How Pelvic Floor Physical Therapy Treats Interstitial Cystitis

A year ago, Greater Boston Urology introduced pelvic floor physical therapy in our Dedham Care Center for both women and men. Since then, our pelvic floor physical therapist, Alicia Jeffrey-Thomas, has built a thriving practice, and our goal is to bring even more opportunities for pelvic floor physical therapy to GBU in 2020.

Pelvic floor physical therapy can treat a wide variety of conditions. Below, Alicia discusses how pelvic floor physical therapy can treat interstitial cystitis.

Reminder: the information here and elsewhere on our site is merely educational in nature and should not to be considered medical advice or a diagnosis. Always consult your physician about your specific medical needs.

What is interstitial cystitis (IC)?

ALICIA JEFFREY-THOMAS: Interstitial cystitis is a chronic inflammatory condition that affects the bladder, the pelvic floor muscles, and the nerves and the fascia in the pelvic region. It can cause symptoms such as urgency and frequency of urination. It can cause bladder pain and lower abdominal pain. It can lead to things like lower back pain or pain with sex—things that can be really debilitating to a person's life.

How can people envision what's happening with IC?

ALICIA JEFFREY-THOMAS: If you think about your pelvic floor muscles as a voluntary muscle—so they're like your bicep muscle or the muscles that would make a fist in your hand—think about those muscles as constantly being held. You can't do the things that you want to do if your muscles are constantly clenched.

Your pelvic floor muscles should be able to contract and relax normally to allow for bowel and bladder function, to hold up your organs, and to send the right signals to your brain. With IC and with pelvic floor dysfunction, that doesn't happen the way that it should.

Who is likely to develop interstitial cystitis?

ALICIA JEFFREY-THOMAS: Interstitial cystitis can affect people throughout the age spectrum, both female and male. I'll see people as young as 18. I'll see people well into their 60s and 70s that have these same kinds of symptoms. Usually they present with symptoms of bladder pain or urgency and frequency. If we do a pelvic exam, we'll notice that their pelvic floor muscles are tight or clenched up, and they're not able to contract and relax appropriately.

Are there any misconceptions regarding IC and treatment?

ALICIA JEFFREY-THOMAS: Many times, you'll hear people say, 'Oh, if you have a pelvic floor condition, just do Kegels.' That's a common misconception. When you have a pelvic pain condition associated with bladder frequency and urgency, you don't want to do Kegel exercises. That can actually make things worse.

How do you evaluate patients presenting with IC symptoms?

ALICIA JEFFREY-THOMAS: When we assess a patient, we do an external screen and an internal exam to look at not only the pelvic floor muscles, but also everything that could possibly be tightened up because of the IC.

So we also look at the muscles in your glutes and in your abdomen to see where we need to start to work on normalizing muscle tone. I'm primarily focused on relaxing and stretching and lengthening these muscles back out so that they can work appropriately. So we'll do different manual therapy techniques, we'll have patients do stretches, we'll have them do different relaxation exercises to try to get things to be how they should be.

How effective is pelvic floor physical therapy in treating interstitial cystitis?

ALICIA JEFFREY-THOMAS: The American Urological Association has given pelvic floor physical therapy an evidence grade of A, meaning that it should be in the first line of treatment for interstitial cystitis.

When can patients expect to start seeing results/relief?

ALICIA JEFFREY-THOMAS: That really varies on the individual. Depending on the pelvic floor dysfunction, depending on the chronicity of it, and how severe it is, you can have people that will start to see results within a couple of visits. You can also have people who take a lot longer to start feeling relief. But generally, I would say within six visits or so, you should start to see some improvement and know that we're headed in the right direction.

Watch Alicia Jeffrey-Thomas discuss interstitial cystitis in the video below:

If you think you could benefit from pelvic floor physical therapy, contact your GBU physician to discuss.

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