Back Pain and Numbness When Urinating: Causes and Solutions

When I feel the urge to urinate, I experience numbness and pain in my lower back?

When I feel the urge to urinate, I experience numbness and pain in my lower back.
I have visited two hospitals, and both urine tests came back normal.
They only prescribed me pain relievers and anti-inflammatory medication.
However, after more than four months, this suffering has not changed.
Could it be a spinal issue? I do have back pain, but this specific aching sensation seems different from the numbness and pain I feel in my lower back when I need to urinate.
Interestingly, the pain in my lower back suddenly disappears after I urinate.
I am at a loss as to which specialist to consult.
I am truly grateful for any guidance.
Additionally, I have had my kidneys checked, and one side showed the presence of uric acid crystals (I have gout), but the doctor said this is unrelated to the pain I experience in my lower back when I feel the urge to urinate.

Kang Shuyuan, 20~29 year old female. Ask Date: 2002/08/05

Dr. Song Zhixian reply Urology

Normal urine formed by the kidneys travels through the renal pelvis and ureters to reach the bladder.
During urination, urine in the bladder is expelled through the urethra, and there is no backflow of urine.
There is a condition known as "vesicoureteral reflux," which is caused by incomplete closure at the ureter-bladder junction, leading to the backflow of urine from the bladder to the kidneys (partially).
Increased bladder pressure can cause kidney pain and, in severe cases, can lead to hydronephrosis and recurrent infections.
A voiding cystourethrogram is needed for diagnosis.
You mentioned the presence of uric acid stones, which likely indicates that an ultrasound examination was performed.
If the doctor did not mention hydronephrosis, the issue may not be serious.
Nevertheless, please seek medical attention for a thorough examination.

Reply Date: 2002/08/05

More Info

Understanding back pain and numbness when urinating can be quite complex, especially when the symptoms persist despite multiple medical evaluations. Based on your description, it seems that you are experiencing a unique combination of symptoms that may be related to both your spine and urinary system.

Potential Causes of Your Symptoms
1. Spinal Issues: Given your history of back pain, it is plausible that your symptoms could be related to spinal problems, such as a herniated disc or spinal stenosis. These conditions can lead to nerve compression, which might cause pain or numbness that radiates to different parts of the body, including the lower back and legs. The fact that your back pain alleviates after urination suggests that there may be some form of nerve involvement that is temporarily relieved when your bladder is emptied.

2. Muscle Strain: Another possibility is that you may be experiencing muscle strain or tension in the lower back, which can be exacerbated by the act of urination. The muscles around the lumbar region can become tight and painful, especially if you are in a position that puts additional strain on them.

3. Urinary Tract Issues: Although your urine tests have returned normal, it is still worth considering that there could be a mild urinary tract issue that is not easily detectable. Conditions such as interstitial cystitis or bladder irritation can sometimes cause referred pain to the lower back.

4. Kidney Stones or Ureteral Issues: Given your history of uric acid crystals and gout, it is essential to consider the possibility of kidney stones or other ureteral issues that could cause pain during urination. Even if your kidney function tests are normal, stones can still cause intermittent pain.

Recommendations for Further Evaluation
1. Neurological Assessment: Since you are experiencing numbness and pain, a consultation with a neurologist may be beneficial. They can perform specific tests, such as nerve conduction studies or electromyography (EMG), to assess nerve function and determine if there is any nerve compression or damage.

2. Imaging Studies: An MRI of the lumbar spine may provide more detailed information about any potential disc herniation or spinal stenosis that could be contributing to your symptoms. This imaging can help visualize the spinal structures and any potential nerve involvement.

3. Urological Consultation: Since your symptoms are also related to urination, it may be worthwhile to see a urologist. They can conduct further evaluations, such as a cystoscopy or bladder function tests, to rule out any underlying urinary tract issues.

4. Physical Therapy: Engaging in physical therapy may help alleviate muscle tension and improve spinal alignment. A physical therapist can provide exercises tailored to strengthen the core and back muscles, which may help reduce pain.

5. Pain Management: If your pain persists, discussing pain management options with your healthcare provider may be beneficial. This could include medications, injections, or other therapies aimed at reducing inflammation and pain.

Conclusion
It is understandable to feel frustrated when symptoms persist despite medical evaluations. Given the complexity of your symptoms, a multidisciplinary approach involving neurologists, urologists, and physical therapists may provide the best chance for a comprehensive diagnosis and effective treatment plan. It is crucial to continue advocating for your health and seeking answers until you find a resolution to your pain and discomfort.

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