Over-active Bladder is a catch-all diagnosis for people suffering from urinary urgency and frequency. It can sometimes be called urge incontinence, which indicates urinary incontinence due to strong sensation of urgency and inability to control it. There can be different causes of over-active bladder and in some cases, it can be treated effectively with medication. Myrbetriq, an often-prescribed medication can help reduce urinary frequency significantly but for some people it is cost-prohibitive to take it, so therefore not a good long-term solution.
So, what causes over-active bladder? As a Pelvic Floor Specialist, I have seen several issues that lead to urinary frequency and incontinence. I will look at a few of them here and discuss Holistic ways to treat it.
Pelvic Floor Weakness: The pelvic floor is made up of 3 layers of muscles with 3 specific roles. First, the muscles help support the organs in our abdominal cavity. Second, the muscles help us stay continent, both bowel and bladder. And lastly, the pelvic floor muscles have a role in sexual function and pleasure. If these muscles have become weak and we get a strong sense of urinary urgency, the muscles will not be able to hold us continent. The bladder muscle will start contracting and we will experience incontinence. This type of incontinence is called stress incontinence and is treated with Kegel exercises to improve strength, endurance and control of the pelvic floor.
Pelvic Floor Tightness: Like any other muscle in our body, pelvic floor muscles can become tight, develop trigger points and be painful. During a pelvic floor exam, muscle tone is assessed as well as strength. If there are trigger points and muscle tightness, upon palpation, urgency can be reproduced. The treatment is to reduce the muscle tightness through hands-on muscle work or with functional dry needling. Functional dry needling uses filament needles to target specific muscles to help them re-set to a normal functional state. Dry needling can help tight muscles relax and weak muscles work better.
Overactive Bladder: The bladder is wrapped in a muscle called the detrusor muscle. When our bladder fills up, our bladder signals to our brain that it is time to pee. Once we are sitting on the toilet, the detrusor muscle contracts and the pelvic floor muscles relax, and we can empty our bladder. With over-active bladder, the bladder signals the brain before it is full that it is ready to empty. We run to the bathroom urgently but then only pee for a few seconds. This can continue happening every 30 minutes to 60 minutes, depending on how bad the symptoms are. In a healthy bladder, it takes 2-4 hours to fill and it takes > 8 seconds to empty. With over-active bladder, there might also be some triggers for peeing like pulling in the driveway, putting the key in the door or entering a building. With this dysfunction, we go out of our way to always know where the bathroom is and many times, incontinence pads are worn to avoid having an accident. The Holistic approach to treatment involves behavioral modifications, mindfulness techniques, keeping a bladder diary and functional dry needling. In this case, the filament needles are applied to the abdomen and an electrical current is placed on the needles. This technique is called neuromodulation and helps “re-set” normal bladder signaling.
With all these possible causes of over-active bladder, there is a holistic way to treat them. Especially with the costliness of the drugs available to treat it, seeking out care from a trained pelvic floor specialist can allow you to re-gain control of your bladder and have a healthy pelvic floor! If you suffer from urinary incontinence or feel like you might have over-active bladder, call Holistic PT today for an evaluation!