In a recent systematic review, a positive association of 83% was found between urinary incontinence and low back pain or pelvic girdle pain. Pelvic girdle pain is defined as the area below the low back and below the abdomen (gluteal region in the back and pubic bone in the front). The strength of this correlation depends on many factors such as type of urinary incontinence, pain severity, and length of pain.
The relationship between urinary incontinence and low back pain is seen equally in both men and women and can be applied to all folks. Low levels of low back pain were mostly associated with both, stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). Whereas high levels of low back pain were associated more with urge urinary incontinence. Based on one study by Stockil et al., SUI was seen more often with sudden onset pains than with chronic pain. Unfortunately, their sample of patients was limited, consisting mostly of young women who have never given birth. To measure the correlation more accurately, studies involving a broader population will need to be conducted.
A recent pilot study looked at how resilience affects patients with urinary chronic pelvic pain (UCPP) conditions and chronic overlapping pain conditions (COPCs).
Resilience can be defined as the “capacity to adapt successfully to disturbances that threaten a patient's viability, function or development.” (Southwick et al., 2014)
Resilience is now an important aspect in the treatment of pain, as it can increase psychosocial well‐being and the quality of life in patients living with chronic pain. (Casale et al., 2019)
Practicing social distancing and wearing a mask can make it quite difficult to have intimate relationships. Through the last year and half, we have learned more about COVID-19 and each and every day new data helps us better understand this virus and how to practice safe sex during COVID.
The virus spreads through infected saliva, mucus, or respiratory particles entering the eyes, nose, or mouth. This means it can be transmitted through kissing and close contact. Studies have also detected the virus in feces and in sperm in those infected (Diangeng et al., 2020). It is unknown at this point if the virus can be spread through sperm or feces. Educating yourself can be the key to safe sex during COVID.
About 13 million people in the United States experience some type of incontinence, or unwanted leakage of urine. More than 50% of women over 20 years old reported experiencing urinary incontinence at some point in their lives. Moderate to severe urinary incontinence is prevalent in 17% of women aged 20 years or older, but more commonly occurs in 38% of women aged 60 years or older.
Stress urinary incontinence is when leakage occurs during stress-induced activities such as exercises, coughs, and sneezes.
Urge urinary incontinence is leakage associated with urgency, and can make it difficult to hold the bladder without leaking. This can arise from poor bladder habits or overactive bladder syndrome (OAB). About 16% of the United States population are diagnosed with overactive bladder syndrome, which causes intense sudden urgency and frequency to urinate. This can cause depression, social and work disability for many adults.
For urge urinary incontinence alone, the estimated national costs in 2007 included 1.5 billion dollars in direct nonmedical costs (for example, incontinence pads). Depending on the type of incontinence and their comfort level, some people avoid certain activities or perform more “just-in-case” peeing to avoid leakage. There are also many products people use to help them continue those activities but in a more hygienic way.
There are also pharmaceutical treatments available that help improve urinary retention or affect pelvic nerves or muscles that may be the underlying cause for urinary incontinence. Along with incontinence products and/or medication to help you continue to do the things you love, it is best to have a specialized pelvic floor physical therapist by your side to help understand your bladder physiology and thus improve incontinence or prevent worsening of symptoms. This way, we can help you decrease incontinence, reduce reliance on such products, or reduce the absorbency needed so you can get back to doing the things that you love in a leak-free manner!
Sexual functioning can be defined as “specific physical, physiological, neurological and emotional behaviors expressed by an individual response” (Wood, 1984).
Some cancer treatments can cause unwanted side effects that affect our sexual health such as decreased sexual arousal or desire, vaginal stenosis (narrowing of the vaginal canal), dyspareunia (painful sexual intercourse), and bladder/bowel dysfunction. Issues with sexual function after cancer can affect our relationships with ourselves and with our partners, and reduce quality of life. Hopefully a physical therapist is part of your team to help guide you during this challenging time and minimize these aforementioned side effects. Otherwise, ask for a pelvic floor physical therapist to join your team during your recovery!
Tarlov cysts are sacral perineural cysts that consist of cerebrospinal fluid (CSF) close to the dorsal root ganglion on our sacral spine (the triangle shaped bone that connects to our tailbone). Tarlov cysts are often incidental findings on MRI’s, meaning most people with no symptoms may have Tarlov cyst(s). Paulsen, et al, looked at 500 MRIs of the lumbosacral spine and found an incidental rate of 4.6%; of which 20% were symptomatic. Approximately 1% of the cysts are large enough to cause compression, thus requiring prompt treatment.
Pelvic health is not only tied to females; males also experience pain in their pelvis including their bladder and rectum, but may also extend to their testicles, penis, prostate, etc. Common mens pelvic pain diagnoses include (but not limited to):
Just like females, males also have a pelvic floor that controls the sphincters to either contract or release (for holding in urine or releasing urine, respectively). When there is dysfunction or coordination issue (whether it is weakness or too tight) in the pelvic floor, incontinence can occur. The CDC estimates that almost 44% of men in the US who are not in an institution struggle with urinary incontinence.
June is Scoliosis Awareness Month! If you recall from part 1, scoliosis is a 3-D curvature of the spine. Some people get it in early childhood or adolescence, and others get it as an adult. This can lead to low back pain, breathing difficulties, and … affect the function of the pelvic floor muscles!
There are many different types. There is juvenile scoliosis starting at a young age, or adult-onset scoliosis. It can be categorized as congenital (some type of deformity causing irregular alignment), neuromuscular (neurological disease leading to asymmetries), or its most common form, idiopathic scoliosis (unknown).
We wanted to share this article that we found published by the New England Journal of Medicine. We all have a lot of ongoing questions about the ongoing COVID-19 vaccine, and this is a great resource that answers nearly every question we’ve had regarding testing, vaccines and more.
Image courtesy of NEJM
A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.
Chronic pelvic pain is generally defined by chronic pain in the region of the pelvis (Lai, 2015).
It is a common symptom that can be caused by several different structural and functional dysfunctions/disorders that affect the anorectal area, urinary bladder, reproductive system, and pelvic floor muscles. Unlike pelvic pain caused by structural diseases like endometriosis, pelvic pain linked with functional disorders cannot be explained by an organic or other specified pathological reason (Clemens, 2008).
Functional disorders that can cause pelvic pain are classified into three general categories:
**This information is for educational purposes only and is not intended to replace the advice of your doctor.