Bladder Pain: Causes, Seriousness, Relief

Bladder Pain: Causes, Seriousness, Relief

Your bladder is a hollow, muscular organ that stores urine and sits behind the pubic bone. Pain in your bladder can occur when you develop some underlying condition that causes aching or discomfort in the lower abdomen—the area located just below your belly button. There are many possible causes of bladder pain, but the most common ones include urinary tract infections (UTIs), interstitial cystitis, and bladder stones.

When your bladder hurts, it can affect your ability to go about your day comfortably. For instance, you may have to pee more frequently or urgently, have pain during urination, notice blood in your urine, and have trouble sleeping.

Most causes of bladder pain require treatment, so it’s important to see a healthcare provider when you feel pressure, tenderness, or aching pain where your bladder sits in your lower abdomen. Prompt diagnosis and timely treatment often help relieve pain and reduce your risk of complications.

Bladder pain varies widely—it may feel like a dull ache, sharp stabbing pain, tenderness, or pressure in the lower abdomen. The frequency and severity of the pain can also vary. Some people experience occasional, fleeting discomfort, while others have recurrent pain that comes and goes. The pain may worsen with bladder filling, causing a frequent urge to urinate even after passing small amounts of pee.

In some cases, bladder pain can radiate to the lower back, pelvic and groin area, and thighs. The pain also frequently occurs with other symptoms, such as a burning sensation when urinating, difficulty starting or stopping urination, and discomfort in the penis or vagina. 

Bladder pain is a symptom of several conditions, ranging from acute (short-term) to more serious, chronic (long-term) conditions. 

Bladder or Urinary Tract Infection (UTI)

A bladder infection is the most common type of urinary tract infection (UTI) and the most common cause of bladder pain. Large amounts of bacteria live in the area around the genitals and rectum. A bladder infection can develop when bacteria enter the urethra—the thin tube that carries urine out of the bladder when you pee—and enter the bladder.

As the bacteria grow, the bladder becomes inflamed and irritated, leading to symptoms of a bladder infection, such as: 

  • Burning or stinging pain during urination
  • Urgent and frequent urination, even if there are only a few drops 
  • Urinary incontinence (leaking urine) 
  • Foul-smelling or cloudy urine 
  • Blood in the urine

Approximately 60% of people assigned female at birth and 12% of people assigned male at birth will develop at least one UTI in their lifetime. Your risk of getting a UTI is higher if you are sexually active, use hormonal birth control, have gone through menopause, live with diabetes, or have a weakened immune system.

Interstitial Cystitis (Bladder Pain Syndrome)

Interstitial cystitis (IC), also known as bladder pain syndrome, is a chronic condition that causes bladder pain and pressure that lasts six weeks or longer without the presence of an infection. Some people with IC experience symptom flares (periods when symptoms worsen), while others will have constant, persistent pain and discomfort. 

IC symptoms can range from mild to severe and may include:

  • Pain and pressure in the lower abdomen that worsens as the bladder fills
  • Frequent urination
  • Urinary urgency, or feeling like you have to pee even when very little comes out 
  • Lower back pain
  • Pain that radiates to the vulva, vagina, scrotum, testicle, or penis
  • Pain during and after sex

Researchers don’t know what causes IC, but some evidence suggests the condition may develop in response to abnormal immune responses or occur when infections damage the bladder tissues or nerves. People with certain conditions, including irritable bowel syndrome (IBS), fibromyalgia, endometriosis, and allergies, have an increased risk of IC. 

Bladder Stones 

Bladder stones are hard masses that form in the bladder when minerals in urine (e.g., calcium oxalate, uric acid, and phosphate) crystalize and clump together. In some cases, these stones may also have originated in the kidneys and traveled to the bladder. Bladder stones come in various shapes and sizes and can irritate the bladder lining or block urine flow, causing pain. 

Symptoms of bladder stones include:

  • Pain and pressure in the lower abdomen 
  • Cloudy or dark-colored urine 
  • Bloody urine 
  • Difficulty urinating
  • Interruptions in the urine stream, causing you to start and stop peeing repeatedly
  • Inability to urinate unless in certain positions 
  • UTI symptoms, including fever or painful and frequent urination

Bladder stones affect people assigned male at birth more frequently. Risk factors include dehydration, urinary tract infections, and an enlarged prostate. People with bladder problems, such as neurogenic bladder—a condition where the nerves that control the bladder don’t function as they should—also have a higher risk of developing bladder stones.

Bladder Cancer

Bladder cancer develops when abnormal cells in the bladder lining grow uncontrollably, forming a tumor. Blood in the urine is typically the first symptom of bladder cancer. There may be very little or a significant amount of blood, changing the color of your urine to pink, orange, or dark red. Bladder cancer can also cause urinary changes, such as: 

  • Frequent, urgent urination
  • Burning sensations while peeing
  • Difficulty urinating or a weak urine stream
  • Frequently waking up at night to empty the bladder 

As the tumor grows and bladder cancer progresses, additional symptoms can include: 

Risk factors for bladder cancer include smoking, exposure to certain chemicals, chronic bladder inflammation, and a family history of bladder cancer. 

Bladder Endometriosis 

Bladder endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows on the bladder wall or inside the bladder. It’s a rare form of endometriosis, affecting approximately 7% of all people with endometriosis. Symptoms of bladder endometriosis mimic UTI symptoms, including:

  • Frequent urination
  • Pain and discomfort in the lower abdomen 
  • Painful urination
  • Lower back and pelvic pain 
  • Blood in the urine

Bladder endometriosis generally only develops in people with classic endometriosis—when endometrial lesions develop elsewhere in the pelvic region. Endometriosis symptoms include severe pelvic pain that worsens during menstrual periods, sex, and while urinating or having a bowel movement. Some people also experience chronic pelvic pain, heavy menstrual bleeding, bloating, nausea, and fatigue. 

Most causes of bladder pain require diagnosis and treatment to relieve pain and manage the underlying cause. See a healthcare provider for bladder pain that is persistent or ongoing or when bladder pain occurs with other symptoms, such as: 

  • Cloudy, smelly urine
  • Painful urination 
  • Frequent urination 
  • Disrupted or weak urine stream
  • Urinary incontinence (leaking urine) 

Seek prompt medical attention if you have bladder pain with any of the following symptoms:

  • Blood in urine
  • Fever
  • Difficulty urinating or inability to urinate
  • Frequent urination that disrupts daily activities or sleep 
  • Back pain 
  • Nausea or vomiting

To diagnose the cause of bladder pain, your healthcare provider will review your medical history, perform a physical examination, and order diagnostic tests. If necessary, your primary care provider may refer you to a urologist—a doctor with special training in diagnosing and treating conditions affecting the urinary tract. 

During your appointment, you can expect your provider to ask you questions about your symptoms—such as which symptoms you’re experiencing and how often they occur. They’ll also request information about your lifestyle habits (e.g., do you smoke?) Once they learn more about your symptoms, they’ll conduct a physical exam by touching your abdomen to check for swelling or tumors or perform a pelvic or rectal exam.

You’ll often need additional testing to learn the root cause of your bladder pain. As such, your provider may order diagnostic tests that help identify the cause, which may involve one or more of the following exams: 

  • Urine test: Observing the color, appearance, and smell of urine and test for the presence of bacteria, blood, or other abnormalities in the urine
  • CystoscopyInserting a thin tube with a tiny camera (cystoscope) into the urethra and up into the bladder to look for signs of inflammation, stones, ulcers (open sores), and tumors
  • Biopsy: Removing a small tissue sample from the bladder during a cystoscopy procedure and viewing the sample under a microscope
  • Urodynamic test: Filling and emptying the bladder with water using catheters (tubes) to measure bladder pressure as the bladder fills and empties

If you receive a diagnosis for an underlying condition that’s causing your bladder pain, you’ll likely require some form of treatment. While treatment approaches can vary from person to person, your healthcare provider may recommend a treatment plan that includes lifestyle changes, home remedies, medications, or medical procedures. 

Home Remedies

Lifestyle changes and at-home treatments may relieve bladder pain and help reduce the severity and frequency of symptoms. Your healthcare provider may recommend:

  • Dietary changes: Certain foods and beverages may trigger or worsen bladder pain. You may need to limit or avoid tomatoes, spicy foods, alcohol, chocolate, citrus fruits, or caffeinated drinks like coffee. These foods and drinks are common bladder irritants, but everyone is different. Limiting the foods that trigger your pain is an important part of treatment.
  • Bladder training: People with bladder pain may benefit from bladder training. This may involve adding 15 minutes between bathroom visits and gradually increasing the time between bathroom trips to help the bladder retain urine and decrease urination frequency. 
  • Hydration: Drinking plenty of water (approximately eight glasses daily) can help flush out bacteria and bladder stones.
  • Heat therapy: Applying a heating pack or damp, warm cloth to your lower abdomen can relieve pain.
  • Quitting smoking: Long-term smoking can cause a cough that puts pressure on your abdomen, which may worsen bladder pain. Nicotine and other chemicals in smoke pass through urine, which may irritate the bladder and increase pain. 
  • Over-the-counter medications: Pain relievers, such as Advil (ibuprofen), may help reduce inflammation and mild bladder pain. 

Medical Treatments

Prescription medications, therapies, and medical procedures can help treat and manage conditions causing bladder pain that aren’t treatable at home. Depending on your diagnosis, this may include:

  • Prescription medications: Antibiotics for bacterial infections, antispasmodics to reduce bladder spasms, and antihistamines to relieve bladder pain with interstitial cystitis.
  • Chemotherapy: If bladder cancer is causing your pain, may require chemotherapy, radiation therapy, or other types of cancer treatments.
  • Physical therapy: Pelvic floor physical therapy exercises can help address muscle dysfunction by strengthening the pelvic floor muscles and teaching relaxation techniques for pain relief.  
  • Bladder installations: Also known as bladder washes, this treatment fills your bladder with a solution and drains it out with a catheter to relieve inflammation and pain.
  • Surgery: Surgical interventions may be necessary to remove bladder stones and tumors or repair bladder damage or structural abnormalities.  

Bladder pain has many possible causes, including urinary tract infections, bladder stones, interstitial cystitis, bladder endometriosis, and bladder cancer. Depending on the cause, bladder pain may be constant or come and go and feel like a dull ache or pressure in your lower abdomen. The pain may also occur with other symptoms, such as frequent urination or blood in the urine.

Home remedies and medical treatments from a healthcare provider can help ease pain and lower the risk of complications.

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