Interstitial Cystitis
(IC or Painful Bladder Syndrome)

Interstitial cystitis is a condition in which the bladder becomes inflamed leading to pain, an urgency to urinate and painful intercourse. Although the bladder is primarily impacted, the pelvic floor plays a central role. Read on to learn more, including treatment options.  

What is Interstitial Cystitis?

Interstitial cystitis is a condition in which the bladder becomes hypersensitive or inflamed. Rarely, red patches or lesions within the bladder wall, known as Hunner’s lesions or ulcers, appear. When the bladder is inflamed, it can’t hold as much urine as it used to.

Since the symptoms can be confused with other conditions, patients have often been misdiagnosed. That’s why, in recent years, more specific criteria for an interstitial cystitis diagnosis have been defined. They include:

• Frequent urination (urinating more than 8 times per day or at night)

• An urge to urinate, sometimes immediately after urinating

• Pain or discomfort that worsens as the bladder fills, or is improved after emptying the bladder

• Pelvic/genital pain or pelvic pressure

• Painful sexual intercourse (dyspareunia)

To be diagnosed with interstitial cystitis, symptoms must last at least six weeks and occur in the absence of an infection or other known cause. Interstitial cystitis (IC) is sometimes referred to as bladder pain syndrome (BPS). Although the defining difference between the two is the presence of Hunner’s lesions with IC, whereas BPS will typically present with inflammation minus Hunner’s lesions.  

Scientists don’t know the exact cause of interstitial cystitis or BPS, but genetics, frequent urinary tract infections and immune conditions may put people at risk.1

What Is The Role of The Pelvic Floor in Interstitial Cystitis?

The pelvic floor is comprised of a group of muscles that support and protect the organs in our pelvic region, including the bowel and bladder, against changes in intra-abdominal pressure. When they are working properly, the pelvic floor muscles form a basket or hammock shape that supports the organs against gravity and intra-abdominal pressure (pressure in the abdomen).

Although interstitial cystitis affects the bladder, it’s not all about the bladder: the pelvic floor is also key. People living with interstitial cystitis often have multiple areas of tension and weakness within the internal pelvic floor muscles, as well as throughout the external structures surrounding the pelvis. When this tension goes on for a long period of time, nearby nerves become sensitized, triggering the core symptoms of interstitial cystitis: urinary urgency/frequency, pelvic pain, painful sexual intercourse, and difficulty passing bowel movements.  

The pain and discomfort of interstitial cystitis can significantly take away from a person’s quality of life. A great deal of anxiety and stress can be triggered in anticipation of pain (e.g., when urinating or engaging in sex), which in turn, can make the pain worse. Working with a healthcare professional, such as a Pelvic Health Physiotherapist, can help to address physical and psychosocial factors involved in the pain response. 

It has been found that pelvic floor dysfunction occurs in as many as 85% of patients with interstitial cystitis

How Can Pelvic Health Physiotherapy Help Me?

It can be hard sharing an intimate challenge, such as bladder and pelvic pain. You may not even think that anyone can help – but know that help is available. After seeing a doctor to get a diagnosis, a good next step is reaching out to a Pelvic Health Physiotherapist , who is trained in all issues related to pelvic health, including interstitial cystitis.

Pelvic Health Physiotherapy focuses on building up the strength, endurance, and coordination of the pelvic floor muscles so that they can properly support our bladder and bowel, and promote optimal sexual function. The goals of pelvic floor physiotherapy include:

• Identifying any limitations in mobility throughout the spine and pelvic bones

• Increasing the mobility and flexibility of overly tense pelvic floor muscles that are contributing to your symptoms

• Optimizing blood flow to the nerves that supply the pelvic floor and bladder

• Educating on optimal toileting positions, as well as tracking dietary and fluid habits that may be worsening symptoms

• Addressing psychosocial factors that may be contributing to your pain response. Learn more here

There is strong evidence that Pelvic Health Physiotherapy can help those suffering with interstitial cystitis.

How Do We Approach Treatment For Interstitial Cystitis?

At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering people to take control of their bodies. We work with you to understand your pain, identify the causes, and treat the symptoms.

The first step: your Pelvic Health Physiotherapist will take your full medical history and discuss your symptoms. With informed consent, they will perform a complete physical assessment of the affected muscles and tissues. This can include an internal examination to reliably assess pelvic floor muscle tension, flexibility, and weakness. Based on the examination, your Pelvic Health Physiotherapist will work with you to put together a treatment plan specific to your symptoms.

We use a variety of clinically-proven techniques, from manual therapy and bladder training to pelvic floor exercises, to help improve the function of your pelvic floor to better support your bladder muscles, hip/joint stability, and sexual function.