Low Back Pain:
A Link Between Back Pain and Urinary Incontinence
While under chiropractic treatment, it’s not uncommon for a patient to report improvement for an issue that seems unrelated to their chief complaint. For example, a patient with a temporomandibular disorder may experience an improvement in their jaw symptoms following treatment to the neck or upper back. Or treatment to improve hip function may also benefit the ankle or knee. In this article, we’re going to look at how treatment for low back pain may help a patient who also has urinary incontinence (UI) issues.
There are many potential causes for UI, but one contributing factor is weak pelvic floor muscles. Thus, it makes sense that treatment to address impaired pelvic function may benefit some UI patients. A 2018 Cochrane systemic review concluded that pelvic floor muscle training (PFMT) is more effective than either a sham treatment (placebo) or no treatment for some individuals with UI.
This is where back pain comes into play. It’s estimated that back pain will affect more than 80% of us during our lifetime. We often adjust how we perform everyday activities to avoid pain, both consciously and unconsciously. These abnormal movements can place added stress on other parts of the body. In the case of the lower back, altered function in the hips and pelvis is common.
A November 2019 study published in the Journal of Craniovertebral Junction & Spine concluded that individuals with lumbar degenerative disk disease, spondylolisthesis, and failed back surgery syndrome are more likely to exhibit abnormal spino-pelvic alignment. Overtime, these individuals can develop secondary conditions in the hip or pelvis, which can impair the function of soft tissues, including muscles, in the region. Or likewise, injury to the hips/pelvis can lead to dysfunction in the lower back, which may be why the patient sought care in the first place.
Doctors of chiropractic are trained to review a patient’s case history and conduct a thorough examination on the whole patient in order to identify contributing factors for the patient’s chief complaint. Hence the importance of noting all symptoms, even those that seem unrelated or may be embarrassing. If a low back pain patient’s history notes UI and the examination identifies abnormal pelvic posture, then treatment will likely address improving function in both the pelvis and low back to achieve a successful outcome.