Bladder Pain Syndrome (Interstitial Cystitis)

Bladder Pain Syndrome (Interstitial Cystitis)

Charlotte Conlon & Heidi Barlow are a Women’s Health Physiotherapists from Flow Physio Co Sutherland. Today they talks to us about Bladder Pain Syndrome (Interstitial Cystitis)

What is bladder pain syndrome?

The bladder is a pelvic organ that stores urine which is produced by the kidneys, until we decide to empty, the urine then travels down the urethra and is expelled from the body.

Interstitial cystitis is a condition causing bladder pressure, bladder pain and sometimes pelvic pain. Symptoms can vary from person to person and can range from mild to agonising. 


Common symptoms of interstitial cystitis 


• Pain in the bladder/abdomen when the bladder is filling up with urine. The kidney’s make urine constantly so they rarely get a break from pain, some may experience some temporary relief when they empty their bladder 


• Bladder urgency and frequency.  A person with a healthy bladder may urinate 7 times per day, in comparison to someone with bladder pain who may urinate in excess of 20 times day and night.

• Lower back and pelvic pain 


• Worsening of symptoms with menstruation 


• Pain with sexual intercourse 


• Ulcers/sore/bleeding in the bladder which sometimes can be seen in the urine 


• Lack of sleep to due increased urination over night 



Treatment options

• Lifestyle factors such as avoiding smoking and alcohol 


• Dietary factors such as avoiding caffeine, coffee, acidic and spicy foods 

• Managing constipation 


• Physiotherapy - Bladder pain syndrome is associated with an overactive tight pelvic floor, as the bladder fills the pelvic floor tightens and this can increase the severity of symptoms. Physio’s will perform internal and external releases of the pelvic floor and deep internal hip rotators and they can teach you how do do this. They will teach you bladder training and give you techniques to use to try and space out the time between urinating.


• Medication: Pain relief medication can help and your doctor may prescribe medication to help the bladder urgency and frequency


**There is currently no single treatment that has been found to be effective for majority of patients with bladder pain syndrome and to achieve symptom relief, many treatment options may need to be combined**

Pelvic Floor Pain | Common but not NORMAL

Women’s Health Wednesday

Here is a great video below that talks about how pelvic floor health issues are common, but how they are not spoken about and are not normal. 

Let’s start talking about it, so we can lead happier and lives.

SOURCE

What is an over-active pelvic floor? Women's Health Wednesday

This week charlotte, our women's health physio in sutherland, explains AN OVER-ACTIVE PELVIC FLOOR?

Like any muscle in the body it is important that the pelvic floor can both contract and relax.

If you think of your bicep muscle this needs to be able to contract to pick something up and relax to put something down. Imagine if the bicep was contracted all day long, it would be really hard to use your arm functionally and your bicep muscle would not work efficiently. Especially when strength is needed, the pelvic floor is the same.

Some women have pelvic floor muscles which have difficulty relaxing and remain constantly contracted. This however does NOT mean they are strong, imagine how tired they would be when you need them! 

OVER-ACTIVE ≠ STRONG

What are the symptoms of an over-active pelvic floor?

Symptoms will vary from person to person, but often include:

• Pain with sex

• Pain with using tampons

• Pain with pap-smears

• Pelvic or back pain

• Difficulty emptying bladder or bowel (constipation)

• Incontinence

• Increased sensation of needing to urinate

Who is at risk of an over-active pelvic floor? 

People who tend to have a higher risk for an over-active pelvic floor include:

• People with an overactive bladder, this is due to always needing to squeeze their pelvic floor to minimise leaking

• Strong athletic women with strong outer core muscles

• People with anxiety

• Sedentary work/life style (poor posture can shorten the pelvic floor muscles)

• Mouth/chest breathers

What is the treatment for an over-active pelvic floor?

Our initial treatment will always look at the way you breathe!

If you imagine your core and trunk muscles as a box, your pelvic floor is the base of your core with your transverse abdominus being the walls and your diaphragm muscle (breathing muscle) being the ceiling.

It is really important that all aspects of your core are working efficiently. If you are always breathing through your mouth, with a chest pattern of breathing the pelvic floor does not have a chance to relax.

Diaphragmatic breathing or “belly” breathing is essential as this allows the pelvic floor to descend and relax. 

Can I still do pilates with an over-active pelvic floor?

Yes! However more focus should be on the strength of your muscles (not including your pelvic floor initially) therefore you should not actively contract your pelvic floor during initial pilates sessions. 

As symptoms decrease, we start to add in a graded strengthening program for you pelvic floor

WOMEN'S HEALTH PHYSIO - SAFELY RETURNING TO EXERCISE AFTER PREGNANCY

Although a lot of women are keen to get back their pre baby routine it is really important to make this return as safe as possible.  

Whether you have had a caesarian or vaginal delivery we recommend you starting your pelvic floor exercises along with light walking as soon as you feel comfortable.

6 week check with your Women's Health Physio

At 6 weeks you will have a follow up appointment with your Obstetrician or GP, after this we recommend having a 6 week check up with a Women's Health Physiotherapist who will check the integrity of your pelvic floor. This is to make sure you can get a contraction, as some women's pelvic floor can be inhibited after birth and they can struggle to contact their pelvic floor muscles. It will also involve assessing the position of your pelvic organs to make sure there is no prolapse, checking for a abdominal separation and deep core contraction. Following this we will be able to safely prescribe a postnatal exercise program for you to begin. 

What about returning to running or high intensity exercise?

Although every woman’s body recovers differently, we still recommend waiting a minimum of 12 weeks, as well as having no incontinence issues, no pain or no prolapse symptoms before participating in any outer abdominal exercises such as sit ups or any high intensity core work that increases your intra abdominal pressure. This intra abdominal pressures directly puts strain on your pelvic floor.

Running is another hight impact exercise that places strain through these muscles and we recommend before beginning to run that your have your pelvic floor assessed and pass a pelvic floor stress test.