Back Pain and Incontinence — What It Is and How to Resolve It

Back Pain and Incontinence — What It Is and How to Resolve It

Back pain and incontinence are closely related and can occur simultaneously due to an underlying medical condition. For example, a pinched nerve can cause urinary problems and back pain. While you may not initially think these symptoms are related, both can occur because of a pinched nerve.

Back pain and incontinence are closely related and often occur when the sensitive spinal nerves are pinched, compressed or otherwise damaged. Nerve compression causes pain in the back and sometimes down the leg while inhibiting normal bowel and bladder function. Read more to learn about back pain and incontinence.

Schedule a consult

How Can Back Pain and Incontinence Be Connected?

Although we may not realize it, lower back pain and bowel incontinence are often directly related. Our bodies and organs are more connected than many people think, meaning an issue in one area can cause an issue in another part of the body.

Of course, the loss of bowel and bladder control with back pain can be embarrassing, painful and confusing. If you experience these symptoms, the first step to finding relief is understanding the connection between the two.

While some people may experience back pain and incontinence simultaneously, these symptoms don’t always occur at the same time. In some cases, there might be a short pause between a period of back pain and experiencing incontinence. However, these symptoms can be linked despite not happening simultaneously. It is also possible for a person to experience back pain and incontinence without them being directly connected.

Many health care professionals believe activating core muscles may trigger back pain while affecting your body’s ability to hold and release urine. There are several types of incontinence related to back pain, including:

Fecal incontinence: The inability to properly control bowel movements, causing feces (stool) to leak from the rectum. Fecal incontinence ranges from mild, occasional leakage to complete loss of one’s bowels. While many people feel embarrassed by fecal incontinence, approximately one out of every three people who see a primary health care provider experience fecal incontinence.
Overactive bladder (OAB): An overactive bladder causes the sudden and frequent need to urinate, which can be extremely difficult to control. OAB also causes a person to use the bathroom multiple times a night and may lead to urgency incontinence, or the unintentional loss of urine.
Overflow incontinence: Overflow incontinence occurs when your bladder can’t empty itself fully, even while urinating. Because your bladder can’t fully empty itself, small amounts of urine may leak out as the bladder becomes fuller.
Stress incontinence: Stress incontinence occurs when the bladder experiences stress or pressure from certain actions, such as laughing, bending, sneezing, coughing, lifting or exercising. Stress incontinence is more common when a person’s bladder is full.
Urinary incontinence: Urinary incontinence is the loss of bladder control, ranging from mild leakage to complete loss of bladder control. Urinary incontinence is more common in women and affects twice as many women than men.

Common Causes of Incontinence

Numerous conditions may cause a person to experience urinary or fecal incontinence. In some cases, these conditions may also cause back pain and discomfort. Some of the most common causes of incontinence include:

Herniated discs: Spinal discs are the rubbery cushions that rest between each bone (vertebrae) that stack and create the spinal column. A herniated disc is when the nucleus pushes through the annulus. A herniated disc is a progressive condition that may worsen over time, especially without proper treatment. In more severe cases, the disc may slip out significantly, causing incontinence. Approximately 2% of people develop a herniated disc each year.
Spinal cord injury (SCI): Some people may experience a spinal cord injury from an accident. In some cases, a spinal cord injury can disrupt communication between the spinal cord nerves that control the bowels and bladder, which can also cause incontinence.
Pregnancy: Pregnancy often causes back pain, especially later in the pregnancy. Pregnancy is also another common cause of incontinence. As a baby grows, it takes up more room. The uterus expands, causing pressure on the pelvic floor muscles, urethra and bladder. Pregnancy is the main risk factor leading to stress urinary incontinence.
Abscess: An abscess is a pocket of fluid or puss that can collect in organs and tissues throughout the body. Abscesses that form along the spinal column or near spinal structures can cause pain, infection and even fecal incontinence.
Kidney stones: Kidney stones can cause stabbing, sudden and intense pain. A kidney stone is a mineral deposit, which, in severe cases, can cause urinary complications, including urinary incontinence.
Spinal tumor: A spinal tumor is an abnormal growth that develops along the spinal column. Tumors can be cancerous (malignant) and non-cancerous (benign). Back pain is typically the first and most common symptom of a spinal tumor. In some cases, back pain may occur with incontinence.

Incontinence and Back Problems Risk Factors

While anyone may develop a medical condition that causes back problems and incontinence simultaneously, certain risk factors can increase the likelihood of developing both conditions. Some of the most common risk factors for developing back pain and incontinence simultaneously include:

Age: Back problems and incontinence are age-related conditions, meaning they likely occur with age. Back pain typically occurs from spinal degeneration or injury. With age, the bladder muscles often weaken, leading to an increased risk of incontinence.
Weight: Being overweight places additional strain on the spine, causing or aggravating painful spinal conditions like pinched nerves or herniated discs. Excess weight also increases pressure on the bowels, bladder and surrounding muscles. Excess weight can increase the risk of stress incontinence, which can further weaken muscles and lead to worsening incontinence.
Pre-existing medical conditions: Certain pre-existing medical conditions may increase the risk of back pain and incontinence. For example, diabetes and arthritis are two conditions that can cause incontinence and back pain.

Spinal Cord Injuries and Neurogenic Bladder Dysfunction

SCIs involve any damage to the spinal cord or the cauda equina — the nerves at the end of the spinal canal. SCIs range in severity and can cause permanent changes in bodily functions and changes in sensation and strength. An SCI can disrupt communication between the spinal cord nerves and brain.

The spinal cord nerves help with bladder and bowel function, meaning complications with these nerves can cause or worsen incontinence, known as neurogenic bladder dysfunction (NBD). Spinal cord infections and tumors may also lead to NBD.

Common symptoms of NBD related to SCIs include frequent urination, urinary incontinence, urinary tract infections (UTIs), kidney stones and the inability to empty the bladder fully. NBD may lead to cauda equina syndrome (CES).

Cauda Equina Syndrome (CES)

CES develops from the compression of the cauda equina — a sac of nerve roots and nerves at the spinal cord’s base located in the lumbosacral spinal canal. CES is a relatively rare medical condition with an incidence rate that affects approximately 1 of every 33,000 to 100,000 people.

The cauda equina nerves provide sensory and motor function to the bladder and legs. When these nerves experience compression, their natural function is inhibited, potentially causing severe side effects. CES can lead to both bowel and bladder dysfunction.

In severe cases, CES can even lead to permanent paralysis in the leg muscles, meaning it is important to see a professional health care provider as soon as possible if you are experiencing any CES symptoms. The cauda equina was given its name from the Latin words, translating to horse’s tail.

This sac of nerves and nerve roots is thought to resemble a horse’s tail, hence its name. CES can cause various symptoms, including severe back pain, sensory loss in the legs, difficulty walking, muscle weakness, reduction or loss of reflexes and saddle anesthesia — the loss of sensation in the areas of the body that would come into contact with a saddle.

Some patients may experience all of these symptoms, while others may experience only a few. Certain symptoms may not occur simultaneously, meaning they can develop in a unique order, and you may not initially link these symptoms to one another. Symptoms vary from person to person, depending on the degree of nerve compression.

Depending on the severity, CES may be a potential surgical emergency requiring prompt attention. In many cases, CES can be treated with decompression surgery to remove the pressure and strain on the nerve. Early intervention is essential for effective treatment.

Surgery is often more effective at improving muscle and sensory function and treating bowel and bladder dysfunction. Although CES surgery can improve bladder function, it may take the body longer to improve bladder function than muscle function.

Cervical Spinal Stenosis

Cervical spinal stenosis occurs when the spinal canal in the neck narrows. The spinal canal is the bone area between the vertebrae, which comprise the spinal column. The spinal cord is a bundle of nerves that run through the spinal canal from the brain’s base to the lower (lumbar) back.

These nerves are fundamental for bladder and bowel control, movement, sensation and other bodily processes. The cervical spine comprises the seven vertebrae of the upper spine. In cases of cervical spinal stenosis, the upper spinal canal in the neck narrows, compressing the nerve roots where they exit the spinal cord. In some cases, the spinal cord itself may become compressed.

The compression of these delicate nerves can cause stiffness, numbness, weakness and pain in the neck, legs and arms. Cervical spinal stenosis is often more common in those 50 years of age and older. Many people over the age of 50 may have slight spinal canal narrowing but don’t display symptoms.

The spinal canal narrowing only causes symptoms when the nerves are affected. While some symptoms may develop quickly, most cervical spinal stenosis occurs gradually over time. Common cervical spinal stenosis symptoms include balance coordination complications and overall stiffness.

Medication can alleviate painful symptoms in mild and some moderate cases of cervical spinal stenosis. Exercise and physical therapy are two other non-surgical treatments to maintain flexibility and strength without aggravating painful symptoms.

On the other hand, severe cervical spinal stenosis often requires decompressive surgery to alleviate the pressure placed on the spinal nerves. Depending on the individual case, a spinal surgeon may perform decompressive surgery through an incision at the back or front of the neck. In some cases, two or more vertebrae may need to be fused permanently to ensure spinal stability.

How to Manage Back Pain and Incontinence

Although back pain and incontinence can be embarrassing, talking to your physician about these symptoms is important. Finding an effective treatment for incontinence and back pain means determining the underlying medical condition for these symptoms. Once your physician can diagnose the cause of these symptoms, they can recommend effective treatments to improve your overall quality of life. Some effective ways to manage back pain and incontinence include:

Medication: Numerous over-the-counter pain medicines can minimize back pain, stiffness and some discomfort. In severe cases, a physician can recommend prescription pain medicine to improve symptoms. Certain medications can also improve symptoms of incontinence.
Physical therapy: Physical therapy is another effective way to manage back pain by strengthening the muscles and promoting flexibility and coordination. Physical therapy can also strengthen the pelvic floor muscles, helping reduce incontinence symptoms.
Diet: Your diet plays an important role in managing back pain. Research shows that diet can help minimize and even prevent inflammation, an important aspect of easing chronic pain. While there is no specific diet to eliminate incontinence, the foods you eat daily directly affect bladder and bowel leakage.
Exercise: If you have back pain, it may be a challenge to find the motivation to exercise. Light exercise can be extremely beneficial for back pain because it strengthens the leg, stomach and back muscles to support the spine. Certain exercises can also strengthen the pelvic floor muscles and may minimize incontinence symptoms.
Lifestyle products: As you address your symptoms, improvement may take time. Lifestyle products can help provide some immediate comfort as you work towards managing your underlying medical condition. For example, back braces can stabilize the spine and minimize back pain. On the other hand, incontinence products, such as pads or liners, help you complete daily tasks without worrying about leakage.

Contact Metropolitan Pain & Spine Institute

We are a leading provider of spinal care and treatments. Our team of spinal specialists is dedicated to improving back pain at its source and improving the quality of life for all patients. We understand back pain and incontinence can be painful and embarrassing. We approach each patient with the highest level of compassion and care, ensuring all their needs are met.

We treat various spinal conditions with innovative, state-of-the-art technology. Some of our most effective spinal treatments include trigger point injections, epidurals and radiofrequency ablations. We also offer medical branch blocks, percutaneous disc decompression and vertebroplasty.

Back Pain and Incontinence — What It Is and How to Resolve It