As you get older, it’s not unusual to have back pain. After all, it’s something roughly 90 percent of the population will end up facing at one time or another. Incontinence sometimes becomes an issue later in life as well, often for different and unrelated reasons. But there are times when back pain and incontinence are experienced at the same time. What’s the connection between the two?
Cauda Equina Syndrome (CES)
Incontinence is the inability to control the passage of urine or stool, and it’s sometimes a temporary problem. However, a lack of bowel or bladder control can also contribute to other serious health problems if it continues to be an issue for a longer period. If spine-related discomfort is part of the equation, you may have a condition known as cauda equina syndrome (CES).
CES is so named because it’s caused by compression or irritation affecting a bundle of nerves located in the lumbar (lower) spine area collectively called the cauda equina. This group of nerves is responsible for transmitting signals and sensations to the groin area. If you do have cauda equina syndrome, you may notice symptoms that include:
• Lower body weakness and/or numbness
• Weakness, tingling, or numbness extending to the legs and possibly to the feet
• An altered sensation within your “saddle region” (groin, buttocks, genitals, and upper thighs)
• Bladder or bowel incontinence
• Lower back pain that’s localized
• Stabbing or sharp pain in your lower extremities
Common Link: Nerve Compression
One small study found that more than 90 percent of patients with CES also had issues with urinary incontinence (UI) or dysfunction. The common link between CES and back pain appears to be nerve compression, which explains why a common cause of CES is disc herniation. Many people who experience recurrent disc herniations find relief through a surgical procedure called transforaminal interbody fusion. Santa Monica patients who have this procedure often experience a 60–70 percent improvement in their pain levels.
If a spinal disc’s inner material pushes outward, nearby nerves are sometimes irritated. This nerve irritation or compression may extend to nerves that play a role in controlling the signals that need to be sent to make your urological structures work effectively when you urinate or move your bowels. It should be noted that CES isn’t always caused by a herniated disc. Other possibilities include:
• An abscess near the spinal cord
• An accumulation of blood in the space around the spinal cord (epidural space) that results in nerve compression (epidural hematoma)
• A spinal growth (tumor) that forms in a location that compresses nerves affecting the spine and structures in the pelvic area
Non-CES Causes
Back pain and incontinence can occur together for reasons other than irritation or compression of the cauda equina nerves. You could also experience spine-related discomfort coupled with incontinence issues due to:
• Kidney stones
• Bladder or kidney infections
• Issues with artery walls in your abdominal area
• Spinal cord injuries (SCIs)
Because there are many possible factors that can contribute to back pain and incontinence, treatment may involve input from more than one specialist. For instance, you might see a Santa Monica spine surgeon for a herniated disc that’s contributing to the problem and be referred to a urologist if there are suspected issues with your bladder or kidneys that need to be addressed.
If you’re experiencing severe or persistent back pain, whether it’s accompanied by incontinence or not, make sure to see an experienced back pain specialist for prompt diagnosis and treatment. The industry-leading physicians at The Spine Institute are pioneers in spinal health, employing cutting-edge technology and innovative methods to enable patients to live pain-free, active lives. To schedule a personal consultation with one of our spinal health experts, give us a call today at 310-828-7757.