Have you been diagnosed with Interstitial cystitis or know someone who has?
Also known as painful bladder syndrome, it is a chronic, painful bladder condition that is commonly mistaken for a UTI but no infection is found. The bladder walls become irritated and inflamed which can cause sensitivity in the bladder or pelvic region. There are two types of IC which include non-ulcerative and ulcerative. 90% of IC patients have the non-ulcerative form of IC which commonly has pelvic floor dysfunction also as hallmark sign. 5-10% of patients have ulcerative IC which usually presents with hunner’s ulcers or patches, which are red, bleeding areas on the bladder wall.
Common complaints include discomfort above the pubic bone, urinary frequency and urgency, pelvic pain, pressure/pain when bladder is filling, and poor urine output when urinating. Diagnosis is made when symptoms have lasted greater than 6 weeks. It is estimated that 83,000 men and 1.2 million women in the US suffer from interstitial cystitis.
Causes are not fully understood but may be related to autoimmune disease, allergies, defects in the lining of the bladder, blood vessel disease, mast cell abnormalities, abnormal substance present in the urine, unidentified infections.
Treatment can include diet, pelvic floor physical therapy, and medical management including medications and bladder instillations. For pelvic floor physical therapy we typically want to look at visceral mobility, pelvic floor coordination, improve any pelvic floor muscle tightness with manual techniques, and breathing exercises to help manage symptoms.
We want to look past the bladder and look at all the things that may also influence this pain including adductor muscle tightness, fascial restrictions in pelvis and abdomen, superficial pelvic floor muscles commonly can be restricted or painful, pelvic alignment, and poor breathing mechanics or coordination can impact pain.
Doing kegels for this population is not good advice. We want to start with pelvic floor relaxation or down training and general strengthening and movement, avoiding co-contraction of the pelvic floor.
Multiple articles such as “CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome” rate pelvic floor physical therapy as a Grade A treatment for interstitial cystitis vs many medical management techniques as Grade C. Check out the article to learn more, it breaks down each treatment option and gives grades with use of research to back up.
Share this with anyone you know that may be struggling with interstitial cystitis. Find a pelvic floor therapist to help manage your symptoms. We are here to help!
References
My.clevelandclinic.org
Cox, A, Golda, N, Teichman, J. CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065402/