Lower Back Pain Linked to Urinary Urgency: A Guide

If there is a thought of pain in the lower back, it may cause discomfort?

Hello Doctor, I would like to ask about an issue I have.
When I have a slight urge to urinate, I feel a bit of pressure pain in my lower back (it's a dull ache, and my daily activities are still normal, including sleep).
When I go to urinate, if the urge is strong, I can urinate quickly; if the urge is weak, it takes a long time, but there is no pain.
I usually drink tea, soy milk, and soup, and whenever I feel the urge to urinate, it puts pressure on my lower back, which makes daily life a bit inconvenient.

After sexual intercourse, the pain between my lower back on both sides intensifies slightly, but over time, the pain eases a bit.
Additionally, there is more noticeable pain on the left side of my lower back (my left side when facing you), which I injured years ago from a fall.
I did not have this issue before; although the pain from the previous injury has subsided, I had more frequent sexual activity, and over time, I started to feel a dull ache in the left lower back (including the area of the injury), and later, the right side also began to hurt.
Currently, I have reduced sexual activity, but the pressure pain on both sides reappears whenever I have the urge to urinate.

Could you please advise if I have sustained an injury in that area? I do not smoke or drink alcohol, and my lifestyle includes staying up late.
My pain is primarily in the lower back.
I plan to see a doctor; should I consult a urologist? Thank you, Doctor, for taking the time to read my question, and I appreciate your response.
Thank you.

A-Bao, 20~29 year old female. Ask Date: 2009/12/13

Dr. Xu Weikai reply Urology

Hello, based on your description, it is difficult to determine the cause.
You may want to consult with a rehabilitation specialist or an orthopedic doctor to confirm whether there is any nerve compression in the lumbar spine.
Additionally, a urologist can evaluate your sexual function and suggest possible ways to improve it.
If there are any unclear points, feel free to ask again, and we can further discuss and research the issue together.

Sincerely,
Dr.
Hsu Wei-Kai
Chief, Urology Department
Taitung Hospital, Department of Health, Executive Yuan

Reply Date: 2009/12/13

More Info

Lower back pain associated with urinary urgency can be a complex issue that may involve multiple underlying factors. Your description of experiencing a dull, pressing pain in the lower back when you feel the urge to urinate, along with the exacerbation of pain after sexual activity, suggests that there may be a connection between your urinary system and your musculoskeletal health.

Understanding the Connection
1. Anatomical Considerations: The lower back, or lumbar region, is closely associated with the pelvic organs, including the bladder. The nerves that supply the bladder also innervate the lower back, which can lead to referred pain. When the bladder fills and puts pressure on surrounding structures, it can cause discomfort in the lower back.

2. Muscle and Nerve Interaction: The pelvic floor muscles and the muscles of the lower back work together to support the pelvis and spine. If there is tension or dysfunction in these muscles, it can lead to pain in the lower back, especially during activities that increase intra-abdominal pressure, such as urination or sexual activity.

3. Previous Injury: You mentioned a past injury from a fall, which may have resulted in lingering musculoskeletal issues. Scar tissue or changes in muscle tone from the injury could contribute to your current symptoms. The fact that you experience more pain on the left side, where you had the injury, suggests that there may be a chronic issue in that area.

Recommendations for Management
1. Consultation with Specialists: Given the interplay between your urinary symptoms and lower back pain, it would be prudent to consult both a urologist and a physical therapist or orthopedic specialist. The urologist can assess for any urinary tract issues, while the orthopedic specialist can evaluate your musculoskeletal health.

2. Physical Therapy: A physical therapist can help you with exercises to strengthen the pelvic floor and lower back muscles, improve flexibility, and reduce pain. They may also employ modalities such as heat, ultrasound, or electrical stimulation to alleviate pain.

3. Pain Management: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. However, it is essential to use these medications as directed and consult with a healthcare provider if you have any underlying health conditions.

4. Lifestyle Modifications: Consider adjusting your fluid intake to see if it affects your urinary urgency and back pain. Keeping a bladder diary can help identify patterns and triggers. Additionally, practicing good posture and ergonomics, especially during activities that involve bending or lifting, can help reduce strain on your lower back.

5. Mind-Body Techniques: Stress and anxiety can exacerbate pain perception. Techniques such as mindfulness, yoga, or meditation may help you manage stress and improve your overall well-being.

Conclusion
Your symptoms warrant a thorough evaluation to determine the exact cause of your lower back pain and its relationship with urinary urgency. While it is possible that your pain is related to previous injuries and muscle tension, a comprehensive assessment by healthcare professionals will provide clarity and guide you toward effective treatment options. Don't hesitate to seek medical advice, as early intervention can lead to better outcomes and improved quality of life.

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