Relief. Restore. Recover.
Your bladder is one of those things you shouldn’t really feel. But when you’ve been diagnosed with interstitial cystitis or painful bladder syndrome, then boy do you ever!
When it comes to healing from bladder pain, pelvic floor physiotherapy is non-negotiable.
We are here to help you experience relief from bladder pain, to restore normal bladder function, and to recover your health and well being.
There is a lot of confusion about interstitial cystitis (IC) – even among healthcare professionals. No wonder so many people who suffer from painful bladder symptoms are frustrated!
Research continues to evolve but for now, allow us to provide some clarity on the most current thinking:
Interstitial cystitis/painful bladder syndrome is defined as “an unpleasant sensation (pain, pressure and discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes”.
Interstitial cystitis was originally thought to be an inflammatory condition affecting the lining of the bladder wall. For much of the past century, it was thought that lesions (or Hunner’s ulcers) in the bladder lining were responsible for bladder pain.
However, more recent studies have shown that the majority of people with “interstitial cystitis” do not have Hunner’s lesions in their bladder. (This has led to a lot of debate in the medical and scientific community. Its led to even more confusion and sadly, misdiagnoses).
Individuals with interstitial cystitis who have Hunner’s ulcers in the bladder lining have a clinical presentation that is quite differently from those who have interstitial cystitis without Hunner’s ulcers.
The most recent recommendations on interstitial cystitis indicates that the non-Hunner’s ulcers form of IC should be called “painful bladder syndrome”. Yet many clinicians and continue to call it IC.
It is important we have accurate diagnoses and use clear consistent terminology. When we know know we are treating, then we are more likely to get the treatment right!
Signs and symptoms vary based on the individual. But there is a lot of overlap with symptoms that are typical of pelvic floor dysfunction. In fact, up to 87% of patients with the diagnosis of IC (the non-Hunner’s lesions form) have pelvic floor dysfunction.
Increasingly it it thought that the bladder is not really the problem, but that rather, it is an innocent bystander of pelvic floor dysfunction and central sensitization.
Symptoms of non-Hunner’s IC (aka painful bladder syndrome) include:
- urinary urgency
- overactive bladder
- painful sex
- persistent pelvic pain
- urinary retention
Associated diagnoses often accompanying painful bladder syndrome include:
- pudendal neuralgia
- chronic headaches
When care is holistic and comprehensive, then people get the best and most sustained results. It is important to seek care not only from the medical or pharmacological sources, but also through:
- lifesyle medicine
- naturopathic medicine
- complimentary and alternative medicine
- behaviour therapy
- integrative nutrition
- movement therapy
- and importantly, pelvic floor physiotherapy
The majority (87%) of women with IC/PBS also have pelvic floor dysfunction. Why is this and what does it have to do with IC?
The pelvic organs, pelvic fascia, and pelvic floor muscles all lie within close proximity. You may not have heard of the viscerosomatic/somatovisceral reflex, but it helps to explain why pelvic floor physiotherapy can help to improve bladder pain.
The bladder and pelvic floor are two closely interrelated structures that experience “cross talk” all the time. This means that pain or sensations connected to the bladder can manifest or be experienced in the pelvic floor. Conversely, pain or dysfunction in the pelvic floor can manifest in the bladder.
So is it the pelvic floor causing bladder pain? Or the bladder causing pelvic floor dysfunction? That is what research is working on figuring out.
But for our purposes, it doesn’t really matter. We know that when we work directly on the pelvic floor tissues, we can impact the state of the bladder as well.
Our pelvic floor work involves improving tissue health, flexibility and range of motion, compliance, texture, tone, position, resilience, coordination and more.
Pelvic floor physiotherapy treatment for IC/PBS focuses on two key areas:
1) Restoring tissue health by manually working on:
- tender points in pelvic floor muscles
- connective tissue dysfunction
- neural tension
- pelvic floor muscle tightness or spasm
- pelvic floor muscle weakness
- skin and muscles of the low back, groin, buttocks, perineum, lower abdomen
- viscera imbalance
- pelvic, back, and hip issues (joints and muscles)
2) Remapping your brain to bring healing from the top down. What does this mean?
- Your body and brain work together! They are a package deal.
- Your central nervous system is made up of your brain and spinal cord. It is the control centre for everything
- You experience sensations through your nervous system. Your body sends information to your brain via nerves, and your brain interprets the information it receives from your bladder and entire pelvic area.
- Your brain then will send a response back down to your bladder and pelvic area based on how it interprets the information it has received. Often the response is to produce more pain – especially if you have stress, anxiety, depression, tend to catastrophize, or are centrally sensitized!
- We can teach your brain to respond differently by working on various parts of the brain which modulate pain.
- We can change your experience with bladder pain by changing your brain.
Our Bladder Pain Programs
We start by getting to know you and understanding your experiences. We want to know how your painful bladder symptoms are affecting your life, what you have tried, and what your goals are. We’ll ask questions about your pelvic health and look at your bigger health picture as well.
After this, we check out how your unique body is working and let you know what we find. Our programs include custom recommendations, hands on strategies, practical advice, step by step home exercise protocols, email support, accountability, educational resources, product recommendations, letters to your healthcare team, and more.
All that we offer is designed to help heal your body, restore your bladder function, and get back to a pain free life.
Our bladder pain programs will be a great fit for you if…
You’re willing to consider the impact of your whole health on your symptoms (eg. sleep, nutrition, stress, etc.)
You are open to the idea that your bladder pain experience may not be actually coming from your bladder
You want more non-drug options and gentle strategies for effectively managing your symptoms
You are committed to engaging in the progressive and meaningful work of healing from pain