Is it Interstitial Cystitis or Pelvic Floor Dysfunction?
- Dr.Bhavti Soni
- Sep 23, 2022
- 3 min read
Updated: Aug 26, 2025
Bladder Pain Syndrome (BPS), also called Interstitial Cystitis (IC), is a complex condition that affects thousands of people—yet remains widely misunderstood. Patients often describe it as a constant burden of pain, urgency, and uncertainty.
It’s officially recognized as a cluster of symptoms, which may include:
Painful urination
Suprapubic pain or pressure
Urinary urgency and frequency
Pelvic pain radiating into the back, hips, or legs
Because it is considered a diagnosis of exclusion, a variety of other conditions must be ruled out before a diagnosis of IC is confirmed. Importantly, not every patient with IC has Hunner’s lesions (the classic bladder wall finding seen on cystoscopy). In fact, research shows that only 5–10% of IC patients present with these lesions (Hanno et al., 2015, AUA Guidelines). This raises a critical question: If many IC patients don’t have visible bladder lesions, what else could be driving their symptoms?
Symptom Overlap: Pelvic Floor Dysfunction vs. IC
The bladder sits in close proximity to the pelvic floor muscles—a network of muscles that support the bladder, uterus, and bowel. Because of this anatomical closeness, bladder irritation and pelvic floor dysfunction often feed into one another.
Tight or overactive pelvic floor muscles can compress nerves and restrict bladder mobility, leading to symptoms of urgency, frequency, and pelvic pain.
Irritated pudendal or pelvic nerves may radiate pain that feels identical to bladder-related pain.
Studies confirm this overlap: 80% of people diagnosed with IC/BPS also present with some form of pelvic floor dysfunction (FitzGerald et al., 2012, Journal of Urology).
This creates a diagnostic puzzle. Many patients are left wondering:
“Is this an IC flare-up?”
“Is it my pelvic floor muscles?”
“Could it be another UTI?”
Unfortunately, misdiagnosis is common. One study showed that IC patients often experience a delay of 3–7 years before accurate diagnosis because symptoms mimic UTIs and other pelvic conditions (Clemens et al., 2005, Urology).
Why Pelvic Floor Therapy Matters
As a pelvic floor physical therapist, I see this overlap every day in the clinic. Many patients who come in with “IC symptoms” discover that tight, guarded pelvic muscles are amplifying or even causing their bladder-like symptoms.
Evidence supports this approach:
A randomized trial found that pelvic floor physical therapy significantly improved symptoms in women with IC/BPS, particularly urgency and pain (FitzGerald et al., 2012).
Another study demonstrated that myofascial physical therapy led to marked relief in nearly 60% of IC/BPS patients compared to just 26% in a control group receiving general massage (FitzGerald et al., 2012, J Urol).
Common Symptoms Improved with Therapy
Pelvic pain or suprapubic pressure
Urinary urgency and frequency
Incomplete emptying or straining to urinate
Post-void dribbling
Lower back or leg pain related to pelvic nerves
By working to release tight pelvic floor muscles, improve blood flow, and retrain muscle coordination, many patients reduce their flare-ups or even reclaim normal bladder function.
The IC–Vulvodynia Connection
It’s also important to note that a significant number of patients with IC/BPS also experience Vulvodynia—burning or pain in the vulvar region. Research suggests that as many as 25–30% of women with IC also report vulvar pain syndromes (Peters et al., 2007, Journal of Urology). This overlap underscores the importance of a comprehensive pelvic health evaluation, rather than focusing on the bladder alone.
My Approach as a Pelvic Health Specialist
When a patient comes to me with bladder pain, urgency, or frequency, my goal is to unravel the confusion. Unless there are very clear signs of infection, I often encourage patients to first explore their pelvic floor function before assuming every flare is “just IC.”
I combine:
Evidence-based pelvic floor therapy (manual release, relaxation training, neuromuscular re-education).
Bladder-friendly lifestyle coaching (hydration strategies, diet modifications, stress management).
Compassionate care that acknowledges the physical and emotional toll of living with bladder pain.
Over time, many of my patients learn to recognize their flare triggers and develop tools to reduce symptoms before they escalate.
Take the Next Step
If you are navigating the challenges of bladder pain, urinary urgency, or pelvic discomfort, please know: you don’t have to face it alone.
As a pelvic floor physical therapist (and doula), I specialize in helping patients untangle whether their symptoms stem from the bladder, the pelvic muscles, or a combination of both. With the right approach, many people are able to reduce their symptoms and reclaim control of their daily lives.
Click below to schedule a consultation and start your journey toward clarity, relief, and healing.
Dr. Soni is actively involved to improve awareness about the pelvic floor muscle involvement in IC/BPS. She has been a speaker in the Global Interstitial Cystitis Conference since past 2 years and have conducted teachings in US and abroad on the same topic. She is a believer in holistic and wholistic approach to Pelvic health in IC and works alongside urologists, urogynecologists, pelvic pain specialists, functional medicine doctors to improve the outcomes in her patients.
Comments