Is It a UTI (Urinary Tract Infection) or Pelvic Pain?

I am sure that most women have experienced a UTI at some point in their life.  Typical symptoms include bladder pain, burning with urination, peeing frequently and sometimes peeing blood.  This can be very uncomfortable.  The common action that is taken is a visit to a walk-in clinic or your doctor, resulting in an antibiotic prescription. But, what if the antibiotic doesn’t eliminate the symptoms? 

Recurrence of UTI’s is very common.  One study suggests that 27% of college-age women will experience a UTI and will have a recurrence 6 months later.  This study also notes that 50% of women over the age of 55 report UTI recurrence.

It is very important to see a physician when you have these symptoms.  The physician will perform a urinary analysis -  a simple test to see what is in your urine. Results often come back showing bacteria, but this may or may not be the cause of your symptoms. When giving a urine sample, there can be contamination if not correctly done. For example if the urine is not mid-stream or if it comes in contact with your hands, the sample may be contaminated.  The physician should also do a urine culture where your urine sample will grow cells over a few days. A urine culture is the more accurate method to determine precisely what kind of bacteria is in the urine and then the correct antibiotic to treat it.

 After going through these steps, what do you do if you still have pain or burning when urinating? Once an infection is treated and urine samples are clean, it is likely you have pelvic floor dysfunction.  Pelvic floor dysfunction simply means that the pelvic floor muscles are tight, causing pulling and pressure along your bladder and urethra.  And the dysfunction can cause symptoms that mimic a UTI.

Tight muscles can refer pain to the bladder, urethra, and/or vagina.  A Pelvic floor physical therapist can help assess and treat these muscles. The therapist will examine your hips and spine to determine if these may be a contributing factor. They will also check your pelvic floor muscles to see if there is pain, tightness or reproduction of your symptoms.  Poor bowel and bladder habits can also be a contributing factor, so this will be discussed as well.  Treatment usually includes: 

● Myofascial or trigger point release 

● Stretches/Strengthening 

● Bowel and bladder retraining 

● Postural education 

It is helpful to see a urologist that understands pelvic floor dysfunction.  Then they can guide you towards appropriate treatment, including physical therapy, if pelvic floor dysfunction is suspected.  Useful questions to ask the urologist are: 

● Could my pelvic floor be causing these symptoms? 

● Can you check my pelvic floor for pain? 

● Since the antibiotics are not working, what else could be causing my symptoms?

Contact us at Solstice Physiotherapy to learn more about how pelvic floor physical therapy can help.