For many people (almost 90% of those diagnosed with IC) tight muscles in the pelvic floor irritate the nerves running through the area. One of the most important of these is the pudendal nerve.
So what symptoms might be caused by pudendal nerve irritation? One is urethral burning or pain. One branch of the pudendal runs right to the urethra, so it is often responsible for urethral pain or burning.
The pudendal can also be the cause of urinary urgency and frequency. It connects to the bladder. Usually these nerves are ‘silent’, but with IC they are often activated and continue to send signals to the brain. When the brain interprets these as the urgent need to urinate, we get urinary urgency and/or frequency.
(Just a note - Often when we hear ‘pudendal nerve’ we do a Google search and see information about pudendal neuralgia. This is obviously a scary diagnosis. But what we are talking about here is pudendal nerve irritation. We actually compare it to something we’re more familiar with - sciatica)
So it’s definitely possible pudendal nerve irritation is driving symptoms. There are many other nerves in the area which can be causing symptoms as well, so that’s where a pelvic PT can both figure out what is going on and work to address the issue.
This also explains why many people with IC-like symptoms are given bladder-focused treatments (bladder instillations, Elmiron, hydrodistensions, etc.) without benefit.
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About Us
Dr. Nicole and Jesse Cozean are the founders of PelvicSanity Physical Therapy (www.pelvicsanity.com) in Southern California. The clinic has helped thousands of patients in the Orange County, CA area and hundreds from around the world with a remote consultation and Out of Town Program.
They co-authored The IC Solution and Nicole created The IC Roadmap online course to provide the most accurate, up-to-date information for those with interstitial cystitis. They run the Finding Pelvic Sanity Facebook group for a supportive online community for anyone dealing with pelvic health issues.
Nicole has also created courses and trained thousands of pelvic PTs to provide better care through her work with Pelvic PT Rising (www.pelvicptrising.com).
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