Back pain incontinence is a dreaded combination of dorsalgia symptoms that are experienced along with the inability to control the bladder or bowels. Incontinence is one of the worst possible and most life-affecting of all back pain symptoms. Patients who are stricken with urinary or fecal incontinence are greatly limited in their lifestyles and also typically suffer a variety of truly horrible psychoemotional consequences.
Incontinence can be caused by many possible reasons, including those sources directly linked to a back pain problem. However, there are many patient profiles where the pain and incontinence are unrelated to the same process, making diagnostic evaluation a more complicated puzzle that often requires multiple specialists in different medical disciplines to decipher.
This discussion covers the sensitive subject of bladder and bowel control dysfunction, with a focus on spinally-motivated causations. We will also examine instances where the back or neck pain might be independent to incontinence, as well as circumstances where one or both symptoms may be the result of the mindbody interactions.
Unrelated Back Pain and Incontinence
Back pain is an extremely common symptom experienced by the majority of people at some point in life. Fortunately, back pain incontinence is not. Statistics clearly reveal that many of the people with back pain have long struggles with the condition that can last years, decades or even an entire lifetime of recurrent or chronic symptomology.
Some back pain patients will also develop incontinence at some point in life, even though the bladder or bowel issues are not related to the incidental pain complaint. It is crucial to understand that symptomatic separation is possible, in order to improve treatment results for both independent problems. Unfortunately, we have seen many people who have struggled with back pain for an extended duration be forced into unneeded surgical interventions when their incontinence conditions were mistakenly attributed to the same (usually spinal) cause as their dorsalgia. In these scenarios, treatment results are generally poor and a great number of these patients suffered through surgery and still demonstrated bowel or bladder problems postoperatively, even though their spinal problems were structurally resolved to the surgeon’s satisfaction. This is a common form of iatrogenic error that we see daily in the back pain therapy sector of medicine.
Some of the many possible reasons for incontinence to exist completely unrelated to a back or neck pain expressions include any of the following causative circumstances:
Various local bowel or bladder diseases, infections and conditions can create incontinence. These conditions originate in the organ itself and are not linked to a systemic or neurological causation.
Systemic diseases and conditions can affect the bowel or bladder and create dysfunction. These problems range from cancer to neuromuscular disease problems.
Incontinence can be the side effect of some pharmaceutical products and some illicit drugs. Bladder and bowel problems might also originate from drug or substance interactions when the patient is using multiple pharmacological therapies simultaneously or in combination with alcohol or illicit drugs.
Incontinence can come from the mindbody interactions, even when the back or neck symptomology is derived through purely structural mechanisms. This possibility is covered in detail in the final section of this essay.
Incontinence and Back Pain May be Related
In some patients, incontinence may be the direct result of the same causation which is eliciting the back pain symptoms. In virtually all of these cases, the dual symptomologies will be linked to one of two possible causative mechanisms: spinal neurological dysfunction or mindbody origin.
Spinal structural issues can certainly create pain and their effects on the spinal cord and spinal nerve roots can also create dysfunction in the bladder, bowel or virtually any of the body’s many anatomical organs or systems. Remember that the spinal cord and nerves transmit virtually all the motor, sensory and autonomic messages between the brain and the body. Our bowels and bladder operate because of these complex commands from the brain and when the messages are interrupted or changed by neurological impairment, the organs may demonstrate a variety of symptoms including incontinence. For clarification, when we are discussing the bladder and bowel in this regard, we are talking about the larger organ systems including the controlling nerves, muscles and other tissues that regulate proper functionality. Therefore, innervation problems to any of these tissues can create the type of bowel and bladder problems commonly experienced by back and neck pain sufferers.
Some of the more common reasons for structural causation of dorsal pain and related bladder and/or bowel issues include any of these listed factors:
Central spinal stenosis virtually anywhere in the vertebral column can cause pain, neurological expressions and bowel or bladder problems. This stenosis might be enacted by a diverse range of causative conditions including herniated discs, ligamentous hypertrophy, spinal osteoarthritis, spondylolisthesis, scoliosis, or lordotic and kyphotic curvature alterations in the backbone. Any of these conditions can reduce the patency of the central canal though structural impingement or misalignment, potentially compressing the spinal cord, cauda equina or individual nerve roots within the main vertebral canal.
Neuroforaminal and lateral recess stenosis (especially over multiple lumbar or lumbosacral levels) can affect the lower nerve roots that provide some degree of interaction with bladder or bowel. This is not a common event, since most of the appropriate nerve tissues exit the spine in the lower levels of the sacrum, where foraminal stenosis is virtually a nonissue.
Spinal cord injury or cauda equina trauma can both create wide-ranging symptoms including back pain incontinence of bladder and/or bowel.
Alternatively, both the back pain and incontinence might be created by a mindbody process, which is seen in many more cases than are actively diagnosed. Once again, this possibility is detailed in the section immediately below.
Psychogenic Back Pain Incontinence
Psychoemotionally-motivated back pain is truly an rampant problem that rarely receives the benefit of a correct diagnosis. Instead, most cases are incorrectly linked to some structural issue in the spine which is deemed causative, even though the condition is incidental. This is one of the main explanations for why back pain treatment fails so many patients, with so many different diagnoses. It is also one of the prime motivating factors for why we continue to educate the public about these mindbody disorders through the writings on our websites.
While mindbody back pain is swept neatly under the rug, mindbody variants of incontinence are regularly diagnosed within the traditional medical establishment. Many patients have bowel or bladder symptoms that can not be traced to organ or tissue dysfunction and the innervation patterns also check out just fine. We have received many accounts from patients whose physicians told them that their incontinence might be related to stress or anxiety. In fact, it is often these tips that eventually lead patients to link their back pain to the very same causative psychological process and find relief from both sets of agonizing problems.
Typically, both back pain and incontinence that are initiated and perpetuated by the subconscious mind utilize the process of oxygen deprivation to target specific nerves or muscle structures in various areas of the anatomy. It is this ischemia that creates pain and dysfunction in patients, typically in a regional area, such as the lower back, buttocks and pelvis. Since many nerves and muscles might be affected locally, symptoms commonly include lower back pain, sciatica, bowel and bladder dysfunction, perineum pain and sexual dysfunction.
It is vital to remember that most of these back pain incontinence problems are not actually linked to the conscious stress and anxiety that patients are aware of. Instead, the causative issues usually reside deeper in the recesses of the subconscious mind and are often repressed, suppressed or completely unconscious, so that the patient may be completely at a loss to explain why they are suffering so. Luckily, targeted psychoemotional therapies can help to bring out relief when patients are lucky enough to acknowledge the need for some alternative medicine practices.