The spinal cord regulates everything in your body. From your muscles to organs, it really is the control center. It is easy to imagine how injuries to your spine/spinal cord can have a great effect on the function of your bladder and pelvic floor muscles.
Examples of spinal injuries that can affect bladder and pelvic floor function include:
- Disc herniation
- Spinal cord injury
- Spinal fracture
- Spinal tumor
- Spinal stenosis
Spinal injuries can lead to something we call neurogenic bladder. The nerves that control your bladder and pelvic floor are no longer working as they should.
Symptoms of neurogenic bladder include:
- Incontinence
- Urinary frequency/too many bathroom trips
- Strong urge to urinate
- Urinary retention
- Incomplete bladder emptying
Spinal injuries can affect the bladder in two different ways.
It can lead to urinary frequency/urgency/incontinence. Injuries can make the muscle around the bladder, or the detrusor, excitable and more prone to contract. When this happens, the bladder will empty when we don’t want it to. On the other end, spinal injuries can disrupt signals to the brain when we need to empty our bladder, leading to urinary retention and poor bladder emptying. This can also put us at a risk for severe bladder injury. When the bladder overfills, it can permanently stretch leading to even further worsening of function.
Physical therapy can be an effective treatment strategy for neurogenic bladder. By improving pelvic floor muscle function, even in the light of a spinal injury, we can help improve bladder function. By strengthening the pelvic floor muscle, we can help reduce episodes of urinary incontinence. We also need to make sure pelvic floor coordination is where it needs to be. By making sure the pelvic floor muscles can relax fully when needed, we can help with bladder emptying and decreasing urinary retention. We may also be able to help with nervous system function/modulation to further improve bladder function, depending on what injury is present.
Depending on the spinal injury, physical therapy may also be able to help. For example, physical therapy is a known and effective treatment for disc herniation. If we can improve function at the spinal level, we will be able to improve function lower down the chain, in this case, the bladder and pelvic floor. Our body is connected throughout, and just because an injury happened at the spine, the effects can be felt all over.