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Physical Therapy Helps IC
Image Courtesy of Ava Sol via Unsplash

Interstitial Cystitis, Multimodal Treatments, and How Pelvic Health Physical Therapy Helps IC

Interstitial cystitis (IC) also known as bladder pain syndrome or painful bladder syndrome, is a debilitating condition that significantly affects the quality of life of patients living with it.

The definition of IC from an international consensus is:

An unpleasant sensation (pain, pressure, 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 cause" (Hanno et al, 2009).

Interstitial cystitis affects 6-11% of women and 2–5% of men and increases with age from 1.7% under the age of 65 and up to 4.0% in women aged 80 years or older (Clemens et al., 2007 and Lifford et al., 2009). Patients that live with IC report that their quality of life is significantly impacted affecting their psychosocial, work-life, psychological well-being, personal relationships, and general health (Clemens et al., 2007). One important domain that is affected by IC is sexual function. Women with IC rated their sexual dysfunction as moderate to severe when compared to controls and reported increased pain with intercourse, decreased desire, and decreased frequency of orgasm (Peters et al., 2007 and Tincello et al., 2005).

What are the symptoms of IC?

  • The Hallmark sign of IC is pain/pressure above the pubic bone or throughout the pelvis (urethra, vulva, vagina, rectum lower abdomen, and back), related to bladder filling (Tincello et al., 2005; Fitzgerald., 2005 and Warren et al., 2008).
  • Another symptom of IC is increased pain with specific foods or drinks and/or worsened with bladder filling and/or improved with urination (Warren et al., 2008).
  • Additionally, patients with IC commonly experience a sudden urge to urinate that can cause discomfort. This is called urinary urgency and happens in 84% of IC patients.
  • An additional finding in patients with IC is the need to urinate frequently >10x/day. This is seen in 92% of patients diagnosed with IC (Tincello et al., 2005).

How Pelvic Health Physical Therapy Helps IC:

According to the American Urological Association, pelvic health physical therapy is the only treatment modality with an evidence grade of A.

Below we include details from several studies showing that pelvic health physical therapy helps IC patients. Manual therapy techniques were recommended on the pelvic, abdominal, and/or hips regions. Specific techniques used are:

  • trigger point release
  • lengthening of tight muscles
  • lengthening of connective tissue restrictions
  • scar tissue mobilizations

There have been several high quality studies showing the benefits of manual physical therapy to improve the symptoms of IC. One study by Fitzgerald et al., 2012 compared myofascial physical therapy to global therapeutic massage in patients with IC over a twelve week period. The results of the study found the myofascial physical therapy group had statistically significant improvements of 59%, as compared to 26% in the global therapeutic massage group. These results show a positive correlation that pelvic health physical therapy helps IC.

The American Urological Association recommends multimodal therapies to address all domains that IC can affect. Physical therapy, pain counseling, psychology, and stress management are recommended therapies to help manage symptoms. Studies show both that using these therapies together decreases the need for pain medications and that a focus on pelvic health physical therapy helps IC.

If you have some of the above symptoms make an appointment with a pelvic health therapist for an evaluation. Contact us here for an in-office visit, a telehealth session in California, or a virtual consultation worldwide.

** The American Urological Association has recently (2022) published updated guidelines to the treatment of IC and BPS.  These updates are highlighted and discussed in our blog post: Updates to Interstitial Cystitis / Bladder Pain Syndrome Treatment Guidelines. **

 

References

  • Hanno P and Dmochowski R: Status of international consensus on interstitial cystitis/ bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourology and Urodynamics 2009; 28: 274.
  • Clemens JQ, Link CL, Eggers PW et al: Prevalence of painful bladder symptoms and effect on quality of life in black, Hispanic and white men and women. J Urol 2007; 177:
  • Lifford KL and Curhan GC: Prevalence of Painful Bladder Syndrome in Older Women. Urology
    2009; 73: 494
  • Peters KM, Killinger KA, Carrico DJ et al: Sexual function and sexual distress in women with
    interstitial cystitis: a case- control study. Urology 2007; 70: 543.
  • Tincello DG and Walker AC: Interstitial cystitis in the UK: results of a questionnaire survey of
    members of the Interstitial Cystitis Support Group. Eur J Obstet Gynecol Reprod Biol 2005;
    118: 91.
  • Fitzgerald MP, Koch D and Senka J: Visceral and cutaneous sensory testing in patients with painful bladder syndrome. Neurourol Urodyn 2005; 24: 627.
  • Fitzgerald, MP et al: Randomized multicenter clinical trial of myofascial physical therapy in
    women with interstitial cystitis/painful bladder syndrome (IC/PBS) and pelvic floor tenderness. J
    Urol 2012; 187: 2113
  • Warren JW, Brown J, Tracy JK et al: Evidence Based criteria for pain of interstitial cystitis/painful
    bladder syndrome in women. Urology 2008; 71: 444

What Our Patients Have to Say

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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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