What to expect from pelvic floor physiotherapy for interstitial cystitis

Interstitial cystitis, also called bladder pain syndrome, can occur alongside tenderness or excess tension in the muscles around the bladder, vagina and bowel. A physiotherapist may ask about pain, urinary urgency, frequency, bowel habits, sexual discomfort and activities that trigger symptoms.

The examination is explained before it begins. It may include observing posture, breathing and movement, checking the abdomen or hips, and—only with your consent—an internal assessment of pelvic muscle tone. The aim is to find muscles that stay contracted or are difficult to release, not to force a painful contraction.

Wear clothing that allows comfortable movement and bring a record of bladder symptoms if you have one. Treatment may include breathing with a relaxed pelvic floor, gentle manual work, stretches for the hips and lower abdomen, pacing strategies and guidance for comfortable bladder habits.

You may receive a home programme. For interstitial cystitis, it may emphasise letting go rather than repeatedly tightening the pelvic floor. Practise only at the level advised, and report a flare so the plan can be adjusted.

Contact your clinician if pain becomes sharply worse, new urinary symptoms appear, or treatment repeatedly triggers a prolonged flare. Seek urgent care for inability to pass urine, fever with feeling very unwell, severe back or side pain, or visible blood in the urine. Physiotherapy supports symptom management but does not replace assessment for infection or another bladder problem.

Ask whether pelvic muscle tension could be contributing to your symptoms, whether an internal examination is appropriate for you, and how to distinguish a treatment flare from a sign that needs medical review.