Interstitial cystitis is a chronic pain problem involving the pelvis, bladder, and urethra that occurs in men and women. Chronic inflammation in the lining of the bladder wall occurs. There is a defect in the bladder epithelium lining called the GAG (glycosaminoglycan) layer which makes the lining more permeable, sensitive, and easily irritated by the urine or other substances in the urine. Most patients have non-ulcerative IC involving glomerulations or pinpoint hemorrhages in the bladder wall seen on cystoscopy yet some suffer from more intense pain from Hunner’s Ulcers in the bladder wall which are large red patches and are sometimes bleeding. Symptoms of IC may include urination frequency, urgency, pain, pressure, and burning. Other common symptoms include painful intercourse and diffuse pelvic pain. Symptoms can felt be in the suprapubic region of the pelvis and /or surrounding areas. Patients may also experience thigh, groin, low back, and hip pain. Some experience pain or pressure before, during and/or after urination. Upon urinating, symptoms are often alleviated. The cause of IC is unknown yet some theories or possible triggers include bladder trauma, sexual trauma, chronic infections or cystitis, pelvic floor muscle dysfunction, chronic holding or prolonging urination, autoimmune disorders, primary neurogenic inflammation, or spinal cord trauma.
How can Pamela Morrison Physical Therapy, P.C. help with IC?
A comprehensive physical therapy evaluation can determine if there is a musculoskeletal or neurological problem potentially causing or perpetuating the bladder and pelvic pain. Your musculoskeletal evaluation at Pamela Morrison Physical Therapy would determine if there are related joint problems, muscular problems such as pelvic floor muscle dysfunction, or nerve involvement in the pelvis, around the bladder area, and in surrounding structures. Your physical therapist may perform myofascial and trigger point release techniques to abdominal, hip, low back, and buttock muscles; nerve tension release techniques, and realign pelvic, sacroiliac, spine, and hip joints which may improve your symptoms or resolve them. Skillful visceral manipulation to the bladder and surrounding organs has truly proven to be an effective treatment approach in our clinic providing long term relief of symptoms. There are also other modalities such as electrical stimulation that may help calm the bladder and/or relieve pain. Use of physical therapy modalities such as interferential electrical simulation and TENS (transcutaneous electrical nerve stimulation) have been proven effective via research studies in treating patients with IC. Using real-time ultrasound and biofeedback enables the patient to understand the function of the pelvic floor muscles and low back muscles in bladder health. Specific exercises such as stretching, core stabilization, and pelvic floor muscle exercises aimed at down-training may be prescribed. Helping you to gain control of bladder habits and dietary/behavioral triggers is a crucial component of therapy. Sexual positions for improved comfort are also addressed.