Pelvic floor physical therapy is the most proven treatment for interstitial cystitis. It’s the only therapy given an evidence grade of ‘A’ by the American Urological Association and recommended in the first line of medical treatment. But patients often wonder how does treating muscles and fascia reduce urinary symptoms and pain that seem to be coming from the bladder?

This article reports on the first research-based screening questionnaire to determine if pelvic floor dysfunction exists.  The 10-question survey accurately identifies more than 90% of patients with pelvic floor dysfunction based on their symptom presentation, and can allow patients or their physicians to more quickly recognize pelvic floor dysfunction.

A report on a retrospective clinical trial for pelvic floor physical therapy for interstitial cystitis.  Of the thirteen patients, all reported significant improvements.  Pain and symptom bother were both reduced by more than 65%, with more than half of patients noticing an improvement within their first three visits.

A detailed case report on the physical therapy treatment of a women with interstitial cystitis, dyspareunia, and low back pain.  After 19 visits over 3 months, the patient was able to resume full-time employment and sexual intercourse.  Pain was reduced by nearly 80% over the course of treatment.

Written for the ICA Update, this patient-focused article examines how recognizing your mindset - and realizing there are ways to shift it - are keys in the road to recovery from IC and pelvic floor dysfunction.  It guides patients on becoming both better-informed on their condition and more realistically optimistic about their prognosis - creating the conditions for informed optimism, or hope.  

It's clear that successfully treating interstitial cystitis requires looking beyond the bladder.  The vast majority of patients with IC also have pelvic floor dysfunction, which can be causing or exacerbating both pain and urinary symptoms.  Research continues to highlight that recognizing and resolving pelvic floor dysfunction is among the most important aspects of IC treatment. 

For patients with pelvic pain or pelvic floor dysfunction, how you interact with your doctor can have a major impact on how you are diagnosed and treated.  

A self-care stretching regimen for patients with pelvic floor dysfunction can alleviate symptoms, maintain the gains of physical therapy, and provide long-term preventative maintenance.

A patient-centered overview of the pelvic floor and how pelvic floor physical therapy can alleviate pelvic pain and urinary symptoms in interstitial cystitis and other conditions.

Men with interstitial cystitis also benefit from pelvic floor physical therapy.  Pelvic floor physical therapy can address the pelvic floor component of IC symptoms, present in more than 80% of both men and women with an IC diagnosis.

Physical therapy is the most proven treatment for interstitial cystitis.  In studies conducted at PelvicSanity, we evaluated our patients with IC and found that they saw more than a 60% improvement in both the pain and bother of their symptoms.  More than half saw benefits within the first three visits.

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In April of 2018, Nicole will be teaching the first continuing education course for physical therapists focused on interstitial cystitis.

"Most importantly, quercetin is one of the few supplements that have been proven effective in clinical trials for pelvic pain.  In a randomized study of men with chronic prostatitis, quercetin was shown to benefit more than 2 in 3 men.  Symptoms were improved by an average of 38 percent, without significant side effects being reported by the researchers."

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Quercetin is part of our Pelvic Health Supplement pack, along with L-Arginine and Omega-3 Fish Oil.

"By resolving the trigger points in these muscles, pelvic floor physical therapy works to address the underlying cause of pelvic pain and urinary symptoms. This typically involves both external and internal trigger point release techniques, clearing inflammation from the fascia, and a customized at-home program.

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"The results were striking.  In just ten visits, 64% of men reported their symptoms were either moderately or markedly improve, and more than 80% reported at least some benefit...."

The goal is to improve the current trial-and-error approach to treatment. If we can identify underlying phenotypes, it may be possible to predict which treatments will be most effective for a specific patient. This fits with a more individualized approach to medicine, as we realize that there’s no one-size-fits-all approach for complex conditions.

"Many patients with chronic prostatitis and pelvic pain report that their symptoms get worse during the cold weather months.  It’s not just in your head – recent research confirmed the relationship between weather and pain....In fact, pain intensity was reported to be three times greater during the winter months, and the correlation was present for every man in the study.

These results correspond with the muscles of the pelvic floor being a driving force behind pelvic pain with chronic prostatitis.  As the temperature drops, these muscles get even tighter, irritating the nerves that run through the pelvis...."

"The number of trigger points was significantly associated with anxiety, stress, pain experience, and both physical and mental quality of life in patients....Multiple treatments are effective in reducing or eliminating trigger and tender points for pelvic pain. Pelvic floor physical therapy for chronic prostatitis resolves trigger points with manual therapy..."

"“We treat many men for pelvic pain and/or urinary symptoms, often diagnosed as chronic prostatitis, ‘cyclist syndrome,’ or levator ani syndrome. It’s common for these men to also be suffering from sexual pain or dysfunction that they may not even realize is related, until it also starts to improve with pelvic floor physical therapy.” — Dr. Nicole Cozean, PT, DPT, WCS, CSCS