The human neck is fascinating. Along with the spinal cord, it’s strong enough to hold you up — with the help of surrounding muscles of course — as you stroll through life. Yet at the same time, it’s fragile.
Damage to your neck can affect parts of your body that you may not have considered, like your bladder.
At Houston Pain Specialists, board-certified pain management specialist and anesthesiologist Hui Kang, MD, has the expertise to diagnose and treat the cause of your neck pain. In this blog, we discuss the link between your neck and your bladder.
The neck bone’s connected to the …
Your neck contains several important structures, including but certainly not limited to the seven cervical vertebrae, the enclosed spinal cord, and the spinal canal.
The spinal canal is formed by the bones of your spine and protects your spinal cord, which is a big bundle of nerves that allows you to move, feel, and control important bodily functions like bladder and bowel control.
If any kind of damage occurs in this area, your bladder, among other organs, can be affected.
Cervical spinal stenosis
In the case of cervical spinal stenosis, the spinal canal narrows and puts pressure on the nerve roots and can even damage the spinal cord.
The compression on the nerves and spinal cord in the cervical spine can change how the functions of the spinal cord work and cause various issues like pain, numbness, and loss of bladder control.
Cervical spinal stenosis most commonly occurs in people ages 50 and up. In rare instances, people may be born with a narrow spinal canal.
Symptoms develop gradually and may not even be noticeable at first. Severe cervical spinal stenosis can be crippling, so being aware of the symptoms and seeking help early can make all the difference. These symptoms include:
Problems with balance and coordination
Stiffness, numbness, weakness, or pain in your neck, shoulders, hands, arms, or legs
Incontinence
Spinal cord injury
Injury to your spinal cord can disrupt the communication between your brain and the nerves in your spinal cord that help control bladder function, resulting in incontinence. This dysfunction is called neurogenic bladder. Spinal cord tumors and infection can also cause neurogenic bladder.
If you experience a spinal cord injury, you may develop symptoms of neurogenic bladder, including:
Urinary tract infections
Frequent urination
Inability to completely empty your bladder
Urinary incontinence
Kidney stones
Neck pain can be a symptom of many things, but if it doesn’t go away on its own, it could be a sign of something serious.
A simple epidural may be all you need to alleviate your pain or eliminate it all together. In most cases, a cervical epidural could delay or even prevent the need for surgery. But surgical intervention may be necessary in severe cases.
Don’t wait until your case becomes serious. Give our office a call today to schedule an appointment, or contact us using our online form.
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If your spinal cord is damaged, the ability for the signals to travel back and forth is impaired, resulting in bladder emptying problems.
There are different types of damage to the spinal cord. The higher up in the spinal cord an injury occurs, the more muscles are affected. In the case of paraplegia, the spinal cord is so damaged that the legs are affected. In the case of tetraplegia, both arms and legs are affected.
Complete spinal cord damage means that the spinal cord has been completely cut off. No signals can travel along it, which means that all feeling and ability to move is gone below the point of injury.
If the damage is incomplete, you experience a certain loss of the ability to control your muscles. But some signals will still go through. If you have some motor control in your hands and arms, you will most likely be able to choose self-catheterization as a bladder emptying option.
The anatomical location and severity of your injury will determine the type of bladder condition you will have. Simply put, the higher the injury is located, the more serious it may be for your health. This is due to loss of steering and control of urination from the brain, and its centers. An injury above anatomical level of vertebra TH12/L1 may cause something called detrusor-sphincter dyssenergia. This means when no central steering of nerves is present, a reflex center takes over, leaving a chaos of impulses going through to the bladder and sphincter. The result is that the bladder and sphincter are working against each other which is dangerous since high pressure builds up in the bladder, causing urine to back up to the kidneys which potentially can destroy them. This is also associated with an increased risk of infection and incontinence. First line treatment is to reduce bladder pressure with pharmaceuticals and emptying the bladder with Clean Intermittent Catheterization (CIC).
If you have an injury lower in your spinal cord at or below anatomic level of TH12/L1 you lose muscle tone in the bladder and sphincter. Due to the fact that this region is responsible for reflex bladder emptying, a complete injury results in areflexia of the detrusor (missing contraction of the bladder muscle).
Damage below this reflex center affects some or all of the nerves in this region, depending on the type of lesion. If all nerve roots are affected, the condition of acontractile detrusor and sphincter occurs. However incomplete lesions are most common. And then only some nerve fibers are affected, so it may partly function. For example, filling of the bladder may be registered, but activation of the detrusor and/or sphincter is not possible.
A low spinal cord injury results in retention or incomplete emptying, urinary tract infections and (overflow) incontinence. First line treatment is CIC.
It is also worth mentioning that recent studies indicate that up to 30% of those who lose control of their bladder, may regain function again some time after injury.
You can also find additional information in our enCATHopedia Leaflet.
Various nerves control bladder and bowel function. They are responsible for moving food through the digestive system, controlling the anal sphincter, and emptying the bladder and bowel.
These nerves include the spinal cord, cauda equina, pudendal nerves, and the enteric nervous system, which is a complex network of nerves present in the walls of the digestive tract.
If nerves that control the bladder or bowel become damaged, it can result in urinary or fecal incontinence. Conditions that may cause this include herniated discs, spinal cord injuries, and cauda equina syndrome.
Read on to learn more about the nerves that control bladder and bowel function and the conditions that can affect them.
Many nerves are involved in bladder and bowel control. Some of the main nerves responsible for this include:
- The spinal cord: This is the main pathway for nerve signals between the brain and the bladder and bowel. The spinal cord lies inside the bones of the spine.
- The cauda equina: This is a group of nerve roots at the lower end of the spinal cord. They provide sensation and control of movement to the lower part of the body, including the bladder and bowel.
- Pudendal nerves: There are pudendal nerves on the left and right sides of the body within the pelvis. They affect fecal and urinary control.
- Pelvic parasympathetic nerves: These nerves begin at the sacral level of the spinal cord, which is the lowest part of the spine above the coccyx. They stimulate the bladder and relax the urethra.
- Lumbar sympathetic nerves: These nerves of the lower region of the spine stimulate the base of the bladder and urethra.
The body has several nerves that work together to coordinate bladder function. They allow the bladder to hold or expel urine as appropriate by telling the bladder muscles to tighten or release.
The cauda equina
The cauda equina is a group of nerves and nerve roots that stems from the lower end of the spinal cord and helps control the bladder. If the nerves become damaged, people may experience urinary retention or incontinence.
Pelvic parasympathetic nerves
Doctors may also refer to these nerves as the pelvic splanchnic nerves. They arise from the sacral level of the spinal cord and trigger bladder contraction during urination.
Pudendal nerves
The pudendal nerves stimulate the pelvic floor muscles, the anal sphincter, and pelvic organs.
There is a pudendal nerve for each side of the body, arising from the sacral plexus, the lowest part of the spine above the tailbone. The sacral plexus is a complex network of nerves situated at the back of the pelvis.
Lumbar sympathetic nerves
The lumbar sympathetic nerves are a bundle of nerves that lie in front of the spine in the lower back. They carry sympathetic nerve signals from the lower extremities that control urine storage in the bladder.
Several nerves help control bowel function, digestion, and excretion. This includes the pudendal nerves and the cauda equina, which provides sensation and control of movement to the lower part of the body, including the bowel, anus, and perineum.
However, the primary nerve pathway that controls bowel function is the enteric nervous system (ENS), a complex network of nerves present in the walls of the gastrointestinal tract. It controls the wave-like contractions that push food through the gut, also known as peristalsis.
The ENS also regulates the opening and closing of the sphincters, which are the muscle bands that control the passage of food waste. Usually, signals from the brain and spinal cord control this. For example, the ENS may receive signals to speed up or slow down digestion based on emotional stress.
If necessary, the ENS can also function independently. For example, if a person’s brain no longer controls peristalsis, the ENS would still work to push food through the digestive system.
Several conditions can affect the nerves that control bowel or bladder function.
Cauda equina syndrome
Cauda equina syndrome (CES) may develop if the cauda equina nerves become compressed. It is a rare but serious condition.
Because the cauda equina sends sensations to the bladder, bowel, and legs, people with CES can lose muscle sensation, resulting in loss of bladder and bowel control.
In a 2017 survey of 75 people with CES, urinary problems were a symptom for 92% of the participants. This includes mild incontinence and being unable to fully feel the sensation of passing urine. Almost three-quarters of the respondents also experienced fecal dysfunction.
Spinal cord injury
Spinal cord injuries can disrupt communication between the brain and the nerves of the spinal cord that control the bladder and bowel. This can result in a neurogenic bladder or neurogenic bowel. A person with a neurogenic bladder may experience:
Symptoms of neurogenic bowel include:
- constipation
- bowel frequency
- bowel incontinence
Neuropathy
Neuropathy is nerve damage or dysfunction. For example, diabetic neuropathy is nerve damage that occurs due to diabetes. People with this condition may develop diabetic bladder dysfunction, including overactive bladder, incontinence, and needing to urinate during the night.
A number of other conditions can also lead to neuropathy. Some people may develop neuropathy and urinary incontinence following surgery to remove the prostate, for instance.
Yes, back problems can cause bowel or bladder issues. Herniated disks are the most common cause of CES. Disk herniation happens if the flexible disk between the vertebrae, or spinal bones, slips out of place.
A damaged or pinched nerve in the spine can also lead to problems controlling the bladder.
A person experiencing bowel or bladder incontinence should speak with their doctor. It is particularly important to do so if the problem is new or the individual also has neurological symptoms such as weakness, numbness, or tingling in the legs.
If incontinence is sudden and severe and accompanied by the above symptoms, it may be a medical emergency. A person should dial 911 or the number of the nearest emergency department.
Conditions such as CES are serious, and the person may require surgery to prevent permanent loss of bowel or bladder function.
There are many nerves that control bladder and bowel function, including the spinal cord, cauda equina, ENS, and more. If these nerves become damaged, a person may experience incontinence, difficulty controlling the urge to urinate or defecate, urinary or fecal frequency, urinary tract infections, or constipation.
Conditions such as cauda equina syndrome can result from a herniated disc. A person may require emergency surgery to prevent lasting nerve damage. Therefore, anyone who develops bowel or bladder incontinence should speak with a doctor urgently to rule out any potentially serious causes.