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  • Writer's pictureNicole Cozean

What is Interstitial Cystitis?

If you're dealing with interstitial cystitis or another cause of pelvic pain, there's absolutely hope. As we say in the first lines of The Interstitial Cystitis Solution:

For practical, positive information and a supportive community, we established the Finding Pelvic Sanity online Facebook group - feel free to join!


Interstitial cystitis is defined as pelvic pain or pressure that is perceived as being related to the bladder and urinary urgency/frequency. How it is experienced varies greatly from patient to patient - common places for pain to manifest are in the suprapubic area (just below the belly button), as bladder pain or urethral burning.

IC affects approximately 1 in 20 people (both men and women) in the United States.

While IC used to be thought of as primarily a bladder condition, our current understanding is that it's a complex condition that entangles the pelvic floor, bladder and central nervous system. Often the bladder is an 'innocent bystander' in the symptoms.


The two hallmark symptoms of interstitial cystitis are pelvic pain and urinary urgency/frequency. However, symptoms can manifest differently for patients, and can also include:

  • Urethral burning

  • Low back pain

  • Painful intercourse

  • Hip/groin pain


Interstitial cystitis is a diagnosis of exclusion - it's diagnosed when there isn't an infection or other discernable cause. It does not require any testing and can be diagnosed by the symptoms alone. According to the American Urological Association guidelines, symptoms must be present for at least six months for a true IC diagnosis.

Urologists will often perform a cystoscopy to look for either bladder cancer or Hunner's lesions (injuries to the bladder lining found in about 10% of IC patients), but it is not necessary for a diagnosis.

Physical Therapy for Interstitial Cystitis

According to the American Urological Association, physical therapy is the most proven treatment for IC and the only treatment given an evidence grade of 'A'. It's recommended in the first line of medical treatments.

More than 90% of patients with IC have pelvic floor dysfunction. Tight muscles within the pelvic floor irritate the nerves running through the pelvis, which can cause pain anywhere they run. The brain can also interpret this as the urgent need to use the bathroom (even though it may be hard to relax enough to go when you do reach the toilet).

The pelvic floor is also responsible for many of the associated symptoms with IC, including painful intercourse, low back pain, hip/groin pain, bowel symptoms, and more.

Wondering if you may have pelvic floor dysfunction? Take the free Cozean Pelvic Health Screening Protocol!

Pelvic physical therapy alleviates the irritation to the nerves, calms the muscles, and reverses nervous system upregulation. Learn more from the article 'The ABCs of IC and PT.'

Your pelvic PT should be addressing both internal and external factors to find the underlying 'why' of your symptoms.


At PelvicSanity, we support patients beyond the walls of our own clinic in Southern California. We offer an Out-of-Town program, remote consultations, and a Facebook support group for patients called Finding Pelvic Sanity.

Nicole Cozean

Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.

Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.

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