Is there a link between back pain and urinary symptoms?

Area of Science:

• Epidemiology
• Urology
• Physiotherapy

Background:

• Low back pain (LBP) and urinary dysfunction are common conditions.
• A potential link between LBP and urinary symptoms exists, but the underlying mechanisms require further investigation.

Purpose of the Study:

• To systematically review epidemiological studies on the association between mechanical low back pain and urinary dysfunction.
• To explore evidence supporting a potential mechanism for this relationship.

Main Methods:

• A systematic online search was performed across EmBASE, Medline, CINAHL, and PEDro databases.
• Studies were screened by two reviewers using predefined inclusion/exclusion criteria, with data extracted and summarized via narrative review.
• Study quality was assessed for all included articles.

Main Results:

• Twenty-two studies were included, revealing a statistically significant association between low back pain and urinary incontinence or symptoms (aORs 1.1–3.1).
• This association remained consistent across different demographics and when adjusted for confounders.
• Pelvic floor dysfunction was prevalent in women with LBP, but pelvic floor physiotherapy yielded mixed results for improving LBP.

Conclusions:

• Epidemiological data strongly associate low back pain and urinary incontinence, suggesting a bidirectional predisposition.
• Current evidence for the efficacy of pelvic floor interventions in managing low back pain within this population is limited.
• The precise mechanism linking mechanical low back pain and urinary dysfunction remains unclear.