Complementary and Alternative Medical Treatments of Bladder Pain Syndrome

  • Z. Chad Baxter
  • Helen R. Levey
  • Jennifer Yonaitis Fariello
  • Robert M. Moldwin


Complementary and alternative therapies (CAM) may offer adjuvant treatment options for patients with bladder pain syndrome (BPS) for which “traditional” therapies alone have failed. The goal of CAM therapies is improved quality of life through patient education and empowerment. CAM therapy is individualized to the need of the patient. Support groups, behavioral techniques, lifestyle modification, and psychotherapy are some examples of different types of CAM therapies employed in the treatment of patients with BPS.


Pelvic Floor Muscle Pelvic Floor Muscle Training Sham Acupuncture Bladder Pain Syndrome Myofascial Trigger Point 


  1. 1.
    Ottem DP, Carr LK, Perks AE, Lee P, Teichman JM. Interstitial cystitis and female sexual dysfunction. Urology. 2007;69(4):608–10.PubMedCrossRefGoogle Scholar
  2. 2.
    van Tulder MW, Ostelo R, Vlaeyen JW, Linton SJ, Morley SJ, Assendelft WJ. Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine (Phila Pa 1976). 2000;25(20):2688–99.CrossRefGoogle Scholar
  3. 3.
    Bergeron S, Binik YM, Khalife S, et al. A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91(3):297–306.PubMedCrossRefGoogle Scholar
  4. 4.
    Breton A, Miller CM, Fisher K. Enhancing the sexual function of women living with chronic pain: a cognitive-behavioural treatment group. Pain Res Manag. 2008;13(3):219–24.PubMedGoogle Scholar
  5. 5.
    McCracken LM, MacKichan F, Eccleston C. Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change. Eur J Pain. 2007;11(3):314–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Butrick CW, Howard FM, Sand PK. Diagnosis and treatment of interstitial cystitis/painful bladder syndrome: a review. J Womens Health (Larchmt). 2010;19(6):1185–93.CrossRefGoogle Scholar
  7. 7.
    Whitmore KE. Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol. 2002;4 Suppl 1:S28–35.PubMedGoogle Scholar
  8. 8.
    Parsons CL, Koprowski PF. Interstitial cystitis: successful management by increasing urinary voiding intervals. Urology. 1991;37(3):207–12.PubMedCrossRefGoogle Scholar
  9. 9.
    Chaiken DC, Blaivas JG, Blaivas ST. Behavioral therapy for the treatment of refractory interstitial cystitis. J Urol. 1993;149(6):1445–8.PubMedGoogle Scholar
  10. 10.
    McNaughton Collins M, Pontari MA, O’Leary MP. Quality of life is impaired in men with chronic prostatitis: the Chronic Prostatitis Collaborative Research Network. J Gen Intern Med. 2001;16(10):656–62.PubMedCrossRefGoogle Scholar
  11. 11.
    Sullivan MJ, Thorn B, Haythornthwaite JA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52–64.PubMedCrossRefGoogle Scholar
  12. 12.
    Tripp DA, Nickel JC, Wang Y, et al. Catastrophizing and pain-contingent rest predict patient adjustment in men with chronic prostatitis/chronic pelvic pain syndrome. J Pain. 2006;7(10):697–708.PubMedCrossRefGoogle Scholar
  13. 13.
    Nickel JC, Tripp DA, Chuai S, et al. Psychosocial variables affect the quality of life of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome. BJU Int. 2008;101(1):59–64.PubMedGoogle Scholar
  14. 14.
    Nickel JC, Tripp DA, Pontari M, et al. Psychosocial phenotyping in women with interstitial cystitis/painful bladder syndrome: a case control study. J Urol. 2010;183(1):167–72.PubMedCrossRefGoogle Scholar
  15. 15.
    Rothrock NE, Lutgendorf SK, Kreder KJ. Coping strategies in patients with interstitial cystitis: relationships with quality of life and depression. J Urol. 2003;169(1):233–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Nickel JC, Tripp DA, Pontari M, et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol. 2010;184(4):1358–63.PubMedCrossRefGoogle Scholar
  17. 17.
    Rapkin AJ, Kames LD. The pain management approach to chronic pelvic pain. J Reprod Med. 1987;32(5):323–7.PubMedGoogle Scholar
  18. 18.
    Groysman V. Vulvodynia: new concepts and review of the literature. Dermatol Clin. 2010;28(4):681–96.PubMedCrossRefGoogle Scholar
  19. 19.
    Hupcey JE. Clarifying the social support theory-research linkage. J Adv Nurs. 1998;27(6):1231–41.PubMedCrossRefGoogle Scholar
  20. 20.
    Association IC. October 7, 2010; id=329. Accessed 6 Nov 2010.
  21. 21.
    Jensen MP. Psychosocial approaches to pain management: an organizational framework. Pain. 2010;152:717–25.PubMedCrossRefGoogle Scholar
  22. 22.
    Wehbe SA, Fariello JY, Whitmore K. Minimally invasive therapies for chronic pelvic pain syndrome. Curr Urol Rep. 2010;11(4):276–85.PubMedCrossRefGoogle Scholar
  23. 23.
    McCracken LM, Turk DC. Behavioral and cognitive-behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process. Spine (Phila Pa 1976). 2002;27(22):2564–73.CrossRefGoogle Scholar
  24. 24.
    Lopez-Martinez AE, Esteve-Zarazaga R, Ramirez-Maestre C. Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients. J Pain. 2008;9(4):373–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Sinclair VG, Wallston KA. Predictors of improvement in a cognitive-behavioral intervention for women with rheumatoid arthritis. Ann Behav Med. 2001;23(4):291–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Evers AW, Kraaimaat FW, van Riel PL, de Jong AJ. Tailored cognitive-behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial. Pain. 2002;100(1–2):141–53.PubMedCrossRefGoogle Scholar
  27. 27.
    Sinclair VG. Predictors of pain catastrophizing in women with rheumatoid arthritis. Arch Psychiatr Nurs. 2001;15(6):279–88.PubMedCrossRefGoogle Scholar
  28. 28.
    Eccleston C, Palermo TM, Williams AC, Lewandowski A, Morley S. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2009;(2):CD003968.Google Scholar
  29. 29.
    Nickel JC, Mullins C, Tripp DA. Development of an evidence-based cognitive behavioral treatment program for men with chronic prostatitis/chronic pelvic pain syndrome. World J Urol. 2008;26(2):167–72.PubMedCrossRefGoogle Scholar
  30. 30.
    Morley S, Eccleston C, Williams A. Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain. 1999;80(1–2):1–13.PubMedCrossRefGoogle Scholar
  31. 31.
    Landry T, Bergeron S, Dupuis MJ, Desrochers G. The treatment of provoked vestibulodynia: a critical review. Clin J Pain. 2008;24(2):155–71.PubMedCrossRefGoogle Scholar
  32. 32.
    Bergeron S, Landry T, Leclerc B. Cognitive-behavioral, physical therapy and alternative treatments for dyspareunia. In: Goldstein AT, Pukall C, Goldstein I, editors. Female sexual pain disorders. 1st ed. Hoboken: Wiley-Blackwell; 2008.Google Scholar
  33. 33.
    Bergeron S, Khalife S, Glazer HI, Binik YM. Surgical and behavioral treatments for vestibulodynia: two-and-one-half year follow-up and predictors of outcome. Obstet Gynecol. 2008;111(1):159–66.PubMedCrossRefGoogle Scholar
  34. 34.
    ter Kuile MM, Weijenborg PT. A cognitive-behavioral group program for women with vulvar vestibulitis syndrome (VVS): factors associated with treatment success. J Sex Marital Ther. 2006;32(3):199–213.PubMedCrossRefGoogle Scholar
  35. 35.
    Madsen MV, Gotzsche PC, Hrobjartsson A. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009;338:a3115.PubMedCrossRefGoogle Scholar
  36. 36.
    Lee SW, Liong ML, Yuen KH, et al. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med. 2008;121(1):79.e71–7.CrossRefGoogle Scholar
  37. 37.
    Chen R, Nickel JC. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003;61(6):1156–9. discussion 1159.PubMedCrossRefGoogle Scholar
  38. 38.
    Lee SH, Lee BC. Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology. 2009;73(5):1036–41.PubMedCrossRefGoogle Scholar
  39. 39.
    Carrico DJ, Peters KM, Diokno AC. Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study. J Altern Complement Med. 2008;14(1):53–60.PubMedCrossRefGoogle Scholar
  40. 40.
    Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995;63(2):189–98.PubMedCrossRefGoogle Scholar
  41. 41.
    Turner JA, Jensen MP. Efficacy of cognitive therapy for chronic low back pain. Pain. 1993;52(2):169–77.PubMedCrossRefGoogle Scholar
  42. 42.
    Manyande A, Berg S, Gettins D, et al. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosom Med. 1995;57(2):177–82.PubMedGoogle Scholar
  43. 43.
    Ripoll E, Mahowald D. Hatha Yoga therapy management of urologic disorders. World J Urol. 2002;20(5):306–9.PubMedGoogle Scholar
  44. 44.
    Peters KM, Carrico DJ, Kalinowski SE, Ibrahim IA, Diokno AC. Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology. 2007;70(1):16–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Ulger O, Yagli NV. Effects of yoga on balance and gait properties in women with musculoskeletal problems: a pilot study. Complement Ther Clin Pract. 2011;17(1):13–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Bower JE, Garet D, Sternlieb B. Yoga for persistent fatigue in breast cancer survivors: results of a pilot study. Evid Based Complement Alternat Med. 2011;2011:623168.PubMedCrossRefGoogle Scholar
  47. 47.
    Wren AA, Wright MA, Carson JW, Keefe FJ. Yoga for persistent pain: new findings and directions for an ancient practice. Pain. 2011;152:477–80.PubMedCrossRefGoogle Scholar
  48. 48.
    Cohen L, Parker PA, Vence L, et al. Presurgical stress management improves postoperative immune function in men with prostate cancer undergoing radical prostatectomy. Psychosom Med. 2011;73:218–25.PubMedCrossRefGoogle Scholar
  49. 49.
    Jefferson LL. Exploring effects of therapeutic massage and patient teaching in the practice of diaphragmatic breathing on blood pressure, stress, and anxiety in hypertensive African-American women: an intervention study. J Natl Black Nurses Assoc. 2010;21(1):17–24.PubMedGoogle Scholar
  50. 50.
    Mendelowitz F, Moldwin R. Complementary therapies in the management of interstitial cystitis. In: Sant G, editor. Interstitial cystitis. Philadelphia: Lippincott-Raven; 1997. p. 235–9.Google Scholar
  51. 51.
    Srinivasan AK, Kaye JD, Moldwin R. Myofascial dysfunction associated with chronic pelvic floor pain: management strategies. Curr Pain Headache Rep. 2007;11(5):359–64.PubMedCrossRefGoogle Scholar
  52. 52.
    Anderson RU, Sawyer T, Wise D, Morey A, Nathanson BH. Painful myofascial trigger points and pain sites in men with chronic prostatitis/chronic pelvic pain syndrome. J Urol. 2009;182(6):2753–8.PubMedCrossRefGoogle Scholar
  53. 53.
    Anderson RU, Wise D, Sawyer T, Chan C. Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. J Urol. 2005;174(1):155–60.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Z. Chad Baxter
    • 1
  • Helen R. Levey
    • 2
  • Jennifer Yonaitis Fariello
    • 3
  • Robert M. Moldwin
    • 4
    • 5
  1. 1.Urology, Center for Pelvic Health and Reconstructive SurgerySmith Institute for Urology, North Shore—LIJ School of MedicineNew Hyde ParkUSA
  2. 2.The Arthur Smith Institute for Urology, North Shore—Long Island Jewish Health SystemNew Hyde ParkUSA
  3. 3.Urology Division, Department of Obstetrics and Gynecology, FPMRS, The Pelvic and Sexual Health InstituteDrexel University College of MedicinePhiladelphiaUSA
  4. 4.Urology Division, North Shore-Long Island Jewish Health SystemThe Arthur Smith Institute for UrologyNew Hyde ParkUSA
  5. 5.Urology DepartmentThe Hofstra University School of MedicineNew Hyde ParkUSA

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