“Only a fraction of patients with the key symptoms of IC/BPS – urinary frequency, urgency, and pelvic pain – have ulcers within the bladder. And many of the patients who are diagnosed with IC/BPS are found not to have bladder pathology as the name implies, but rather pelvic floor dysfunction.”
– Dr. Kenneth Peters, Chair of Urology at Beaumont Hospital, MI
You may have heard the term Interstitial Cystitis (IC) which is now commonly called Bladder Pain Syndrome (BPS). It is a condition that affects women more than men with an incidence of 197/100,000 women and 41/100,00 men. One of the biggest myths of Bladder Pain Syndrome is that it is exclusively a bladder condition. Fewer than 10% of patients have confirmed damage to the lining of the bladder (known as Hunner’s lesions). In fact, experts in the field now believe the bladder to be an ‘innocent bystander’ in many cases of Bladder Pain Syndrome. This condition is characterized by both pelvic floor and bladder symptoms. Symptoms related to the bladder/pelvic floor may include:
- Bladder pain
- Pain above pubic bone
- Urinary urgency or frequency
- Night time urination
- Burning with urination
Other symptoms that you may not think are related may include:
- Low back/hip/groin pain
- Painful intercourse
- Constipation
These symptoms can range from mild to severe discomfort and you may have only some and not others.
You may not know pelvic floor physiotherapy is one of the top recommended treatment options for Bladder Pain Syndrome. So how does treating muscles and fascia reduce urinary symptoms and pain that seem to be coming from the bladder?
The muscles of the pelvic floor are often tight in patients with BPS. The tension in the pelvic floor starts to affect the neighbouring fascia and muscles of the pelvis, inner thigh, lower abdomen as well as around the pelvic organs. Muscle/fascial tension also can combine to irritate the nerves that run through the pelvis, which can cause pain to manifest throughout the pelvis and surrounding areas. This cascading effect can result in poor muscle control and function of the pelvic floor. Tension in the pelvic floor as well as around the bladder can cause the brain to interpret these signals as the urgent need to go to the bathroom, which creates the urge to go even when you know the bladder is nearly empty.
Here at Donna Sarna Phyiotherapy, our treatment approach is global as many people with BPS/IC may have tension that extends throughout the whole body. By performing myofascial release, visceral manipulation, posture education and stretches, and modalities such as acupuncture, tension can be reduced and function can be restored!
Stay tuned for our next post on “Vocal Dysphonia”