Bladder pain is horrific. It's up there with migraines in terms of unbearable pain. Over the last 4 years I have had numerous episodes of being in agony, feeling so stuck and not knowing what to do. Playing that fun game of...Is it an infection? I am in retention? Is it my catheter? Is it inflamed? Or does it just hate me and want to ruin my life? It's often scary, not knowing what is causing the pain. It's isolating and a lonely place to be. It's usually me and my bladder, sitting on the bathroom floor with an ice pack shoved between my legs, with suppositories and catheter supplies scattered around me trying ANYTHING that might help.
I am sure most bladder pro's, like myself, already know all these things. But I thought I would share 10 things I do in case even just one thing helps add another tool into someones tool box. As thats how I think about managing my bladder pain, using each management tool one after the other until something or some combination of things helps. To have a toolbox of things that you trust will help a little, helps you mentally feel more in control of your pain which is so important.
1. Ice Pack and Hot water bottle
My usual go to is a hot water bottle, either between my legs or on my stomach. Even better is the yuyu bottle (extra long water bottle) as that goes both on my stomach and legs at the same time. But some times when the spasms are crazy or you have that burning pain either from an infection or catheter discomfort, ice really helps. Then I will do ice pack between legs and heat on stomach and sometimes heat on my back too as the pain radiates up to my kidneys.
2. Diclofenac Suppositories
I never mention medication as everyone responds differently and what could be a positive experience for someone, could be negative for someone else. However Diclofenac is my new go - to medication for bladder spasms/catheter pain. I'm on all the usual bladder meds to help with spasms which on a day to day basis do help a little, but nothing would touch the crazy agonising pain of spasms..until this! It's an anti-inflammatory but you take it rectally so its absorbed quickly, avoids stomach issues usually associated with anti-inflammatory meds and most importantly, I find it really helps. The spasms go from unbearable to more manageable which is a massive win as normally I just had to wait them out.
3. Open your bowels
So your bladder and bowels obviously both hang out in the same area and if one is 'full' it puts pressure on the other, as they aren't always great at sharing the space. I have chronic constipation due to GI dysmotility and I am unable to independently open my bowels so I use colonic irrigation. I know there is a strong link to when I am full and my bladder spasms. I never think its the only factor, but one of many contributing factors so I will increase my medication and add in more colonic irrigation to try to help relieve the pressure.
4. Pelvic Floor Release
Sometimes the spasms are from the pelvic floor itself, or sometimes the pain and spasms from your bladder and urethra trigger spasms in your pelvic floor due to the effect of pain. Either way it's likely that your pelvic floor muscles are in spasm too. If you haven't already, find a good woman's health or pelvic floor physiotherapist. They can help assess your pelvic floor and work on both strengthening it as well as helping it relax and let go. They can also teach you some gentle techniques you can use yourself to release muscles both externally and internally. When my pain is severe I can only tolerate some gentle external self-release work which does help a little. I will link some information here if you want to try but I would recommend seeing a professional first to