Sphincter dysfunction

Disturbance of bladder or bowel control, which may be a neurological warning sign depending on context.

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Distinguishing a new emergency from a longstanding problem

Sphincter dysfunction concerns control or emptying of the bladder and bowel. It can involve retention, leakage, loss of sensation or altered control. A longstanding pelvic floor problem does not automatically mean spinal compression. A recent change in a neurological context requires a different level of concern.

Timing, usual function, medications and associated symptoms guide assessment. New loss of control with perineal numbness or leg weakness can indicate sacral pathway dysfunction. Bladder and bowel symptoms do not both need to be present before seeking care. A clinician must distinguish urological, digestive, neurological and functional causes before recommending rehabilitation or comfort-oriented treatment. A previous explanation for chronic leakage should not be used to dismiss a clearly different new pattern.

Immediate assessment rather than a treatment appointment

A recent change in this function, particularly with back or leg symptoms, should be reported immediately to an emergency department. Do not wait for the next treatment session, for every warning sign to develop or for pain to become severe. Describe the time of onset, progression, medication use, spinal history and any other sensory or motor changes. Call emergency services if travelling is unsafe. Symptoms can be incomplete, and the absence of one typical feature does not make a new concerning change safe to ignore.

Investigations, treatment and follow-up

The medical team investigates sacral root or spinal cord dysfunction and other possible causes. Depending on the presentation, assessment may include a neurological examination, a bladder emptying measurement and urgent imaging, often MRI. No home self-test rules out compression. A compressive cause may require urgent surgery; other causes need their own treatment. Surgical decompression is different from motorized traction offered in some clinics. Spinal decompression sessions, laser treatment and manual therapy do not treat a neurological emergency. Any rehabilitation follows medical management and includes monitoring of bladder, bowel and mobility functions.

Frequently asked questions

Does all urinary leakage originate in the spine?

No. Causes vary, but a new change with neurological findings requires urgent assessment.

Should several warning signs be present?

No. One concerning new change can justify emergency evaluation.

Is mild pain reassuring?

No. Neurological function matters more than pain intensity.

Can a treatment session be tried first?

Not before medical assessment of a possible emergency.

Is recovery guaranteed?

No. The cause and severity of neurological injury affect the outcome.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.