Bladder Pain, Urgency, and No Infection? It Might Not Be Interstitial Cystitis — Here’s What You Should Know

At our pelvic floor physical therapy practice, we often see patients who’ve been quietly suffering with urinary urgency, frequency, and pelvic pain — sometimes for years. Many have been told it’s “just a UTI,” others are given a vague diagnosis of Interstitial Cystitis (IC) or are left wondering if they’ll ever get answers.

Here’s the truth: it’s not always IC. In fact, many people are dealing with something called Painful Bladder Syndrome (PBS) — and pelvic floor dysfunction is often a major part of it.

IC vs. Painful Bladder Syndrome — What’s the Difference?

While the terms are often used interchangeably, there is a difference:

• Interstitial Cystitis (IC) refers to a more specific diagnosis, sometimes involving bladder wall inflammation, lesions (Hunner's ulcers), or other changes seen on cystoscopy.

• Painful Bladder Syndrome (PBS) is a broader, more common term used when symptoms are present (like bladder pain, urgency, and frequency) without clear findings of IC.

Both conditions can feel very similar to the person experiencing them — but the root causes may be different and often involve the pelvic floor.

What We See Clinically

In our clinic, we frequently meet patients who:

• Feel like they need to urinate all the time — even when their bladder isn’t full

• Experience pain or pressure in the bladder, urethra, or lower abdomen

• Have pain with sex, tampons, or pelvic exams

• Have been told “everything looks normal” on labs and imaging

• Are starting to believe the problem is “in their head”

But what’s really happening?

Often, the pelvic floor muscles are overactive and tight, creating a feedback loop of pain, urgency, and dysfunction.

Why Pelvic Floor Therapy Helps — Even When the Bladder Seems to Be the Problem

Your pelvic floor muscles support and surround your bladder and urethra. When these muscles become tense, restricted, or poorly coordinated, they can:

• Trigger bladder urgency, frequency, and pain

• Restrict full emptying of the bladder

• Contribute to pain with intercourse and pelvic exams

• Irritate surrounding nerves, like the pudendal or pelvic nerves

Pelvic floor physical therapy works to restore healthy muscle function and calm the nervous system — two essential pieces of the puzzle.

Our Approach: Whole-Body and Whole-Person

At your evaluation and through your treatment plan, we may address:

• Pelvic floor muscle release (internally and externally)

• Breathwork and nervous system regulation

• Manual therapy to the abdomen, hips, and low back

• Bladder retraining strategies

• Customized movement and exercise to support pelvic alignment and tissue health

We also empower you with education on bladder-friendly diets, stress management, and pacing tools.

Other Helpful Interventions

In many cases, we collaborate with your healthcare team. Depending on your case, you might benefit from:

• A quality, pH-balanced lubricant to support tissue comfort during intimacy

• Topical vaginal estrogen, especially in perimenopause or menopause, to restore vaginal and urethral tissue health

• Referral to urogynecology or gynecology when more in-depth testing is needed

You’re Not Broken — You Just Need the Right Tools

Whether your symptoms are labeled IC, PBS, or still undiagnosed — please know that relief is possible. And it often starts with understanding that the pelvic floor is part of the picture.

Tight muscles are not strong muscles. In fact, a chronically tight pelvic floor is dysfunctional, and restoring the ability to lengthen, relax, and coordinate is key to lasting relief.

Improving tissue health, muscle coordination, and nervous system balance can reduce symptoms and give you your life back.

Ready to Feel Better?

At our practice, we treat more than just symptoms — we treat the whole you. If bladder pain or pelvic discomfort is interfering with your quality of life, know that you’re not alone and you don’t have to keep guessing.

Let’s work together to figure out what your body is trying to say — and create a plan to help you feel strong, supported, and in control again.

👉 [Contact us to schedule your pelvic floor PT evaluation today!]