interstitial cystitis

What Causes Bladder Pain and How's it Treated?

Pelvic Floor Doctor
Medically Reviewed By Dr. Amanda Olson, DPT, PRPC

Bladder pain is commonly caused by the following factors: Interstitial cystitis (IC), urinary tract infection, bladder cancer, and muscle spasms in the pelvic floor. It is often necessary to be evaluated and receive testing by a urologist to determine the driver of bladder pain.

Common Causes

It can be caused by an impairment in the bladder lining, and injury to the bladder itself or the spinal cord. The primary symptom of IC is bladder pain, particularly when the bladder fills.

Those with IC may also report pain in the low back, abdomen, groin, and inner thigh. Pain with intercourse is also common. People with IC also commonly experience the urge to urinary frequently, however may only urinate small amounts.

To rule out other issues such as urinary tract infection, or bladder cancer, a physician will commonly test the urine for the presence of bacteria, and perform other blood tests and imaging on the bladder.

Treatment varies depending on the diagnosis. Interstitial cystitis is a chronic inflammatory condition of the bladder.

5 Treatments for Bladder Pain and Interstitial Cystitis 

A myriad of treatments are available for those suffering from IC and bladder pain symptoms. It can sometimes require trying different forms of treatment to determine what works best for the individual.

The following treatments are commonly offered to people with IC:

Medications

Elmiron is currently the only medication approved for the treatment of IC. Some people do not experience relief with Elmiron, and it is known to take several months for effects to be felt.

Anti-seizure medications such as gabapentin (Neurontin) or Topomax are sometimes prescribed to treat the effects of IC. Tricyclic antidepressants are also sometimes prescribed.

Pelvic Physical Therapy

Pelvic health physical therapy (PT) is a specialized form of physical therapy. The pelvic floor muscles surround and support the bladder and other pelvic organs. Often these muscles become too tight with tender points in them that can make pain and urination symptoms worse.

Pelvic floor physical therapists use biofeedback, ultrasound imaging, manual therapy, and specific exercises to help decrease pain, retrain bladder behaviors, and improve quality of life for those suffering from IC symptoms.

Pelvic physical therapy is commonly covered by insurance but in some cases is cash based. Often a referral from a doctor is needed to see a pelvic PT.

Diet

Many foods and beverages are irritating to the bladder. It is helpful to eliminate or significantly reduce known bladder irritants. These include: caffeine, alcohol, sugar, and highly citric foods and drinks.

Many people find that using an elimination diet is helpful to determine which foods and drinks are most irritating to them as it can very from person to person.

There is no one size fits all interstitial cystitis diet, but working with a doctor or dietitian can help to find a proper balance.

Mind, Body, and Relaxation Practices

Pain is often worsened with stress. Stress can in turn drive muscle clenching, inflammation, and nerve sensitivity which cyclically causes more pain. It is helpful to find a routine to help reduce daily stress and to help reduce the effects of more acute stress in life.

Breathing exercises, guided meditation, yoga, pilates, walking, and other gentle forms of exercises are highly beneficial in reducing stress, improving body awareness, and improving wellbeing.

Supplements

Natural supplements such as capsulized aloe vera have been reported to reduce pain, improve urinary symptoms, and improve wellbeing in people with IC. 

Soothing aloe vera capsules help to reduce inflammation in and around the bladder resulting in relief of symptoms when capsules are taken orally. L-Arginine can be taken for inflammation and improvement in circulation for healing.

Another supplement for IC is Omega- 3 fish oil, while also helps to reduce inflammation and improve circulation. Be sure to discuss supplements with your doctor as they may impact medications that you are taking.

Bladder pain and IC are challenging conditions to manage, but remedies are available to reduce pain and improve quality of life. Many people respond well to a comprehensive program of gentle exercise, pelvic physical therapy, diet, and supplementation with good results.