Herniated Disc And Urinary Retention: Everything You Need To Know

Urinary retention is a common complication of a herniated disc. It affects men and women equally, but it’s more prevalent in older adults.

The bladder can swell because the muscle that controls its release becomes weakened.

If left untreated, urinary retention can lead to serious medical conditions like kidney damage or infections.

Fortunately, there are treatments for urinary retention including catheters and medications to help you regain control over your bladder again.

Causes of a herniated disc and urinary retention

A herniated disk occurs when the tough, fibrous rings in your spine called the annulus are torn or ruptured. This can cause pain and contribute to nerve problems. A person with a weak bladder may also feel like they have to urinate often or suddenly.

Pressure on the bladder from the herniated disc can also cause urine retention or a full feeling in your bladder that isn’t relieved by urination.

Urinary retention is most common in people over age 50 who have had spinal surgery, but you can develop urinary retention at any age and without any history of surgery.

Symptoms of a herniated disc and urinary retention

Signs and symptoms of a herniated disk may include:

• Intense back pain that can travel to your buttocks or legs, especially if you’re standing or walking

• Feeling like there’s pressure in your lower abdomen

• Muscle weakness in your lower body

• Nausea and vomiting

Signs and symptoms of urinary retention may include:

• Feeling like you have to urinate, but can’t or only a small amount comes out
• Pain while urinating
• A full feeling in your bladder that doesn’t go away after you urinate
• An urgent or sudden need to urinate
• Urine leakage, especially when you cough, sneeze, laugh or lift something

When to see a doctor for a herniated disc and urinary retention

If you have bladder control problems, see your doctor as soon as possible. Urinary retention can push on the kidneys, which may cause pain or other medical conditions including infections or kidney damage.

Your doctor can do tests that measure pressure in your bladder and other parts of your urinary tract. They may also remove some urine to see if there’s blood or other problems in your system.

Diagnosing a herniated disc and urinary retention

Your doctor will ask about your symptoms and medical history. Then they’ll do a physical exam. You may be referred to a doctor who specializes in urinary disorders for more tests. These may include:

• A cystometrogram where a catheter is inserted to measure the pressure in your bladder and other parts of your urinary tract

• A urodynamic study that measures the pressure, muscle function, and urine flow from your bladder

• magnetic resonance imaging (MRI)

• computed tomography (CT) scan

Treatment for urinary retention due to a herniated disc

Treatment for urinary retention caused by a herniated disk may include medication or catheterization. Catheterization involves inserting a thin, flexible tube into your urethra to drain your bladder. The tube is then removed.

Catheterization, if done too often or for a long time, can cause complications such as kidney infections or bladder stones.

Medications that may be prescribed include:

• Oxybutynin relaxes the smooth muscle around your bladder and urethra to make it easier to urinate
• Propantheline (Probanthine) which relaxes the smooth muscle around your bladder and urethra to make it easier to urinate
• Tamsulosin (Flomax), an alpha-1 blocker that reduces pain, urinary frequency, and urine leakage
• Imipramine (Tofranil), a tricyclic antidepressant that reduces pain, urinary frequency, and urine leakage
• Duloxetine (Cymbalta) treats depression and reduces pain, urinary frequency, and urine leakage.

The first step should be conservative treatments and medications. As a second step, herniation surgery may be necessary.

If you have symptoms that are more severe, your doctor may recommend surgery to repair the herniated disk.

You may also need surgery if you develop kidney problems or infections after urinary retention due to a herniated disc.

What disc causes bladder issues?

The intervertebral discs support the spine. The lumbar discs are located in the lower back (lumbar region). You have five discs in your lumbar spine that separate and cushion each of your vertebrae. A thin, fluid-filled space between each vertebra allows movement in your back.

Everyday activities put stress on your spine. This leads to wear and tear of the discs in your lower back, which can lead to pain or a herniated disc. The outside of an intervertebral disc is made up of cartilage. The center is made of a rubbery material called the nucleus pulposus.

The outer layer of each disc is made up of layered, strong fibers. The fibers help the thin outer layer withstand stress and pressure.

Your body makes new intervertebral discs as you age, which helps account for pain that occurs in your lower back as you get older. However, severe or heavy lifting can speed up this process if the loads are too big for your discs to carry.

Can a herniated disc cause urinary retention?

A lumbar herniated disc is a painful and debilitating injury to the discs located in your lower back. The discs are the shock-absorbing components in between your spine’s vertebrae.

When a disc herniates, it means that an outer portion of this thick, pulpy material also called the nucleus bulges through the outer annulus (the disc’s tough, fibrous exterior ring), and can press against a nerve root.

The compressed spinal nerve often causes radiating pain in the buttocks, lower back, and legs. The most common cause for a herniated disc is trauma or injury to your spine from an automobile accident or fall.

In many cases, a lumbar herniated disc is associated with urinary retention. Bladder problems due to a herniated disc occur when:

• The spinal nerve root lying next to the bulging disc is pinched and irritated, causing pain and bladder dysfunction
• There’s increased pressure on your lumbar spine from the bulge in the disc, putting pressure on the back of your spinal cord. This can cause bladder problems due to central neurologic involvement
• The pressure on your spine causes a reduction in the space inside your spinal canal. This causes anatomical changes and impedes proper urine flow
• There’s both central and peripheral neurologic involvement due to the bulge, which also impairs bladder function

What are the first signs of cauda equina?

Cauda equina is a rare medical condition in which nerve roots in your lower back are compressed. Nerve damage due to cauda equina can change the way you walk, urinate or have bowel movements.

Cauda equina usually occurs at the L4-S1 vertebrae. It’s most common in people over age 50, although it has also been diagnosed in children.

Cauda equina is caused by swelling of the disc between your vertebrae or by a condition that affects one or more of your nerve roots. Other common causes include:

• Overuse of pain medications

• Infections that cause inflammation around your spine

• A history of spinal stenosis

• Back or neck injury that causes nerve root damage

Cauda equina symptoms include:

Cauda equina may also cause changes in how you urinate, defecate and have bowel movements. Cauda equina is a medical condition that can’t be self-diagnosed. You should see your doctor if you have any of the symptoms listed above. If possible, take someone with you who can help with directions when you leave the hospital or doctor’s office.

A spinal tap may be needed to diagnose cauda equina in which nerve roots are compressed in your lower back. This test can show how much pressure is on your spinal cord and nerve roots. It can also show whether you have any infection, bleeding, or other problems affecting the nerves in your lower back.

Cauda equina symptoms are similar to those of a herniated disc, which is another condition that can cause pain in your lower back. Your doctor will determine what’s causing your symptoms by asking about your symptoms and examining you. You may be referred to a doctor who specializes in treating nerve problems (neurologist) for more tests.

• Pain that starts suddenly or becomes worse quickly
• Numbness, weakness, tingling, or loss of feeling in your legs
• Bowel or bladder control problems
• Pain that gets worse when you cough, laugh, or sneeze
• Muscle weakness in your legs or problems with coordination
• Cauda equina symptoms often come on quickly and can get worse very fast. It’s important to see your doctor right away if you have any of these signs and symptoms. If possible, take someone with you who can help with directions when you leave the hospital or doctor’s office.

Cauda equina is a medical emergency that requires immediate treatment. If possible, call 911 to go to the nearest emergency room. Or visit your local emergency room or urgent care center right away. You may need tests to diagnose cauda equina, including a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan.