Revitalize Physical Therapy Blog

You’re convinced you have a UTI. You constantly need to pee, yet not a lot comes out. You’re having pelvic pain. And, worst of all, having sex hurts.

You finally go to the doctor’s office. Only you don’t get the answer you were expecting. Your doctor tells you that you have interstitial cystitis, which can closely mimic but is not a urinary tract infection.

Interstitial cystitis? You’ve never heard the term before. You wonder what that even means.

What Is Interstitial Cystitis?

While IC shares a lot of symptoms with a UTI, it is not the same condition. According to the Mayo Clinic, it’s a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. Up to 8 million people have it. Most of those are women or those assigned female at birth.

Anyone who has gone through a UTI knows it can be uncomfortable. But knowing the pain will soon ease via antibiotics makes it at least somewhat bearable. Those with IC have it much harder. They have to manage their discomfort indefinitely.

What Causes Interstitial Cystitis?

According to Healthline, IC is caused by a damaged bladder lining. Many things, including bacterial infections, might cause that damage. In fact, painful bladder syndrome is another name for IC. There is also a theory that IC has a genetic component.

How Is Interstitial Cystitis Diagnosed?

Your evaluation for IC can involve ruling out similar conditions, according to the Mayo Clinic. A urine test is performed to determine whether or not there is a UTI. A biopsy and urine cytology, a sample of urine, can test for cancer.

Doctors often ask patients to keep a diary of how many times they are going to the bathroom. This is part of the diagnosis process. You may need to have a cystoscopy, a procedure that fills the bladder with water to see why you have bladder pain.

Interstitial Cystitis Treatment Options

IC treatment can be natural, over-the-counter or involve surgery. Your medical team will create a plan for you after diagnosis. But it can be helpful to know what to expect.

One of the treatments is physical therapy for the pelvic pain. Your physical therapist will work on releasing muscle tightness.

Your doctor may treat your IC with Advil, stress reduction techniques and dietary changes. Wearing looser fitting, less constricting clothing can help too.

Drinking more water (always a good idea) and quitting smoking (also a great idea) may noticeably improve IC. Elmiron is an FDA approved medicine for IC your doctor may recommend.

Surgery, which can enlarge the bladder and resolve bladder ulcers, is infrequently recommended.

Getting Your Life Back

Those first steps, getting a diagnosis and a treatment plan, are vital to managing this condition. They are how you ultimately get your life back. IC can be a very tricky condition. But once you uncover and expose your bladder’s great pretender, it loses so much of its power. And you restore yours.

If your doctor believes you should have physical therapy as part of your IC treatment, please don’t hesitate to reach out to me if you are near any of my locations. I offer free consultations, and we can talk about how I can help you treat your IC.

If you’ve never had pelvic floor physical therapy, I know it can seem overwhelming, scary and even embarrassing. But it can make a huge difference. It would be an honor and a pleasure to help you feel like yourself again.

affordable pelvic floor therapy — Dr. Riva Preil with a patient on the Upper West Side, NYC

The Real Cost of Getting Care

Treating gynecological pain is challenging. First, there’s receiving a proper diagnosis, which is often not an easy feat. Next, there is putting together the right medical team. And then, if this wasn’t hard enough, there is figuring out how to pay for it all.

That last part can be the most frustrating. It’s something I touched upon in a prior blog post, and it’s something that’s fortunately being addressed in the news recently: The Guardian recently profiled Jennifer Vargas, a 35-year-old woman who has shelled out, to date, about $15,000 to treat chronic vaginal pain. That’s a year’s worth of rent in some states!

Why Does It Cost So Much?

So why is it so expensive?

Well, for starters, not all providers will take your insurance. And while it is easy to say, “Just go to someone who will,” you need to have a special rapport with anyone who treats such an intimate part of your body, particularly a gynecologist or pelvic floor physical therapist. You are also seeing them more often than most providers. So while you may be able to ignore it if your in-network dentist is a little short with you during your annual visit, that can be harder to do when you are seeing a pelvic floor therapist for months at a time.

And the fact that you are seeing them so often is another reason why the cost adds up. It could cost several hundreds of dollars a month alone, just on physical therapy, if you can’t find a competent in-network provider.

You may, like Vargas, need to see more than one provider at a time. Or maybe you need medication, surgery, yoga, nutritional guidance and dilators. You may need need to travel, as patient SB who had pudendal neuralgia did. Or maybe you need to pay for childcare while you receive treatment.

On top of that, many with pelvic pain are unemployed or underemployed because they are unable to work or are very limited in their work abilities due to their medical issues and pain.

The Good News: You Have Options

But I’m happy to report there are ways to help you access the care you need and deserve, regardless of your income.

Talk to Your Therapist About Your Budget

First of all, don’t be ashamed to tell your therapist you’re on a budget. Yes, ideally, they may want to see you more than once a week at the beginning, but they might be able to space out appointments and work with you on creating a schedule that fits your budget. You can also do homework with dilators to stay on track in between sessions.

Ask About a Payment Plan

If your therapist doesn’t take your insurance, you should inquire about a billing plan. They may be able to work something out or offer a sliding scale option. Of course, it is never comfortable to discuss money, or lack thereof, and no one wants to be anybody’s “charity case.” But that is not how your physical therapist views it. Your therapist became a therapist because they want to help you get better. I often say in the course of these conversations with patients that I didn’t choose physical therapy to get rich. You know, I would have become a finance bro if that was my goal in life! I became a PT because I genuinely want to make a difference in people’s lives and help them feel better in their own bodies.

This Conversation Should Never Feel Awkward

These conversations shouldn’t be awkward. If they are, and if your PT doesn’t make you feel safe to be vulnerable and raise this topic, you may want to reconsider your choice of PT.

Check Your HR Benefits

If you are employed, inquire with your company’s HR department if there are any stipends allotted towards healthcare. Sometimes your company will provide reimbursement if you show them a receipt. Your therapist will be more than happy to provide that.

Consider Care Credit

Care Credit is a credit card you use to pay for various forms of care, like physical therapy. You pay monthly, so it is less overwhelming.

Save on Medications with GoodRx

GoodRx can make medications more affordable, up to 80%! Coupons are free and accepted at pharmacies you’re already using, like Walgreens and CVS. It’s not health insurance, so you don’t need to apply through your job and your income is irrelevant.

Don’t Skip the Superbill

Superbills are an important part of the insurance process that a lot of people are not familiar with. Even if a provider is out of network, you can submit it to your insurance company. If you have out of network benefits, you may be eligible for reimbursement.

Look Into the Aziza Project

The Guardian highlighted how the nonprofit Aziza Project is helping fund some medical costs for people with complex gynecological problems, so it’s worth looking into, especially considering that they offer free, remote consultations.

Take Advantage of Free Consultations

If you are at the beginning stage of your journey and are unsure about which pelvic floor therapist to go to, take advantage of free phone consultations so you don’t waste money on a therapist you don’t vibe with. This is a service I am proud to offer.

The Bottom Line

It’s easy to feel overwhelmed when you realize how expensive pelvic floor healthcare costs. You might decide it’s easier and more economical to simply live with the pain. But remember that untreated pain has costs too: lost workdays, more money spent on pain medications, missing out on special events.

Yes, it takes a lot of effort to determine how to best afford pelvic healthcare, so much that it can feel like a second job. But the work is worth it when you consider how priceless the end goal is. And, you deserve to feel great in your own body and to live your beautiful life to the fullest.

Interstitial Cystitis: Your Bladder’s Great Pretender