• Emily Reul, PT, DPT

Interstitial Cystitis

Hello friends, today let’s talk about Interstitial Cystitis (IC). This can be a very frustrating condition as there is often controversy about how to diagnose it and how to treat it. This can make navigating treatment and managing symptoms very difficult, but it is possible to live a happy life with IC!

What is IC?

Let’s start by first defining what IC is. You may hear it described as other names like painful bladder syndrome (PBS), hypersensitive bladder syndrome, bladder pain syndrome, or urologic chronic pelvic pain syndrome.


There has been debate over how to diagnose it, but it is currently a diagnosis of exclusion which means your provider will give you this diagnosis when everything else has been ruled out. In the past, Hunner’s lesions (ulcers in the bladder) used to be the characteristic for diagnosing IC, but they have found that the majority of people with IC don’t have these lesions. Your provider will diagnose you with IC when symptoms are present for longer than 6 weeks and no other condition (like a UTI or bladder cancer) can explain your symptoms.


What symptoms are we talking about? IC is often a combination of bladder and pelvic pain symptoms. Some of the bladder issues include urinary urgency (that strong “gotta go” sensation), urinary frequency (more than 5-8 times per day), and nocturia (having to get up in the middle of the night to go to the bathroom). Pelvic pain symptoms may be pain in the pelvic floor muscles but can also be referred pain to the back, hips, groin, or tailbone. You may also experience dyspareunia (pain with sex). The nervous system and inflammation play large roles in IC symptoms and can be part of the key to treating them.


About 90% of patients with IC may find that they have sensitivities to certain foods, which when consumed can make their symptoms worse. These foods often include caffeine, alcohol, artificial sweeteners, spicy foods, and citrus.


Who gets IC?

Both males and females can get IC. There’s actually some research that suggests that chronic prostatitis in men is actually IC. IC is very common, but may be underdiagnosed and underreported in research. It is estimated that more than 12 million individuals in the United States deal with IC symptoms. It’s as common as other conditions like heart disease and depression.


Individuals who have disorders like irritable bowel syndrome (IBS), fibromyalgia, asthma, allergies, migraines, depression, and heart disease are more likely to have IC.


How do we treat IC?

One of the major keys to treating IC is using an interdisciplinary approach. That’s a fancy way of saying that it often takes multiple providers to successfully treat IC. Your physician will help with ordering test to make sure your symptoms aren’t another disorder and with prescribing medications to help with symptoms. Your physical therapist will help with pelvic pain and pelvic floor muscle dysfunction. Your mental health provider will help with managing stressors to help calm the nervous system. When looking for a pelvic floor PT, it may be beneficial to find a provider that has experience in treating chronic pelvic pain.


It can often be overwhelming to see different providers, especially if they are not working together. Trust your gut, and remember you can heal with IC. The more you educate yourself on IC and the most up-to-date research, the more you will be able to advocate for yourself to each provider.


Are you ready to take control of your IC? Here are some great resources:

  • Ask your healthcare provider for a referral to a pelvic therapist.

  • Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.

  • Watch our interview with Dr. Nicole Cozean PT, DPT, WCS, CSCS

What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.  

Written by Emily Reul, PT, DPT


References

1. Cozean N, Cozean J. The Interstitial Cystitis Solution: a Holistic Plan for Healing Painful Symptoms, Resolving Bladder and Pelvic Floor Dysfunction, and Taking Back Your Life. Beverly, MA: Fair Winds Press; 2016.

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This information is for awareness purposes and not individual medical advice. You should seek your own professional counsel for any medical condition or before starting or altering any exercise or fitness program.

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