The relationship between urethral sphincter mechanism incompetency and lower back pain: Positing a novel treatment for urinary incontinence in dogs

BACKGROUND: In humans, multiple researchers have not only determined that there is a relationship between urinary incontinence (UI) and lower back pain (LBP), but that by treating the LBP, clinicians are able to improve or resolve the UI. Up until now, no equivalent canine research has investigated whether treatment of LBP can improve the clinical signs of acquired, non-neurologic UI in dogs. AIM: To determine if a relationship exists between LBP and urethral sphincter mechanism incompetence (USMI) in dogs. METHODS: Review of medical records of all patients that presented to Points East West Veterinary Services with a history of naturally occurring acquired UI from May 2013 to December 2019. Thirty-nine patients treated for LBP using combined acupuncture and manual therapy, and 33/39 patients that also received concurrent photobiomodulation (PBM) therapy, qualified for this study. RESULTS: Treated patients showed a statistically significant reduction in both the frequency (p < 0.01) and volume (p < 0.01) of UI episodes. Treatment responses ranged from no improvement, to complete resolution of the USMI clinical signs. CONCLUSION: The reduction of USMI clinical signs following LBP treatment suggests a relationship between these two conditions. Combined acupuncture, manual therapy, with or without PBM was shown to be an effective treatment for USMI. By corollary, USMI incontinence should be considered a potential pain symptom.