The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study

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.

Figures

Figure 1. Flowchart of subject selection for analyzable dataset

Note: KWHR = Kentucky Women’s Health Registry; SUI = stress urinary incontinence, MUI = mixed urinary incontinence; UUI = urge incontinence only. Exclusion 1 includes patients with a self-reported history of cancer, neurological disorders, bone disorders, pelvic disease or history of joint, spine and/or disc surgery. Exclusion 2 includes patients with missing data for chronic back pain. Exclusion 3 includes patients with missing data for UI. Exclusion 4 includes patients with missing data for type of UI (SUI or UUI). Exclusion 5 includes patients with missing data for any of the other variables included in the analysis. The final analyzable dataset included women who either reported No SUI, SUI only, or MUI (SUI and UUI). Women who reported UUI only were excluded from analyses.