Understanding the Link: Can a Herniated Disc Cause Constipation?

Yes, a herniated disc can cause constipation. A herniated disc has the potential to interfere with nerve signals responsible for regulating bowel movements, which may result in constipation. We will discuss why this issue occurs, identify symptoms that should alert individuals to this condition, and explore different treatment methods available.

How can a herniated disc cause constipation?

A herniated disc might primarily cause back discomfort, but it can also significantly disrupt your digestive system.

While often overlooked, it’s important to recognize how spinal problems can affect digestive health and overall physical wellness.

How are spinal nerves connected to bowel movements?

When a spinal disc herniates, it can press on or irritate the nerves of the spinal cord. This can interfere with nerve signals that regulate bowel movements, potentially leading to neurogenic bowel dysfunction – bowel issues such as constipation or fecal incontinence that are caused by issues with the nerves, rather than issues with the physical form of the bowel or your diet. This happens because the nerves that manage colon and intestinal functions can be affected by this spinal issue.

Think of your spine as a pathway for nerve communication. Compression of the spinal cord caused by herniated discs in either the upper or lower back can act like a blockage on this pathway, preventing critical signals from getting through.

These signals include those that signal when it's time to go to the bathroom, and those that control the wave-like muscle contractions that move matter through your digestive system. This often leads to hard stools that are difficult to pass.

People with neurogenic bowel dysfunction might face challenges similar to those with irritable bowel syndrome (IBS), a disorder that causes abdominal pain, bloating, and changes in bowel habits like diarrhea or constipation.

Does a herniated disc always cause pain?

A herniated disc doesn't always cause pain. There has been studies where people had MRIs showing herniated discs, even though they were not experiencing any pain¹. Research also shows that other factors could be at play.

This means that if you have a herniated disc and are experiencing back pain, that does not always mean the disc is causing the pain. Sometimes, it is just an incidental finding. Other conditions like referred pain or central sensitization might be causing your back pain.

Central sensitization

Central sensitization is a condition in which the central nervous system becomes overly sensitive to stimuli that normally wouldn't cause pain. This increased sensitivity leads to a stronger response signals such as touch or movement, or even pain without any injury or external cause. The nervous system gets stuck in a heightened state of reactivity, making the body more prone to pain.

Research indicates that back pain can be influenced by the central nervous system, which affects how we process pain and involves our immune system². This means that pain isn't just due to physical issues like a herniated disc. It's also significantly affected by how the brain and spinal cord process signals.

What are the symptoms that my constipation is caused by a herniated disk?

If you have a herniated disc, it’s important to understand how it might affect your digestion. Symptoms that suggest this condition is impacting your digestion include:

• difficulty controlling bowel movements
• abdominal pain
• persistent dull ache in the abdomen
• episodes of diarrhea
• nausea
• vomiting.

Recognizing and understanding these symptoms promptly can speed up the diagnosis and improve treatment effectiveness.

If you experience fewer than three bowel movements per week, strain during defecation, or have a constant feeling of incomplete bowel emptying, these signs could indicate spinal health problems like herniated discs. When these symptoms occur along with back pain, it’s important to consider that there might be more at play than just ordinary back discomfort.

How is a herniated disc diagnosed?

Doctors often use MRI scans to identify and locate nerve impingement from herniated discs that might be causing bowel dysfunction. This precise imaging helps understand the severity of the condition and guides appropriate treatment strategies.

In some cases, doctors might choose to perform a myelogram. This technique involves injecting contrast material into the spinal canal and then taking X-ray or CT images to observe how the nerves are affected by the herniated disc. These essential diagnostic methods are crucial for establishing a connection between back pain and bowel issues, ensuring you receive accurate treatment recommendations.

It's important to know that you don't have to get imaging done, because imaging can't always explain our pain and a herniated disc will usually heal by itself. However, many people like having a clear diagnosis because it can help them to feel more at ease. Talk to you healthcare provider if you have any questions about your symptoms, diagnosis, or treatment.

What are the treatment options for a herniated disc?

A herniated disc will naturally heal itself. However, there are many lifestyle changes you can make to help your body treat disc herniation and related constipation, by activating or strengthening your body's natural healing responses.

Retraining your pain

It is possible to identify the triggers of your pain and change lifestyle habits to minimize them. This might involve eating a healthier diet, improving your sleep, staying active, or learning new ways to think about and respond to these triggers. With time and practice, you can teach your brain to handle pain differently.

At MoreGoodDays® we have a program based on scientific research to help you with chronic back pain. Our approach debunks common myths about back pain, focuses on understanding the root causes, identifying triggers, and learning to change your body’s response to pain using neuroplasticity principles. We offer personalized coaching and tools to help you manage pain, mental health and overall well being.

Download our mobile app for free from the Apple App Store or Google Play Store for immediate access to some of our content and to see your support options.

Yoga & meditation

Yoga and meditation are effective strategies for managing the discomfort and stress associated with herniated discs, as well as providing relief from constipation. Engaging in these practices can not only alleviate symptoms but offer other benefits such as improved flexibility and a greater sense of wellness.

Breaking up long periods of sitting

Stand, stretch, or walk intermittently to reduce tension on your discs and promote regular bowel movements.

Healthy body weight

It's not about the number on the scales. But if you are carrying extra pounds or eating on the unhealthy side, this can increase the risk of disc herniations and put additional stress on your spine. Eating a healthy diet that includes plenty of fruits, vegetables, and wholegrains can support your fiber intake, which in turn can promote healthy bowel movements. Book an appointment with a registered nutritionist for personalized support.

Quitting smoking

Improves spinal health by enhancing circulation to the discs, aiding their healing process. This can also positively affect bowel function³.

Physical therapy

Physical therapy is an approach that can reduce pain, alleviate symptoms of constipation, and enhance overall bodily function for individuals with herniated discs. Therapists use an integrated approach that includes:

• Exercise-based therapy: Specific exercises designed to strengthen muscles and improve mobility.
• Massage: Techniques to relieve muscle tension and improve circulation.
• Thermal treatments: Use of heat or cold to reduce pain and inflammation.
• Ultrasound procedures: Use of sound waves to promote tissue healing.

These interventions help relieve back pain and promote healthy bowel movements by reducing muscle strain and strengthening the pelvic floor muscles. Strengthening the pelvic floor muscles can:

• improve control over bowel movements
• support the organs in the lower abdomen
• reduce the risk of constipation and other digestive issues.

Exercise & physical activity

Consistently participating in exercise and activities that enhance the strength of the lumbar area can mitigate constipation issues. Common strength-building exercises include: knee-to-chest stretches, bridges, and cat stretches, but it is important you consult a medical professional on what exercise is most appropriate for you.

Regular exercise also positively affects emotional wellbeing, which can help make the symptoms of a herniated disc less intense and less distressing. When introducing to physical activities after lumbar disc herniation, it’s important to:

• gradually reintegrate exercises into your routine
• start with low-intensity movements and slowly increase the intensity based on comfort level
• use proper lifting techniques, such as squatting at the knees rather than bending from the waist
• maintain a neutral spine position to avoid excessive pressure on vertebral structures and reduce the risk of developing herniated discs.

Dietary changes for bowel health

Altering your diet is a crucial step in managing constipation and aiding recovery from a herniated disc. Consider these dietary changes:

• Incorporating fiber-rich foods: Adding foods high in fiber to your meals promotes regular bowel movements and enhances digestive health.
• Drinking ample fluids: Consuming plenty of fluids softens stool, making bowel movements more comfortable.
• Maintaining regular physical activity: Engaging in consistent exercise helps alleviate back pain and may relieve constipation by improving the function of the lower back.
• Eating a nutrient-rich diet: Consuming fruits, vegetables, whole grains, and legumes can prevent constipation by increasing the bulk and softness of stools. Insoluble fiber, often found in fruit skins, acts as a natural laxative, speeding up food transit through the digestive system and making stools easier to pass. Drinking plenty of water alongside high-fiber foods is recommended to keep stools soft for smoother elimination.

Medication for herniated disc

In more serious cases, medicine can also be used to treat pain from a herniated disc, constipation, or both.

To manage pain from a herniated disc, several types of medication can be used:

• Over-the-counter analgesics: Medications such as acetaminophen, ibuprofen, or naproxen sodium are commonly used for mild to moderate pain relief. These drugs reduce inflammation and alleviate discomfort, indirectly aiding bowel function by making movement easier.
• Neuropathic medications: For more intense pain, doctors may prescribe gabapentin or pregabalin, which help modulate nerve signal transmission.
• Muscle relaxants: These medications reduce muscle spasms and stiffness, which not only relieve pain but also improve the range of motion.
• Corticosteroid injections: In some cases, these injections provide temporary relief from severe back pain and improve mobility, helping to reduce complications related to constipation.

Medication for constipation

To address constipation associated with herniated discs, the following over-the-counter medications may be recommended:

• Stool softeners: These help make bowel movements easier and less painful.
• Laxatives: Used when necessary to facilitate relief from constipation.

It’s important to use these treatments as needed and under the guidance of a medical professional to ensure safe and effective relief from this symptom. Before starting any medication, seek advice from medical experts to determine the best course of treatment for both pain management and constipation.

When is surgery necessary?

Surgical procedures may be considered in instances where herniated discs lead to constipation and:

• non-invasive treatments fail to provide relief
• daily life is significantly affected by the symptoms
• conditions escalate to extreme levels, such as cauda equina syndrome (CES), a rare neurological (brain, spinal cord and other nerves in the body) condition that affects the nerves at the bottom of the spinal cord and can cause problems with bladder and bowel control.

The primary goal of surgery is to relieve nerve compression and restore normal bowel function.

When to seek medical attention

It’s crucial to seek medical care if you experience symptoms such as bowel or bladder dysfunction, or if usual treatments don’t relieve your pain. When these issues arise, you should immediately consult a healthcare provider or go to an emergency department. Acting quickly can prevent the progression of complications and lead to better health outcomes.