Why Do I Feel Like I Always Have a UTI?

By Dr. Christine Martirez PT, DPT on 11/1/2024

Picture this--you experience the urgent need to urinate, frequent trips to the bathroom, and even a sensation of burning or discomfort. It sounds like a urinary tract infection (UTI), so your doctor sends you to get blood work. But when you get blood work performed, it comes up clean! Does this story sound familiar to you? These symptoms without an actual infection can be both confusing and frustrating. While these symptoms often make us think of a urinary tract infection (UTI), they can also indicate pelvic floor dysfunction (PFD), where the pelvic floor muscles are tense or overactive. Learning about this condition and how pelvic floor therapy can help is empowering for anyone struggling with constant UTI-like symptoms in the absence of an infection.

Shared Symptoms Between Pelvic Floor Dysfunction and UTIs

Pelvic floor dysfunction can cause many of the same symptoms associated with a UTI, including:

• Urinary urgency

  A sudden, intense urge to urinate that may be difficult to control.

• Urinary frequency

  An increased need to urinate more often than usual, even if the bladder isn’t full.

• Burning sensation or pain with urination

  Discomfort when urinating, similar to what people experience during a UTI.

• Pelvic pain or pressure

  A sensation of discomfort or heaviness in the lower abdomen or pelvic area.

• Difficulty emptying the bladder

  A feeling of incomplete bladder emptying or needing to go again soon after urinating.

People with PFD may even be misdiagnosed with recurring UTIs due to the overlap in symptoms. But if tests reveal no bacterial infection, pelvic floor dysfunction is a likely cause of these sensations.

Anatomy of the Pelvic Floor and How It Relates to Urinary Function

The pelvic floor muscles are a group of muscles that stretch like a hammock across the base of the pelvis, supporting the bladder, intestines, and, in women, the uterus. Key muscles in this region include the pubococcygeus, puborectalis, iliococcygeus, coccygeus, and obturator internus.

These muscles serve several functions related to urinary and bowel control, stability, and sexual health. Ideally, they maintain a balanced tone, contracting to maintain continence and relaxing when it’s time to void the bladder. However, when the pelvic floor muscles become overactive or hypertonic, they may remain tense and resist relaxation. This constant contraction can create sensations of urgency, frequency, and pain, even if there is no actual infection.

How Pelvic Floor Dysfunction Leads to UTI-Like Symptoms

When the pelvic floor muscles are tight, the nerves around the bladder and urethra can become irritated, leading to sensations similar to those of a UTI. Here’s how hypertonicity in the pelvic floor impacts the body:

1. Increased Pressure on the Bladder and Urethra

   : Tense pelvic floor muscles can apply pressure to the bladder, increasing sensations of urgency and frequency, even if the bladder isn’t full. This muscle tension can also create a “burning” sensation similar to that experienced during a UTI.

2. Nerve Irritation

   : Hypertonic pelvic floor muscles may compress or irritate nerves, especially the pudendal nerve and other nerves in the region. This can send false signals to the brain, making it feel like there’s an urgent need to urinate or creating discomfort when urinating.

3. Difficulty Relaxing the Pelvic Floor

   : If the pelvic floor muscles are chronically tight, they may struggle to relax when it’s time to urinate, making it feel like the bladder is never fully empty. This can lead to repeated trips to the bathroom.

4. Altered Bladder Sensitivity

   : Tension in the pelvic floor can increase sensitivity in the bladder, making it feel fuller than it actually is. This altered sensation can cause frequent bathroom trips that seem disproportionate to actual fluid intake.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy addresses the root of these UTI-like symptoms by targeting the pelvic floor and surrounding involved musculature. A physical therapist specialized in pelvic health can assess, treat, and help you manage pelvic floor dysfunction through several techniques:

1. Assessment and Education

   : The first step in pelvic floor physical therapy involves an evaluation to determine if pelvic floor dysfunction is the underlying cause of symptoms. Therapists will educate you on pelvic anatomy and the reasons for your symptoms, which is crucial in managing and understanding your condition.

2. Manual Therapy

   : Therapists may use hands-on techniques, both externally and internally, to release trigger points or tension in the pelvic floor and surrounding musculature. This helps reduce hypertonicity, ease muscle tension, and alleviate pressure on the bladder and surrounding nerves.

3. Biofeedback and Neuromuscular Re-education

   : Biofeedback can be used to help you gain awareness and control over your pelvic floor muscles. Through visual or auditory feedback, you learn how to consciously relax your pelvic floor, reducing hypertonic symptoms.

4. Stretching and Breathing Exercises

   : Techniques to release tension, including deep breathing and targeted stretches, can help relax the pelvic floor and surrounding muscles, reducing feelings of urgency and frequency.

5. Pelvic Floor Coordination and Relaxation Techniques

   : Pelvic floor therapists will guide you through relaxation and coordination exercises that help balance muscle tone. By learning how to control the pelvic floor muscles, you can reduce tension and improve bladder control, which can alleviate symptoms like frequency and urgency.

Experiencing persistent urgency, frequency, and discomfort without infection is challenging, but pelvic floor dysfunction is a common cause of these UTI-like symptoms. Pelvic floor therapy offers effective relief by addressing the muscular tension at the root of the problem, empowering you with the knowledge and tools to manage your symptoms and regain comfort. If you suspect that your symptoms may stem from pelvic floor dysfunction, consider consulting one of our pelvic floor therapists to explore this tailored and holistic approach to symptom relief.

Suffering from constant UTI symptoms? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.

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