I recently read this article from a journal called Pain Medicine:
Interstitial Cystitis and Pelvic Floor Dysfunction: A Comprehensive Review
This quote stood out to me:
Many patients with IC have concomitant pelvic floor muscle tenderness and spasm known as high tone pelvic floor dysfunction. It is not clearly known why PFD exists in these patients, and no data have been published regarding its true epidemiology in the IC population. Pelvic floor dysfunction exacerbates IC symptomatology and has been reported to appear in response to events such as bladder inflammation, postural instability, sacro-iliac malalignment, and trauma. Patients with IC should be thoroughly evaluated for the presence of this condition.
(BTW, the above article is AWESOME so do check it out when you have time)
And this article from the Internationl Journal of Urology states that 50-87% of IC patients have pelvic floor dysfunction. Up to 87%!
That means that you, my dear reader, are likely to have pelvic floor dysfunction.
Maybe you see that as bad news.
But you shouldn’t. You know why?
Because you can do something about it, that’s why. You and I both know that the worst part of IC is that you often feel there is NOTHING YOU CAN DO (though I hope that you’ve read enough of our posts to know that there is always SOMETHING you can do).
And we’ve actually already written about some of the methods for treating pelvic floor dysfunction. Check out this article on biofeedback for IC and this one on physical therapy for IC.
Now, let’s be clear. There are many different types of pelvic floor dysfunction. The one that we are most interested in as people with IC is this one: high tone pelvic floor dysfunction.
When most people (including your treatment team) think of pelvic floor dysfunction, they aren’t thinking of high tone dysfunction, they are thinking of low tone dysfunction. Low tone pelvic floor dysfunction includes stuff like pelvic organ prolapse and urine leakage where kegel exercises are helpful.
High tone disorders are caused by non-relaxing pelvic muscles and can be trickier to identify. Thus, the disorder often goes untreated and is misdiagnosed related to whatever their particular symptoms are. Uh, sound familiar?
Here is what the Mayo Clinic says about high tone pelvic floor dysfunction:
…women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect the quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition.
The good news (we are full of good news today, aren’t we!) is that there are 2 fairly mainstream methods of treating high tone pelvic floor dysfunction: Physical Therapy and Biofeedback.
Physical Therapy for pelvic floor dysfunction &
The journal article from Pain Medicine also had some interesting statistics on using PT for IC:
Treatment of high tone pelvic floor dysfunction involves physical therapy. We have observed that realignment of the sacrum and ilium restores normal tension to the pelvic floor musculature. In a pilot study of 16 patients with IC diagnosed with pelvic floor dysfunction and sacroiliac dysfunction (malalignment), 94% of subjects exhibited an improvement in irritative voiding symptoms and dyspareunia following physical therapy [58]. Specific therapeutic techniques included myofascial release, joint mobilization, muscle energy techniques, strengthening, stretching, neuromuscular re-education, and instructions in an extensive home exercise program.
You all know that this site is focused on treating IC without prescription drugs. But we also want to make it clear that partnering with your health care provider is still an important part of getting better. The issue of pelvic floor dysfunction is a great example of when you can team up with your doctor or practitioner to see if this is contributing to your IC symptoms.
Your role is to recognize when your personal IC symptoms might suggest nonrelaxing pelvic floor dysfunction and to communicate your concerns to your healthcare team. They can then assist with performing diagnostic testing to confirm the diagnosis.
They can also get you that all-important referral for physical therapy so that it’s covered by your insurance!
Biofeedback for pelvic floor dysfunction & IC
Biofeedback is used to retrain the pelvic floor muscles and help patients learn to strengthen (or in our case) relax their pelvic floor muscles.
By learning to properly identify which muscles are being used and how to contract and relax them APPROPRIATELY, you can improve bowel or bladder function and decrease some types of pelvic floor pain. Biofeedback uses special sensors and software that can detect muscle contraction and relaxation. This info is then displayed to the person so that they can become aware of the muscle activity.
This real-time feedback is used to gain better control and awareness of the muscle function of the pelvic floor. Biofeedback therapy requires multiple sessions and ongoing practice to work. But, when you follow through with the regimen, it can be very successful in helping patients to stop using the incorrect pelvic floor muscles and start using the correct ones.
To wrap up, here are some other excellent resources on pelvic floor dysfunction:
Article on how to diagnose pelvic floor dysfunction and what sort of treatments are available.
Article on Biofeedback and how it is done
Okay my friends, that’s all for today. If you feel like your IC may involve your pelvic floor, take action! Read up and make an appointment to see if this is something that you should tackle.
And, as always, if you’ve had experience with this subject then leave a comment below so that other IC patients can benefit!
**Disclaimer: NO information on this site should be used to diagnose, treat, prevent or cure any disease or condition. See more information here By reading this website, you acknowledge that you are responsible for your own health decisions. Do not take anything from any website, including this one, and try it without proper research and medical supervision.
