The Facts
Interstitial Cystitis/Painful Bladder Syndrome is common, affecting up to 12 million people in the United States alone. IC/PBS is a clinical diagnosis of exclusion, which means the diagnosis is made by ruling out other symptom causes, such as infections. Less than 10% of people diagnosed with IC/PBS have Hunner’s Lesions on the bladder lining, these lesions are identified via cystoscopy. The majority of patients have other causes of their symptoms. The three main subtypes are pelvic floor dysfunction, hormonal deficiencies, and central nervous system dysregulation. The diagnosis is made based on symptom report alone for most people.
Symptoms
- Urinary urgency, frequency, and pain in the absence of infection
- Lower abdominal pressure
- Pain upon bladder filling or emptying
- Painful sex
- Painful orgasm
- Generalized pelvic pain
- Nocturia (waking at night to urinate)
Symptoms
- Urinary urgency, frequency, and pain in the absence of infection
- Lower abdominal pressure
- Pain upon bladder filling or emptying
- Painful sex
- Painful orgasm
- Generalized pelvic pain
- Nocturia (waking at night to urinate)
Associated Diagnoses
IC/PBS is considered a chronic overlapping pain condition (COPC). Many people who have the symptoms of IC/PBS may also suffer from Vulvodynia, Endometriosis, Fibromyalgia, TMJ, and migraines. All of these conditions are associated with pelvic floor dysfunction and pelvic floor physical therapy can help!
Causes of IC/PBS
- Pelvic floor dysfunction
- Hormonal deficiencies
- Central Nervous Dysfunction
- Repetitive Urinary Tract Infections
- Orthopedic injuries/trauma
- Surgical trauma
- Endometriosis
- GI dysregulation
Causes of IC/PBS
- Pelvic floor dysfunction
- Hormonal deficiencies
- Central Nervous Dysfunction
- Repetitive Urinary Tract Infections
- Orthopedic injuries/trauma
- Surgical trauma
- Endometriosis
- GI dysregulation
Diagnostic Challenges
Many experts understand IC/PBS and its various subtypes, recognizing that IC/PBS is not a disease of the bladder but rather a syndrome that can be managed with effective interdisciplinary, coordinated care. The majority of urologists in the US have not undergone training in pelvic pain syndromes, including IC/PBS, which leads to misdiagnosis and management. The American Urologic Association updated the IC Guidelines in 2022, stating that manual pelvic floor physical therapy should be offered to all people who meet the diagnostic criteria for IC/PBS.
Diagnostic Challenges
Research shows that it can take up to five years for women with pelvic pain to get a proper diagnosis and up to 11 years for a woman with Endometriosis. This is because the symptoms of pelvic pain can mimic conditions such as urinary tract, yeast, bladder and sexually transmitted infections. When the pelvic floor is the culprit, the diagnostic tests for these infections are negative, leading to confusion for both the medical provider and the patient. Many medical providers are not aware that pelvic floor dysfunction can cause pelvic pain and it certainly does not occur to women to go to physical therapy when these symptoms arise. The majority of our patients tell us they did not know they even had a pelvic floor until things started to go wrong!
Treatment:
How we can help you
If you are having issues with your sexual function, it is in your best interest to get evaluated by a therapist for pelvic floor therapy, so they can establish what part, if any, of your pelvic floor may be contributing to the symptoms you are experiencing. During the course of the examination, the physical therapist will talk to you about your medical history and symptoms, including what you have been previously diagnosed with, the treatments or therapies you have had, and how effective or ineffective these therapies have been for you. It is significant to mention that we fully comprehend what you’ve been dealing with and that the majority of individuals are angry by the time they make it to see us. The physical therapist will conduct an evaluation of the patient’s nerves, muscles, joints, tissues, and movement patterns while doing the physical examination. After the examination is finished, your therapist will go over the results of the assessment with you. The physical therapist will conduct an evaluation to determine the cause of your symptoms and will establish both short-term and long-term therapy goals based on the results of the evaluation. Physical therapy treatments are typically administered between once and twice each week for a period of around 12 weeks. Your physical therapist will assist you in coordinating your recovery with all the other experts on your treatment team. They will provide you with an exercise regimen to complete at home and the sessions you attend in person. We are here to assist you in getting better and living the best life possible.
For more information about IC/PBS please check out our IC/PBS Resource List.
Treatment:
How We Can Help You
If you are having issues with your sexual function, it is in your best interest to get evaluated by a therapist for pelvic floor therapy, so they can establish what part, if any, of your pelvic floor may be contributing to the symptoms you are experiencing. During the course of the examination, the physical therapist will talk to you about your medical history and symptoms, including what you have been previously diagnosed with, the treatments or therapies you have had, and how effective or ineffective these therapies have been for you. It is significant to mention that we fully comprehend what you’ve been dealing with and that the majority of individuals are angry by the time they make it to see us. The physical therapist will conduct an evaluation of the patient’s nerves, muscles, joints, tissues, and movement patterns while doing the physical examination. After the examination is finished, your therapist will go over the results of the assessment with you. The physical therapist will conduct an evaluation to determine the cause of your symptoms and will establish both short-term and long-term therapy goals based on the results of the evaluation. Physical therapy treatments are typically administered between once and twice each week for a period of around 12 weeks. Your physical therapist will assist you in coordinating your recovery with all the other experts on your treatment team. They will provide you with an exercise regimen to complete at home and the sessions you attend in person. We are here to assist you in getting better and living the best life possible.
For more information about IC/PBS please check out our IC/PBS Resource List.
Frequently Asked Questions
What is Interstitial Cystitis (IC)?
Is a cystoscopy needed to diagnose IC?
What are common symptoms of Interstitial Cystitis?
What are recommended treatments for people with IC?
How common is it for people with IC to also have pelvic floor dysfunction?
How common is it for people with IC to have vulvodynia?
Are there exercises that can make IC symptoms worse?
Are there exercises that can make IC symptoms better?
What are different causes of IC?
Do all physical therapists know how to treat IC?
What does a PT evaluation for IC entail?
How many physical therapy visits does it typically take for people with IC to feel better?
Why didn’t my doctor tell me about pelvic floor physical therapy?
Can menopause cause IC?
Can birth control pills cause IC?
What are IC subtypes?
A pelvic floor physical therapy evaluation is recommended to help people determine if pelvic floor dysfunction is contributing to their symptoms. If pelvic floor dysfunction is found the AUA recommends manual pelvic floor physical therapy as part of the treatment plan.