What Can Cause Lower Back Pain When Urinating?

Taking bathroom breaks to pee should usually be pain-free. However, it isn't uncommon for people to experience pain when urinating. This problem manifests in many ways, from experiencing burning or stinging sensations to feeling some lower back pain.

The sooner you can get pain while peeing checked out by a healthcare professional, the better. Fortunately, there are multiple treatment options that could help.  Read on to learn some of the possible causes of back pain when urinating, methods used for diagnosis, and how different conditions related to the lower back when urinating are treated.

What are common causes of lower back pain and frequent urination?

Some of the most common causes¹ for lower back pain and frequent urination include:

Kidney problems

Your kidneys are in your lower back. These bean-shaped organs help filter toxic waste products from your blood and release them through your urine. If your kidneys have a problem, you could experience frequent urination and back pain.

You will experience back pain either at the small of your back or near your side, often on one side. There are cases where you might feel pain at the center of your abdomen. This pain could also move to your groin and include frequent, painful urination. Getting medical attention early on is essential for early diagnosis and effective treatment.

Urinary tract infection

A urinary tract infection²(UTI) occurs when there is an excessive accumulation of bacteria along your urinary tract. Your urinary tract runs from your kidneys to the bladder, then to the urethra (where urine exits your body).

If you have an upper UTI, the infection can reach your kidneys and cause back pain. Other common symptoms that may accompany a UTI include:

• Fever

• Foul-smelling urine

• Passing cloudy or blood-tinged urine

• Frequent urination

• Lethargy, nausea, loss of appetite

Prostate infection

Prostate gland inflammation or prostatitis occurs when an infection causes swelling and inflammation of the prostate. It may be accompanied by lower back pain or rectal pain and a frequent urge to urinate. It may need a longer course of antibiotics than an uncomplicated UTI. Some other symptoms include:

• Fever

• Chills

• Fatigue

• Muscle pain

• Painful urination

• Pain around the scrotum and penis

• Painful ejaculation

• Frequently recurring UTI 

Ovarian cysts

Ovarian cysts are small fluid-filled sacs that form inside or on ovaries. They can develop on either one or both of the ovaries. While the majority are non-cancerous, they can cause discomfort or pain. Some women have ovarian cysts without knowing it. Lower back pain when urinating can be a symptom.

Other common symptoms for those with ovarian cysts include:

• Unusual vaginal bleeding

• Breast tenderness

• Painful periods

• Pelvic pain

• Pain during sex 

• Frequent urination

• Incomplete bladder emptying

Sexually transmitted infections

Sexually transmitted infections³ (STIs) like gonorrhea, chlamydia, and herpes can cause urinary tract infection and pain when urinating. It is also common for these infections to lead to lower back pain. Symptoms vary between STIs. If you suspect that you’ve contracted an STI, get screened as soon as possible — some will be curable, and others treatable. Early detection is key to getting the medical attention you need. Testing is also essential to prevent transmission and enable partners to access screening or treatment. Undetected and untreated STIs can cause fertility problems, but this is often preventable with early treatment.

Other common causes

Some other causes for back pain when urinating include:

• Pregnancy

• Kidney stones

• Pelvic abscess

• Cushing’s syndrome

• Uterine or ovarian cancer

• Uterine prolapse

• Overactive bladder

• Vaginitis

Common secondary symptoms 

The more you can tell your doctor about your symptoms, the easier it will be to zero in on the primary cause of your back pain while peeing. Some other common symptoms you might experience include:

• Cloudy urine

• Constant urge to urinate

• Fever

• Nausea

• Vomiting

• Blood in urine

• Pain that moves to your groin or lower abdomen

• Pain or a burning sensation when urinating

• Difficulty emptying your bladder or starting urination

• Painful ejaculation

• Unusual discharge from the penis or vagina

How doctors evaluate the cause of low back pain when urinating

Medical history

Since there could be many reasons behind your back pain, your doctor will ask many questions about your medical history. Some of these questions might not seem immediately relevant to you, but they help your doctor better understand your situation.

For instance, your doctor could ask you about the onset of the pain. They want to rule out things like a possible injury. Your doctor will also ask when the pain started, and what (if anything) makes the pain better or worse.

Your doctor will want to know about any recent illness or symptoms you have experienced or are experiencing. They will inquire about symptoms like fatigue, coughs, fever, stomach illness, and urinary difficulty. If you are female, your doctor may ask about any vaginal bleeding, discharge, cramping, or pain in the pelvis.

Physical examination

Your doctor will typically perform a physical exam.  In some cases, you might need to undergo an abdominal, rectal, or pelvic examination. These checkups aim to rule out the presence of any disease or nerve damage as a cause for your lower back pain.

For example, the nerves along your lower spinal cord control your anal and urethral sphincter. Injury to the spinal cord can make it tough to control urination and bowel movements. A rectal exam can identify nerve damage as well as identify prostatitis.

Imaging

Your doctor can use several imaging tests to look for internal issues that explain your pain. X-rays are among the most common imaging tests. The second option is myelograms, a form of X-ray involving contrast dye to examine the spinal cord. Finally, an MRI test can also scan for tumors or infections.

Blood tests and urinalysis

These lab tests can identify abnormalities in your urine or blood. For instance, a blood test can identify infection or inflammation. The presence of white blood cells within your urine could also indicate an infection.

How is back pain while urinating treated?

Your treatment will be dependent on your diagnosis. For instance, if the reason behind your lower back pain when urinating is a UTI, you will need to take medication to resolve the UTI. On the other hand, if the cause of the discomfort is a tumor, abscess, or kidney stones, surgery could be necessary.

For alleviating back pain specifically, therapeutic options might include:

• Acupuncture

• Transcutaneous electrical nerve stimulation (TENS therapy)

• Physical therapy

• Spinal injections

Signs that you need to visit a doctor

When experiencing lower back pain while peeing, the best option is to visit your doctor as soon as possible. Be sure to see a healthcare professional right away if you:

• Experience vomiting

• Observe blood in your urine

• Lose control of  your bowel or bladder

• Have a fever or chills

• Your urine is cloudy

• You have an unusual discharge from your vagina or penis

• Pain and frequent urination are making it hard to go about your day

How to prevent back pain when urinating

While many causes of lower back pain when urinating are challenging to prevent, there are a few things you can do to prevent urinary health problems in general. For example, you can reduce the risk of a UTI by staying well hydrated and urinating directly after sex (to flush out potential bacteria). In addition, if your doctor identifies that you have a history of kidney stones, they will likely recommend a suitable diet and medication that prevents kidney stone formation.

The lowdown

Experiencing back pain when urinating is quite unpleasant but usually very treatable.  It may signify a specific condition, such as kidney stones, a UTI, or even ovarian cysts. It is best to treat lower back pain while urinating as soon as possible. If you notice any of the above signs, see a medical professional as soon as possible to address them and avoid possible complications.