Sciatica and the urge to urinate: should you be worried?

hip pain

You often hear about the sciatica, but have you ever heard of cauda equina syndrome? These two nerve damage are often confused because of the similarity of their symptoms.

The frequent urge to urinate (the main subject of this article) is one of the characteristic symptoms of a cauda equina syndrome, not sciatica.

If this desire is accompanied by abnormal symptoms other than the usual sensory-motor disorders, then, yes, you have to worry and go to an emergency doctor. Otherwise, conservative strategies can be practiced to calm the urge to urinate.

In short, discover without further delay the details of all this information in this article!

Definition of sciatica

La sciatic neuralgia, known to all under the simple name of "sciatica", is characterized by pain felt on the path of the sciatic nerve.

As you probably know, the pain of sciatica is caused by damage to this nerf or one of its lumbar nerve roots : L4 to S3.

From an anatomical point of view, we distinguish two sciatic nerves in humans: one for the right leg and another for the left.

So if the sciatic nerve left leg or one of its roots are affected, the symptoms of sciatica will be observed in the left leg. Conversely for the right sciatic nerve. The pain is said unilateral.

Cauda equina syndrome, differential diagnosis of sciatica

Le cauda equina syndrome and differential diagnosis sciatica. That is to say that most of the symptoms of these two pathologies are similar and can cause confusion.

Focus on cauda equina syndrome

All the nerves of the body (apart from the cranial nerves) arise from the spinal cord. The latter runs along the spine and stops at the level of the second vertebrate lumbar (L2).

The nerve roots that originate at the bottom of the spinal cord then move downwards sacred by forming a sort of "ponytail".

cauda equina syndrome occurs when one of these nerves forming this ponytail is affected.

Comparison of cauda equina syndrome and sciatica

The two attacks are both of nervous origin, which explains the similarity of their symptoms. But, they are two different pathologies.


For each of these two pathologies, we can observe sensory-motor disorders such as: tingling, tingling, numbness and loss of reflexes as well as muscle disorders.


  • topography of pain

As mentioned previously, the symptoms of sciatica are unilateral and are observed at the level with one leg.

While for cauda equina syndrome, the symptoms are observed in the two legs.

  • Frequent urge to urinate

The frequent urge to urinate is a characteristic symptom cauda equina syndrome.

Indeed, apart from the sensory-motor disorders mentioned above, this syndrome also causes urinary and anal sphincter.

These sphincters are circular muscles responsible for urinary and fecal continence. Their dysfunctions can lead to the frequent urge to urinate, even going as far as urinary or fecal incontinence.


Consult urgently

The first and best thing to do is to consult a doctor urgently, especially in the presence of abnormal symptoms (sign of seriousness) such as:

  • Personalized lower back pain
  • Pain or difficulty passing urine (Dysuria)
  • Loss of sensitivity in the perineum, upper thigh and genitals
  • male sexual impotence
  • Inability to stand and walk on tiptoe
  • In extreme and urgent cases, a paralysis more or less complete lower limbs (paraplegia)

Conservative strategies for the urge to urinate 

If the doctor has ruled out the possibility of a serious problem, you can apply some conservative strategies to control the frequent urge to urinate:

 1- Pelvic floor exercises

Pelvic floor exercises or Kegel are forms of perineal rehabilitation that can correct, or at least improve, the frequent urge to urinate.

they can be done alone or guided by a physiotherapist (physiotherapist). But according to statistics, perineal rehabilitations that have been assisted are more effective.

Briefly, the exercises go as follows:

Exercises 1: slow contraction

  • Lying down and knees bent, contract the pelvic muscle for 5 seconds then rest for 10 seconds.
  • Repeat this ten times
  • Pause for 60 seconds, then do two more sets of 10 contractions each.

Exercise 2: rapid contraction

  • Same procedure as the first exercise, but this time contract the pelvic muscle quickly on the exhale.
  • Release quickly and inhale.

Exercise 3: Perineal lock

This last exercise is done daily, before any effort that may cause urinary leakage (cough, sneeze): tighten the pelvic muscles before coughing or sneezing.

2- Kinesitherapy (Physiotherapy)

The frequent urge to urinate can also be controlled with physical therapy (Physiotherapy).

Several techniques can be used by the physiotherapist (physiotherapist) specialized in perineal rehabilitation:

  • Manual method: consisting in evaluating the contractions of the perineum.
  • Toning the muscles: thanks to electrostimulation of the muscles via two electrodes. The patient must at the same time perform contractions.
  • Biofeedback: Allows you to visualize the contractions of the perineal muscle on screen.
  • Behavioral management, which is rather a kind of educational session to guide the patient to better manage his urges to urinate.


Anticholinergic drugs reduce bladder tenderness and overactivity. Combined with a therapy session, the results can only be beneficial.

4-Avoid bladder irritants

Minimize the intake of foods that irritate the bladder such as: coffee, tea, soft drinks, alcohol, chocolate, acid fruits and spices. You should also wear loose clothing!


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