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Interstitial Cystitis (Painful Bladder Syndrome)

Physiotherapy

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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Physiotherapy is an important way to manage the symptoms of interstitial cystitis.

There are many ways that physiotherapy can help people with interstitial cystitis (IC), also known as painful bladder syndrome (PBS), so they can have a better quality of life.

How do I know if I have problems with my pelvic floor muscles?

To find out if you have problems with your pelvic floor muscles, you’ll need to see a healthcare provider who will ask about your health and examine you. You might also need connective tissue (muscle, ligaments, and tendons) and skin sensitivity testing.

To find out if your symptoms are related to problems with your pelvic floor muscles (also called pelvic floor dysfunction), you’ll need to see a pelvic health physiotherapist. You might need a referral to see a pelvic health physiotherapist. You might also need to have some tests.

How can physiotherapy help IC/PBS?

Exercises to make your pelvic floor stronger (called Kegels) won’t likely help IC/PBS. Sometimes, they can even make symptoms worse.

A therapist will help you with treatments and teach you exercises that you can do at home.

Try this exercise:

  1. Gently tighten the muscles of your anus (the hole bowel movements are passed through). Imagine pulling a bucket up from a well.
  2. Relax these muscles. Concentrate on letting the bucket drop.
  3. Focus on feeling the anus lifting and dropping, not squeezing or clenching. Practise this for 2 to 3 minutes about 5 times a day.
 

Your physiotherapist will teach you about:

  • stretches for tight muscles in your back, hip, and pelvis
  • exercises to make muscles stronger in your back, hip, and pelvis
  • keeping a bladder diary
  • exercise programs that are right for you
  • ways to help you relax (like hatha yoga, mindful meditation, deep breathing, and Tai Chi)

You might also find out about other treatments including:

  • treatments for joint problems in your back, hip, and pelvis
  • good posture habits
  • ways to make your muscles stronger and help your connective tissue (such as ligaments and tendons) move better using massage, trigger point release, connective tissue release (such as skin rolling), and dry needling like acupuncture and intramuscular stimulation (IMS)
  • ultrasound and laser treatments to help you learn to relax the pelvic floor muscles

How do I see a physiotherapist?

Public funding for physiotherapy treatment of IC/PBS in Alberta is limited. You can find a private physiotherapist through the Physiotherapy Alberta College + Association. You can search for a physiotherapist by name or location. You can also search for “urinary incontinence” or “pelvic pain disorders” in the Conditions field. There’s a cost for seeing a private physiotherapist.

You’ll likely get in to see a private physiotherapist faster, but IC/PBS is a complex problem and it’s best to use different types of treatments at the same time. This might mean you’ll need to see other healthcare providers in the community. Your healthcare team will work together so you get the treatment that’s best for you.

Other healthcare providers that may be able to help you include:

​​Before you decide to see a private physiotherapist, call your insurance company to find out about your coverage.
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Current as of: May 1, 2020

Author: Calgary Pain Program, Alberta Health Services