Myofascial physical therapy efficacious in interstitial cystitis/painful bladder syndrome

Stanford, CA-In 10 years of NIDDK-sponsored clinical trials for interstitial cystitis, there hasn't been one treatment tested that made a significant difference for these patients-until now. That treatment is myofascial physical therapy.

The therapy used in the trial presented at the 2010 AUA annual meeting is different from the therapy physical therapists were trained to use a decade ago. That included muscle stretching and Kegel exercises for strengthening, developed to prevent and treat incontinence. But techniques aimed at pelvic pain have been developed and become more widespread, thanks to the physical therapists who developed them, the urologists who saw the value of the treatment, and the patients who felt much better and spread the word.

Although already experienced in treating pelvic pain, the therapists underwent training to ensure they were delivering the same therapy. This type of therapy includes both internal massage, intravaginally or intrarectally, of the pelvic floor muscles and external massage and connective tissue manipulation.

Even in this pilot trial with only 44 patients, indications were that the differences between the therapies were significant, at least among women. Judged on the basis of the global response assessment, a patient rating of how they did on a 7-point scale, 50% of IC/PBS patients who received the specialized therapy were moderately or markedly better, compared with a mere 7% who got general massage (J Urol 2009; 182:570-80).