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Lauren Campbell, PT, MScPT, MCPA,1 Jessica Nargi, PT, MScPT, MCPA,2

1Registered Physiotherapist, Pelvic Health Physiotherapy on Bay, Toronto, ON.
2 Registered Physiotherapist, Pelvic Health LifeMark Physiotherapy, Toronto, ON.

CLINICAL TOOLS

Abstract: Bladder pain syndrome/interstitial cystitis (BPS/IC) is associated with symptoms of urgency, frequency, and pain in the bladder or pelvis, in the absence of infection or disease. While manual therapy skills performed by a specialized pelvic floor physiotherapist can improve pain and symptoms by as much as 75-80%,23 treatment strategies need to look beyond, because the persistent nature of this condition suggests there is also dysfunction occurring within the peripheral and central nervous systems. Other symptom-improving treatments include bladder retraining, neurophysiology-based pain education, mindfulness meditation, and a variety of other strategies to help quiet their hypersensitive nervous systems.
Key Words: bladder pain syndrome, interstitial cystitis, pelvic floor physiotherapy, biopsychosocial framework, neurophysiology-based pain education, central sensitization.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Identify research and treatment for BPS/IC need to be beyond the bladder.
Understand a pelvic physiotherapist's assessment and treatment framework for BPS/IC.
Understand the importance of tissue dysfunction and central sensitization in BPS/IC.
Use a biopsychosocial framework when approaching BPS/IC
The bladder is likely not "at fault" and given the persistent nature of symptoms, one must consider the whole body.
Pelvic floor physiotherapy is MORE than manual treatment and exercise prescription
Physiotherapists have an excellent knowledge base, dynamic skill set, and also have the time required to educate and help implement behavioural modifications.
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