cuts off sensation and control. The nerves that control your bladder and bowels are particularly susceptible to the loss of control caused by this disorder.

A ruptured disk may cause pressure on the nerve roots. This disk and the pressure on the nerve roots can lead to back pain.

Likewise, a form of arthritis called ankylosing spondylitis may cause back pain. This condition causes inflammation in your spinal joints. The inflammation can lead to discomfort and chronic severe pain.

Check out: 6 stretches for sciatica pain relief »

How is a diagnosis reached?

The only way to properly diagnose the underlying cause of both back pain and UI is to see your doctor and receive a full medical exam. This can help your doctor decide whether the symptoms you’re experiencing are related or are caused by separate conditions that need individual attention.

To diagnose the symptoms, your doctor may first conduct a physical exam. During this exam, it’s important that you detail any symptoms you experience, when you experience them, and how they are relieved.

After this initial diagnosis phase, your doctor may order several tests. These tests, including imaging tests like X-rays and blood work, can eliminate potential causes for your symptoms.

If your general practitioner or family doctor is unable to reach a diagnosis, they may refer you to a urologist or a back pain specialist.

What are the treatment options for back pain and incontinence?

Treatment for back pain and incontinence relies on finding an underlying cause. Once you and your doctor understand what’s causing your symptoms, you can develop a plan to alleviate or better manage your symptoms.

Back pain

Common treatments for back pain include:

  • over-the-counter or prescription pain medications
  • lifestyle changes, such as getting a new mattress pad
  • exercise
  • physical therapy

In serious cases, surgery may be necessary.

Incontinence

First-line treatments for UI can include:

  • training your bladder to hold urine for longer periods of time
  • changing urination strategies, including voiding your bladder twice in one bathroom break to more fully empty your bladder and scheduling toilet breaks
  • pelvic floor muscle exercises
  • prescription medications to help relax bladder muscles

In some cases, your doctor may recommend using a medical device, such as a urethral insert or vaginal pessary, to help support your bladder and prevent leakage.

Interventional therapies may also be beneficial:

  • bulking material injections around your urethra to keep it closed and reduce leakage
  • botulinum toxin type A (Botox) injections to relax your bladder muscle
  • nerve stimulator implants to aid in bladder control

If you haven’t found success through other means, surgery may be recommended as a last resort.

Check out: 11 foods to avoid if you have OAB »

What is the outlook?

Your outlook for life with back pain and incontinence depends on whether you and your doctor are able to identify what’s causing the symptoms. If the cause can be identified, these conditions can be successfully treated. You may only experience symptoms for a short period of time.

In many cases, these symptoms are more long term. It can be difficult to determine the exact cause, and attempting to identify it through trial and error can take time. Diagnosing the cause and finding a treatment may take time and patience, but permanent relief from the symptoms is worth the effort.

How can back pain and incontinence be prevented?

If you’re experiencing infrequent bouts of back pain and incontinence, you may be able to reduce your risk for another episode.

Although your best line of defense is getting your doctor’s diagnosis, these general tips may be a helpful addition to your doctor’s treatment plan. Be sure to discuss your options with your doctor.

Prevention tips

  • Exercise: Regular exercise may help prevent weak back muscles, which reduces your risk for back pain. Similarly, exercise can increase your pelvic floor muscles. Stronger pelvic muscles make holding urine easier.
  • Maintain a healthy weight: Excess weight can cause both back pain and UI.
  • Eat a smart diet: Eating a balanced diet with plenty of fiber, lean protein, fruits, and vegetables can help you maintain your weight and fuel exercise. Likewise, a healthy diet reduces your risk for constipation. Constipation can cause both lower back pain and incontinence.
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