(646) 355-8777

Herman & Wallace Blog

Pelvic Floor Physical Therapy for Interstitial Cystitis

Interstitial cystitis is a chronic pain condition characterized by both pelvic pain and urinary symptoms.  It’s diagnosed by unexplained pain or pressure that is perceived to be related to the bladder, and affects more than 12 million Americans.  It’s often described as the sensation of a urinary tract infection, but without any bacterial infection.  Many patients report severe pain, often more intense than that associated with bladder cancer, and up to 85% of patients have accompanying pelvic floor dysfunction.

Pelvic floor physical therapy is the most proven treatment for interstitial cystitis.  It’s recommended by the American Urological Association (AUA) as a first-line medical treatment in their IC Guidelines, and is the only treatment given an evidence grade of ‘A’.  Furthermore, it’s the sole intervention that provides sustained relief; bladder treatments and oral medications must be continued indefinitely to provide benefit, if they work at all.


Research has demonstrated that at least 85% of patients with interstitial cystitis also have pelvic floor dysfunction.  In fact, many of the symptoms of IC can only be explained by the pelvic floor.  The majority of patients report painful intercourse, low back pain, hip pain, or constipation accompanying the condition; symptoms that have nothing to do with the bladder.

“More than 20 years of research supported by the National Institutes of Health and industry have failed to show that bladder-directed therapy is superior to placebo [for IC].  This fact suggests that the bladder may be an innocent bystander in a larger pelvic process.  As clinicians, we must be willing to look beyond the bladder and examine for pelvic floor issues and other causes of patient’s symptoms and not be too quick to begin bladder-focused treatments.” – Dr. Kenneth PetersPatients discover that Pelvic PT is an option

Despite this, many patients don’t learn about pelvic floor physical therapy for years after their diagnosis.  Many have to discover pelvic PT for themselves, or their doctor only mentions physical therapy as a last resort.  At PelvicSanity, we just published a study of our interstitial cystitis patients in the International Pelvic Pain Society (IPPS) meeting, reporting on both patient outcomes and their experience with the medical system following their IC diagnosis.


In following the results for thirteen consecutive patients with an interstitial cystitis diagnosis, patients reported more than a 60% improvement in pain, symptom bother, and how much symptoms limited their daily activities.  On average, their pain level was at a 7.6 out of 10 upon initial evaluation, which fell to 2.6 after treatment.

ICimpPatients saw a relatively rapid improvement in their symptoms with treatment.  Over half (54%) reported an improvement in symptoms within their first three visits; 31% saw their first improvement in visits 4-6 and 15% required ten or more visits for subjective improvement.  Importantly, all patients in the study reported a better understanding of their condition and feeling more hopeful for recovery after their initial evaluation.


More than half of these patients reported seeing five or more medical doctors for their condition prior to beginning pelvic floor physical therapy, and had been prescribed multiple medications and undergone bladder treatments without success.  However, only a single respondent (7.7%) believed they had been referred to pelvic PT by their doctor at the appropriate time.  Nearly half (46%) had to find out about pelvic floor physical therapy for interstitial cystitis themselves, while the remainder felt they had been referred by their doctor far too late, as a last resort.

With more than 12 million women and men suffering with this condition in the United States alone, increasing education – for both doctors and patients – is vital.  In our upcoming course for physical therapists in treating interstitial cystitis (April 28-29, 2018 in San Diego), we’ll focus on the most important physical therapy techniques for IC, home stretching and self-care programs, and information to guide patients in creating a holistic treatment plan

An Introduction to Mindful Awareness Training for ...
Trauma Informed Treatment Approach

Upcoming Continuing Education Courses

Pediatric Functional Gastrointestinal Disorders - Remote Course

Feb 27, 2021 - Feb 28, 2021
Location: Replacement Remote Course

Pelvic Floor Level 2A - Mequon, WI (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Health In Balance Physical Therapy

Pelvic Floor Level 2A - Garden City, NY Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Metro Physical & Aquatic Therapy

Pelvic Floor Level 2A - Bozeman, MT Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Great Northern Physical Therapy

Pelvic Floor Level 2A - Annapolis, MD Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Encompass PT

Pelvic Floor Level 2A - Louisville, KY Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: KORT - Kentucky Orthopedic Rehab Team

Postpartum Rehabilitation - Remote Course (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Replacement Remote Course

Pelvic Floor Level 2A - Fort Smith, AR Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Arkansas Colleges of Heatlh Education

Pelvic Floor Level 2A - Marietta, GA Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Southern Pelvic Health

Pelvic Floor Level 2A - Little Rock, AR Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Core Pelvic Physical Therapy

Pelvic Floor Level 2A - Torrance, CA Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Women's Advantage Inc

Pelvic Floor Level 2A - Toledo, OH Satellite Location

Feb 27, 2021 - Feb 28, 2021
Location: ProMedica

Pelvic Floor Level 2A - Asheville, NC Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Cornerstone Physical Therapy

Pelvic Floor Level 2A - Self-Hosted (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Self-Hosted Course

Pelvic Floor Level 2A - Cranford, NJ Satellite Location (SOLD OUT)

Feb 27, 2021 - Feb 28, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Level 2A - Metairie, LA Satellite Location

Feb 27, 2021 - Feb 28, 2021
Location: East Jefferson General Hospital

Bowel Pathology and Function - Remote Course

Feb 28, 2021 - Mar 1, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Self-Hosted Course

Pelvic Floor Level 1 - Brooklyn, NY Satellite Location (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Prime Fitness Physical Therapy

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Mar 5, 2021 - Mar 6, 2021
Location: Replacement Remote Course

Mobilization of Visceral Fascia 2: The Reproductive System - Valencia, CA Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Henry Mayo Newhall Memorial Hospital

Mobilization of Visceral Fascia 2: The Reproductive System - Medford, OR Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Asante Rogue Valley Medical Center

Mobilization of Visceral Fascia 2: The Reproductive System - St. Louis, MO Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Mercy Hospital St. Louis

Mobilization of Visceral Fascia 2: The Reproductive System - Jackson, WY Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Four Pines Physical Therapy

Male Pelvic Floor - Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Replacement Remote Course

Male Pelvic Floor - St Paul, MN Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Regions Hospital

Male Pelvic Floor - Kenosha, WI Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: Aurora Health Care