Patients with a diagnosis of interstitial cystitis (IC) often have other related symptoms and conditions caused by a hypertonic pelvic floor. This case report examines the physical therapy diagnosis, management, and outcomes of a patient with IC, dyspareunia, and low back pain.
A single-subject case report on the initial examination, interventions, and outcomes of the pelvic floor physical therapy for a patient with a common triad of pelvic floor conditions. The case report includes a detailed description of each session and patient response to guide interventions in similar cases.
This case follows the management of a patient with a diagnosis of IC accompanied by urgency and frequency of urination, severe dyspareunia, and low back pain. Interventions included a combination of orthopedic and pelvic floor physical therapy, internal and external manual therapy, behavioral therapy, therapeutic exercises, and education.
After 19 physical therapy visits over 3 months, the patient was able to resume full-time employment and sexual intercourse with little to no pain. Pain was reduced by nearly 80% on the Short-Form McGill Pain Questionnaire. On evaluation, the patient scored below average on 7 SF-36 quality-of-life subcategories, which improved to above-average scores in 7 of the 8 subcategories at discharge.
The diagnosis of IC is often accompanied by other associated pelvic floor conditions. A combination of pelvic floor physical therapy and orthopedic techniques may be necessary to relive urinary frequency and urgency, nocturia, bladder pain, dyspareunia, and low back pain in complex patients with IC.