Back Pain and Incontinence: What Can I Do?

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

Mostly symptoms of UI depend on the type you have. The types and symptoms of UI 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. And, 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 affected 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.

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

A Brazilian study published in 2015, explored the 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 affected their urinary health.

In a 2015 study of women one year after giving birth, researchers found that back pain and UI are common. This study showed back pain is more common and more likely to interfere with a woman’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 of UI. The study found no connection between women who experienced back pain and their episodes of UI.

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

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

• Obesity: Carrying extra weight puts 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 affect bladder control lose strength as you grow older.
• Other diseases: Some conditions, such as arthritis and diabetes, can cause both back pain and incontinence. People with certain psychological conditions, such as anxiety and depression, are also more likely to experience back pain.

Though rare, one disorder that could cause back pain and UI is cauda equina syndrome (CES). CES affects the bundle of nerve roots at the end of your spinal cord. These nerve roots send and receive signals from your brain and 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 disc may also put pressure on the nerve roots. This disc and the pressure on the nerve roots can lead to back pain.

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

The only way to diagnose the underlying cause of both back pain and UI is to see your doctor and receive a full medical exam. The exam can help your doctor decide whether your symptoms are related to a separate condition that needs attention.

During the exam, it’s important you detail any symptoms, when you experience them, and how you relieve them.

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

If your doctor can’t reach a diagnosis, they may refer you to a urologist or a back pain specialist.

Treatment for back pain and UI relies on finding an underlying cause. Once you and your doctor understand what’s causing your symptoms, you can develop a plan to 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 empty your bladder
• scheduling toilet breaks
• doing pelvic floor muscle exercises
• taking 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 help:

• 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, your doctor may recommend surgery.

Your outlook for life with back pain and UI depends on whether you and your doctor can identify what’s causing the symptoms. If you find the cause, your symptoms can be treated.

In other cases, symptoms may be long term.

It can be difficult to determine the cause for your symptoms. And, identifying it can take time. But permanent relief from symptoms is worth the effort.

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

However, your best line of defense is having your doctor diagnose the condition and setting up a treatment plan.