Lower back issues and BPH

Posted , 9 users are following.

To further muddy the waters on BPH and the factors that may cause or aggravate it:

My own urinary difficulties boil down to difficulty -- and at night, near inability -- to begin the urine stream. My brain is willing but the "let go" message -- for whatever reason - isn't received down below 'til after multiple tries.

Again, this is most serious in the middle of the night. Daytime is not really an issue, insofar as starting a flow. Slow, but adequate and seemingly not worsening. I do take alfuzosin.

But I happen to have a long history of low back issues -- fused lower vertebra a result of years of heavy lifting. Back pain now...and urinary difficulties that -- perhaps -- are not a coincidence.

So now -- at age almost-73, I have decided to re-visit chiropractic, which has helped me in the past.

The other day I am standing in the exam room waiting for the doc for my first overview visit and there is this chart on the wall showing the spine and the various discs and facets and such. Doc wasn't there yet, so I filled the time studying the chart. Next to each disc is a list of the supposed ailments/functions of the nerves in the vicinity of that disk. Well lo and behold -- L4, lumbar disc 4 -- encases nerves supposedly significant to urinary function. And my L-4 has been banged around plenty over the years.

So now that ONLY because chiropractic has helped me in the distant past am I giving it another try with a focus I hope, on that L-4 thingy and how it may be a factor in my urinary difficulties. (I also have serious back pain now...the primary motivator for me to undertake this treatment.)

Wouldn't it be something if a pinched nerve was the source of my problems! (Said problems are not with leakage and such. Quite the opposite, I am not able to urinate without difficulty for a very slow start and a slow stream once started. "I pee in Morse code", as it's been described. So I am actually hoping a lower back nerve has something to do with it and will report here if it does. BTW, my PSA tests have been solid "within your normal" range over the years and the DRE always comes back "not a swollen prostate." At least, I guess, on the outside.

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  • Posted

    In 1994 we moved house and had a new GP. My first visit to him was for lower back pain. I was surprised that he immediately suggested doing a DRE . He then told me that I had an enlarged prostate did a PSA test that was 5.1 and referred me to a Uro. I assumed as the Uro wanted a prostate biopsy that they had suspected prostate cancer but the biopsy and a subsequent one were negative.

    I was then fortunate to read of the dangers of TURP by a British investigative journalist who had been diagnosed with BPH. I refused the Uro's suggestion of a TURP and waited a long time for something better to come on line.

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    • Posted

      I was in the news biz for a time so I might caution and question regarding the objectivity of any reporter who claims danger in any procedure -- especially TURP -- when they themselves have some big skin in the game. That carries over to news reportage in general these days -- individuals who bring their personal perspectives to what is supposed to be objective and disinterested "investigation". We, the public, are often the losers in that dynamic.

      That said, TURP seems clearly a procedure that is deserving of careful "look before leap" perspective. Some people swear by it, some people swear at it. I'm just glad that I've been able to cope with BPH symptoms for half of my life with still no absolute plugging of the pipeline. I've learned so much here about watchful waiting. (And consider: when you are in your 70s, you may feel fit as the proverbial fiddle, but it's a likely fact you won't be around 20 or perhaps even ten years from now. (Imagine being 40 and facing that ten-year time line.) So, if BPH is still bearable, why take the chance on anything that involves cutting? I told my new dentist the other day that expensive work in my mouth is perhaps not a good idea. Why spend that money for significantly less than a "normal" life span? I was flattered he had no idea I had rounded 70 headed for 80 😃

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  • Posted

    Hello Owen:

    You are a great example of how we learn about ourselves and start connecting dots. To add to your thoughts, I once read that pain meds can interfere with receptors that allow us to control our sphincters (internal & external). I mention this only because you share the back pain you are having. Not sure if you are managing pain with meds, but if you are, they could possibly interfere with your ability to let go. When I had my enlarged prostate, I had mouth surgery and was given pain meds. I could no longer let go and it happened in the middle of the night. I have more examples where this happened to me because of a pain med being administered. Some food for thought.


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    • Posted

      Indeed! I have a running prescription for hydrocodone (vicodin) -- used very sparingly for when pain disturbs my sleep. But NO fluids for hours before bed when I do use the drug. Yes, steroids especially render the sensory apparatus of the voluntary nervous system pretty useless. 60 vicodin tablets last me six months -- so one must be careful. I never use it in the daytime. Thanks for the thoughts.

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  • Posted


    I've had similar symptoms to yours, starting in my early 50s (currently 63). Doctor started with the traditional methodology, prescribing alpha-blockers (I tried 4 different ones) - none helped. Over many years and numerous visits to many doctors in multiple states, the best information/help I received was from one urologist who explained to me that LUTS (lower urinary tract symptoms) in men can have several contributing factors and of course, we are all different. Alpha-blockers help relax the muscle around the internal sphincter and NIH studies indicate it is effective in approx 50% of the men who take it. One of my issues was (still is) relaxing the external sphincter, and like you described it is primarily an issue first thing in the morning (or if I sit for too long - like on a long aircraft flight). If I walk around for a few minutes, the issue greatly improves .

    There are several things that can impact this, nerve damage/irritation being one of them. I have tried several things over the years, none of which has made much difference. While I have a minor disc bulge between the L4 and L5 (like many), massage/chiro adjustment has not made any difference. While I continue to research/look for better answers, mostly I've learned to cope by knowing what to do/not do.

    There are other things that also impact my urinary health, this is but one. Identifying the potential issues took many years and while I have improved over the past several months, it is still very much a work in progress. If you find out anything new/or something that helps, please let us know.


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    • Posted

      Thanks Tim. I am two visits into a 6-month schedule of thrice-weekly chiropractic visits. For this I will pay around $900. I am that motivated and not afraid to try simpler things -- like hands-on bullying of the damn bones and nerves that make all of this function. Sorry to hear your own urinary difficulties did not respond to chiropractic therapy. My L-4 back pain has improved some after two visits. And it's not just my imagination. Getting out of bed in the morning is the acid test for me -- and this morning I arose with my body at a 10 stopping degree angle instead of the 45 degree angle that has plagued me for years. I am hoping my urinary apparatus will also get the message and I will report here either way. Thanks again.

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