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

Bush, Heather M. PhD1; Pagorek, Stacey PT, DPT2; Kuperstein, Janice PT, PhD2; Guo, Jing BS1; Ballert, Katie N. MD3; Crofford, Leslie J. MD4

Journal of Women’s Health Physical Therapy: January/April 2013 - Volume 37 - Issue 1 - p 11–18
doi: 10.1097/JWH.0b013e31828c1ab3
Research Reports

Objective: The objective of this study was to investigate the association between chronic back pain (CBP) and urinary incontinence (UI) 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 UI. Currently, limited research exists evaluating the relationship between back pain and UI.

Methods and Measures: Data from a sample of 2341 women from the Kentucky Women's Health Registry were used for analysis. The primary variables of interest were self-reported CBP and stress UI (SUI), with SUI serving as the primary dependent variable. Simple comparisons were performed using chi-square tests and 2-sample t tests, and multivariable associations were assessed using binary logistic regression.

Results: Reports of SUI were higher in women reporting CBP than those not reporting CBP (49.0% vs 35.2%, P < .01). After controlling for potential confounders, the adjusted SUI odds ratio for CBP versus not was 1.44 (95% confidence interval: 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.

1Department of Biostatistics, University of Kentucky, Lexington.

2Department of Rehabilitation Sciences, University of Kentucky, Lexington.

3Division of Urology, Department of Surgery, University of Kentucky, Lexington.

4Division of Rheumatology, Internal Medicine, University of Kentucky, Lexington.

The authors thank Mikal Mathies, PT, DPT, and Talissa Dawson, PT, DPT, for their interest in this research topic, Candace Brancato for her help with Kentucky Women's Health Registry data, and the women who participated in the Kentucky Women's Health Registry

This publication was supported by grant number UL1RR033173 from the National Center for Research Resources, funded by the Office of the Director, National Institutes of Health (NIH), and supported by the NIH Roadmap for Medical Research.

The authors declare no conflicts of interest.

Copyright © 2013 by the Section on Women's Health, American Physical Therapy Association.
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