The Association of Chronic Back Pain and Stress Urinary Incontinence

Abstract

Objective The objective of this study was to investigate the association between chronic back pain and urinary incontinence in women. Study Design This study was a cross-sectional, observational study. Background There are numerous factors associated with the development of back pain, yet little consideration has been given to the pelvic floor musculature and dysfunction of this musculature which may also cause urinary incontinence. Currently, limited research exists evaluating the relationship between back pain and urinary incontinence. Methods and Measures Data from a sample of 2,341 women from the Kentucky Women’s Health Registry were used for analysis. The primary variables of interest were self-reported chronic back pain (CBP) and stress urinary incontinence (SUI), with stress urinary incontinence serving as the primary dependent variable. Simple comparisons were performed using chi-square tests and two-sample t-tests, and multivariable associations were assessed using binary logistic regression. Results Reports of stress urinary incontinence were higher in women reporting CBP than those not reporting CBP (49.0% vs. 35.2%, p<0.01). After controlling for potential confounders, the adjusted SUI odds ratio for CBP versus not was 1.44 (95% CI 1.11, 1.86). Conclusion Women who report CBP have an increased odds of having SUI. Therefore, clinicians must consider this association and the relationship of relevant trunk muscles, including pelvic floor musculature, in patients presenting with CBP and/or UI.

Is there a link between back pain and urinary symptoms?

“…When stratified by age groups (younger, middle‐aged, and older people) or sex the results were similar. There were inconsistent results when examining the type of urinary incontinence (stress, urge, mixed) and its association with low back pain . When testing for a linear relationship between low back pain severity and frequency/degree of urinary incontinence some populations demonstrated this and others did not .…”

“…11,12 One study considered storage and voiding symptoms, 11 and four studies evaluated specific subtypes of incontinence. 5,6,11,12 The studies all demonstrated that there was a statistically significant association between the diagnosis of urinary incontinence or urinary symptoms and low back pain, with adjusted odds ratios varying from 1.1 to 3.1. When stratified by age groups (younger, middle-aged, and older people) 10,13,18 or sex 9 the results were similar.…”

“…There were inconsistent results when examining the type of urinary incontinence (stress, urge, mixed) and its association with low back pain. 5,6,12 When testing for a linear relationship between low back pain severity and frequency/degree of urinary incontinence some populations demonstrated this 10,13,18,19 and others did not. 15 Two retrospective cohort studies (conducted with the same source data) demonstrated that women with urinary incontinence who were free of low back pain at baseline had an increased risk of developing low back pain in the future.…”

“…Prior studies have suggested there is a link between low back pain and urinary incontinence, and this has been hypothesized to be mediated through pelvic floor dysfunction. 5,6 Our objective was to identify epidemiological studies of mechanical low back pain and urinary dysfunction and to identify potential evidence for a mechanism that would explain as the association between mechanical low back pain and urinary dysfunction.…”

Is there an association between back pain and stress incontinence in adults with cystic fibrosis? A retrospective cross-sectional study

“…There is a growing body of evidence demonstrating links between SUI and back pain [14][15][16]. In a study of 38,050 healthy Australian women [14], self-report data was used to establish associations between back pain, pelvic floor weakness and disorders of respiration, while considering confounding factors of BMI and physical activity.…”