Overactive Bladder Syndrome
Condition Overview
Overactive Bladder Syndrome (OAB) is a condition where your bladder contracts/spasms involuntarily even if it is not full. This can lead to an overwhelming sense of urgency to urinate and can cause urinary incontinence, increased urinary frequency during the day and night (nocturia). This can lead to increased mental stress and decreased quality of life - feeling like your bladder has full control over your daily activities.
It is more common in people over the age of 45 and increases significantly at the age of 65.
There Can Be Many Causes Of OAB Including
Bladder infections irritate your bladder lining causing involuntary bladder spasms.
Estrogen deficiency during menopause is a hormonal change that can cause urinary urgency; estrogen is also a protective hormone of the pelvic floor allowing increased blood and tone to these tissues so without it they can thin and weaken.
Abdominal trauma such as pregnancy and childbirth can weaken your core muscles including your abdominal and pelvic floor muscles.
Chronic poor bladder habits include just in case urinating, pushing to pee, and hovering over the toilet seat. Over time these can strain the bladder and pelvic floor system and lead to increased urgency, frequency, and incontinence.
Impaired nerves can cause poor signals to be sent from the brain to the bladder which tell the bladder to contract at the wrong times.
Medications can have side effects which dull the nerves and cause your bladder to overflow while bladder irritants such as caffeine and alcohol act as a diuretic which causes your bladder to fill rapidly.
Overactive bladder symptoms include urinary urgency or a sudden uncontrollable need to urinate; urinary frequency or the need to use the restroom every 30 minutes to 1.5 hours; urge incontinence or leaking of urine when you feel the urge to pee; and nocturia or needing to use the restroom at least 2x/night.
How Will Physical Therapy Help Me?
It is important to have a multi-disciplinary approach to treating OAB. One part of that team should be a pelvic floor physical therapist. Although OAB may not always start as a muscular issue, overtime the muscles become a huge part of treating and managing the symptoms.
In pelvic health therapy we will discuss your symptoms and go over each of the systems of the pelvic floor (bladder, bowel, sexual health, and gynecological health). We will also have you fill out a bladder diary which will assist us in noticing patterns in your day to day life that increase your symptoms - with this information we will work on behavioral changes and bladder retraining.
With your consent, we will perform an external and internal pelvic floor muscle assessment. We will assess your abdominal wall, low back/hips, adductors, and superficial and deeper pelvic floor muscles. We will determine your muscle function, strength, endurance, and coordination.
We will set-up a treatment plan depending on your pelvic floor characteristics. We will educate you about optimal bladder and bowel health and hygiene habits. Manual treatment can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization. Exercises can include but are not limited to kegels, hip and abdominal strengthening, downtraining/pelvic floor stretches, and functional mobility exercises. With each session we will reassess and progress as appropriate!