Bladder Pain Syndrome/Interstitial Cystitis
Condition Overview
Bladder Pain Syndrome (BPS) is an umbrella term for a variety of conditions causing a painful bladder. One of those conditions is called Interstitial Cystitis (IC). BPS and IC are diagnosed when you have pelvic pain, pressure or discomfort lasting > 6 weeks with persistent urinary urgency and increased frequency. Your pain increases with bladder filling and eases with emptying, and there is no identified bladder or urethral infection. In addition, those with IC have cystoscopic findings of inflammatory changes in the bladder categorized as Hunner’s Lesions or Glomerulations (aka “bleeding bladder”).
Possible Causes:
Painful Bladder Syndrome/Interstitial Cystitis typically occurs after a urinary tract infection, pelvic trauma, or chronic inflammation of the bladder lining.
A lot of times, these symptoms go away, but occasionally they can turn into a more chronic issue- causing BPS and IC. This is because the initial issue can result in increased central sensitization, meaning we are hypersensitized to this area of our body. This increases our threat response to threatening and non-threatening stimuli. In addition, there is typically an increase in inflammatory, neurological, and endocrine responses as well.
What Does This Have to Do With My Pelvic Floor?
Our pelvic floor muscles support the internal organs such as the bladder, uterus, and rectum and they are connected through endopelvic fascia. If one area of this system is affected negatively, this can have repercussions on the entire system.
In addition, the central nervous system plays a role on our pelvic floor. When we have a heightened central nervous response, our pelvic floor muscles can also become hypersensitive causing overactivity and increased resting tone. Increased pelvic floor muscle tone can contribute to urinary urgency, incomplete bladder emptying, and feelings of muscle tension and pelvic pain.
How Can Physical Therapy Help With This Diagnosis?
This can be such a debilitating diagnosis for many people and it is important to know that you are not alone and there are treatment options for you to help your symptoms. In physical therapy, we will perform an external and internal pelvic muscle assessment to determine your pelvic floor resting tone, strength, endurance, and coordination.
We will set-up a treatment plan and provide you with education on bladder/bowel health, give techniques to reduce your pain, and provide necessary manual treatment to improve tissue mobility.
Manual treatment can include but is not limited to: dry needling, myofascial release, cupping, and connective tissue mobilization.
At some point, it could be helpful to purchase a pelvic wand or dilator set to improve pelvic floor tone and length. If this is the case, we will walk through how to use these.
With each session we will reassess and progress as appropriate!