the low down on interstitial cystitis
Interstitial cystitis (IC), also commonly referred to as “painful bladder syndrome” (PBS) or “bladder pain syndrome",” is pelvic pain or pressure that affects the bladder and can also cause urinary urgency and frequency.
Other symptoms that folks with IC or PBS may experience can include:
Bladder pressure, discomfort, or pain
Pain in the suprapubic region (area in the abdomen just above the pubic bones)
Urethral pain
Pain or burning with urination (dysuria)
Pain in the bladder or suprapubic region that worsens as the bladder fills and temporarily feels better following urination
Discomfort or pain during sex causing dyspareunia and ejaculatory pain
Low back pain
Hip and groin pain
Interstitial cystitis is super common and affects between 3 to 8 million women (or people with internal genitals) and 1 to 4 million men in the US. It is also believed that the prevalence in men (or people with external genitals) is actually much higher than current statistics show since many are misdiagnosed with chronic prostatitis.
IC is typically a diagnosis of “exclusion” which means that it is the diagnosis given when extra testing has been done to rule out an infection or different cause for your ongoing symptoms. Typically a diagnosis can be made based on a person’s symptoms alone, but we do know that symptoms have to be present for at least 6 months according to the AUA in order for a diagnosis of interstitial cystitis to be made.
Sometimes a cystoscopy will be completed (a small lens is inserted inside of the urethra to look at the inner lining of the urethra, where pee comes from, and the bladder) to determine if there are Hunner’s lesions present, which are present in 5-10% of people with IC and are ulcerations or areas of inflammation on the inner lining of the bladder. Hunner’s lesions do not have to be present to receive a diagnosis of IC or PBS.
We know that Interstitial Cystitis or Painful Bladder Syndrome is a complex condition that wraps up the bladder, nervous system, and pelvic floor muscles. Usually your bladder is kind of the “victim” in this situation where your pelvic floor muscles are super tense, tight, and painful and causing significant irritation to your nerves, in addition to your nervous system being ramped up in general.
What’s the good news here? Research that has been widely recognized by the American Urologic Association shows that working with a pelvic floor physical therapist is proven to help with Interstitial Cystitis (or Painful Bladder Syndrome) and is the only treatment intervention that receives a “Grade A” for available current evidence.
Research shows that as many as 85% of people that have been diagnosed with IC/PBS have myofascial pain and pelvic floor muscle dysfunction. Myofascial pain and pelvic floor dysfunction with IC typically involves muscle tension and areas of tightness thoughout the muscles of the pelvic floor. Muscle tension and tightness increases inflammatory responses including inflammation in the nerves of the bladder resulting in painful bladder symptoms, as well as pain in the pelvic region including pain during sex, low back pain, hip or groin pain, bowel symptoms, and bladder symptoms like urinary urgency and frequency.
As a Board-Certified Women’s Health and Pelvic Floor Physical Therapist, I love working with clients with pelvic pain, including folks with interstitial cystitis or painful bladder syndrome and chronic prostatitis. Treating the pelvic floor issues and symptoms from IC is super complicated and varies person to person and I really love the challenge that comes with treating pelvic pain to find a solution that works for each client.
Even though pelvic pain and pelvic floor dysfunction leading to IC/PBS can be challenging to treat, the good news is that it improves and relief is possible when working with a pelvic floor physical therapist who has the expertise to work with this client population. I have a male client that I am currently working with who is struggling with symptoms that are the hallmark presentation of chronic prostatitis (which is analogous to painful bladder syndrome). Within only a few appointments they are starting to notice significant improvements in their pelvic pain and symptoms.
So y’all, if you are struggling with IC/PBS, there is hope. We have a TON of things we can do in pelvic floor physical therapy treatment and I would absolutely love to be a resource for you!
Have questions or feeling on the fence about whether or not pelvic floor physical therapy is for you? If you’re looking for treatment for painful bladder syndrome or interstitial cystitis or are struggling with pelvic floor issues and you’re located in Durham, North Carolina I would love to work with you! Reach out to me here to tell me a little more about what is going on so we can chat more and get the process started. Live outside of the state of North Carolina? I also offer virtual appointment options to provide more accessible care to those seeking out pelvic floor treatment for IC.
Dr. Brook Orvis is a Board-Certified Women’s Health and Pelvic Floor Physical Therapist, Duke Residency-Trained in Women’s Health, and the owner of Flora Physical Therapy. As a momma to a spirited toddler, she understands the difficulty of being a parent while prioritizing self-care, including caring for your body and pelvic floor. She believes that pelvic floor therapy is for everyone and is passionate about providing accessible treatment options for birthing people, men, women, kids, and the LGBTQIA+ community so that they can take better care of themselves and receive equitable care. She loves educating and empowering clients to take charge of their body and health and to not accept leaking of urine, prolapse, pelvic pain, pain during sex, and core weakness as a normal part of being a human.
Thinking that you may benefit from pelvic floor physical therapy treatment? Or know someone else struggling with IC or PBS that you think may need care? Reach out here to schedule a pelvic floor physical therapy appointment with me today. At Flora Physical Therapy I am passionate about providing 1:1 accessible treatment options including in-home, in-clinic, and virtual appointment options to help meet you where you are.
