Sometimes, back pain and incontinence can co-occur as two symptoms of the same condition, such as cauda equina syndrome (CES). At other times, they may develop at the same time but be due to other, unrelated conditions.
Incontinence is a condition wherein a person cannot control how or when their body passes stool (fecal incontinence) or urine (urinary incontinence).
If back pain and incontinence appear suddenly at the same time, it usually indicates a serious problem. For this reason, a person should seek immediate medical attention to uncover the likely cause and receive appropriate treatment.
In this article, we cover some of the conditions that can cause both symptoms to occur at the same time. We also examine potential causes of back pain and incontinence separately, along with treatment options for both.
CES is a rare syndrome that results in back pain and incontinence.
The syndrome develops due to compression on the cauda equina, a bundle of nerves in the lower back that is responsible for providing sensation to the groin area.
According to an article in the European Spine Journal, a survey of 75 people with CES found that urinary dysfunction was a symptom for 92% of them. In over half of these cases, the urinary dysfunction took the form of a reduced feeling of passing urine or mild incontinence.
Around 74% of the survey respondents reported experiencing fecal dysfunction, which may include incontinence.
The most common cause of CES is a herniated disk. Disk herniation can occur when the protective disk between the vertebrae, or spinal bones, slips out of place.
The following are some other potential causes of CES that can cause back pain and incontinence to co-occur:
- Abscess: An abscess is a pocket of pus that can develop in the epidural or spinal spaces around the spinal cord. Several layers of tissue protect the spinal cord, and the spaces in-between are subject to infection.
- Epidural hematoma: This is a buildup of blood in the epidural space of the spine. The blood can build up and press on the nerves. This tends to occur after having an epidural for childbirth.
- Spinal tumor: A spinal tumor is an uncontrolled growth of cells that develops in or around the spine. Sometimes, the tumors are cancerous.
Other conditions that can cause back pain and incontinence to occur at the same time include:
- kidney stones
- a burst artery wall in the abdomen
- spinal cord injury
The sudden onset of incontinence and lower back pain is a medical emergency that requires immediate evaluation and treatment. If a person does not receive treatment promptly, they may be at greater risk of permanent nerve damage.
The back undergoes a lot of wear and tear due to twisting, lifting, and supporting a person’s body weight.
There are many possible causes of back pain. They may occur at the same time as urinary incontinence, though the two symptoms are not always related.
- fibromyalgia, a chronic pain syndrome
- inflammatory medical conditions, such as rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis
- osteoporosis, a condition wherein bone density decreases
- physical inactivity
- poor posture
- scoliosis, a condition that causes the spine to curve sideways
Some people have a family history of spine problems and disorders. This can make a person more likely to experience back pain themselves.
Incontinence can affect the bowel, the bladder, or both.
Sometimes, incontinence occurs when the nerves that sense when the body should release urine or stool do not work as they should.
At other times, incontinence is related to damaged or overactive muscles and ligaments that make up the bladder and its surrounding structures.
Some common causes of incontinence include:
- being older
- overactive bladder
- prostate problems, such as prostate cancer or an enlarged prostate
- taking certain medications, such as blood pressure drugs or muscle relaxants
- urinary tract infections
Consuming foods and drinks that irritate the bladder can also increase the risk of incontinence. Examples of these include caffeine and alcohol.
Learn more about the causes of urinary incontinence and bowel incontinence here.
When incontinence and back pain arise due to a single underlying condition, they are not usually symptoms that a person can treat at home.
However, a person can try the following steps to try to improve their symptoms:
- Avoid substances that worsen incontinence. These include caffeine, alcohol, and carbonated beverages.
- Try nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen and naproxen. NSAIDs can help relieve pain and reduce the inflammation that can lead to discomfort.
- Apply a cloth-covered ice pack to the back for 10 minutes at a time. This can help relieve irritation and swelling that can cause back pain and discomfort.
- Avoid smoking. Smoking is a known risk factor for incontinence and can also contribute to the development of conditions that cause back pain.
A person can also review the medications they currently take with their doctor. However, they should not stop taking any medications without a doctor’s approval.
If someone has a herniated disk, there are several exercises that may help relieve pain. Gentle activities, such as swimming and yoga, can also be beneficial.
In many cases, a herniated disk can be a progressive condition. A person might experience back pain for some time. If the disk begins to slip out of place significantly, incontinence can occur.
As a result, the sudden onset of unexplained urinary incontinence can indicate that a person may need to seek immediate medical attention.
The following signs may also indicate that back pain and incontinence together could be a medical emergency:
- a fever higher than 103°F (39.4°C)
- loss of ability to move the legs or sense the lower body
- severe pain
- tingling or numbness down both legs
In most instances, incontinence and back pain are a medical emergency when they suddenly occur together.
If a person experiences either symptom separately, they should talk to their doctor. Many treatment options are available for both incontinence and back pain.
Incontinence and back pain can be concerning symptoms that, when they appear together, often represent a medical emergency, such as an epidural hematoma or severely herniated disk.
It is possible for both symptoms occur at the same time due to separate and unrelated conditions. If this is the case, each condition will require separate treatments.
Seeking medical treatment can help ensure a person does not experience permanent damage related to nerve compression.