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Bladder spasms in multiple sclerosis (MS) can drag you out of bed at night, take control of your daily agenda, and lead to occasional embarrassing accidents. These spasms, which stem from disrupted signals between your brain and spinal cord, can make you urinate too often, with more urgency, or with trouble fully emptying your bladder.
Members of MyMSTeam discuss the ways bladder spasms influence the choices they make every day. “Frequent urinating is most worrisome. I stay home a lot,” commented one member.
Another agreed, saying, “My bladder is honestly the reason I never want to leave my house.”
If you have MS, it’s important to understand how it can lead to various bladder problems, including bladder spasms. Speak with your neurologist or another healthcare provider if you’re experiencing any of these issues.
A bladder spasm occurs when the muscles in and around the organ suddenly contract, causing it to shrink and urination to occur involuntarily. A spastic (overactive) bladder cannot fill to its normal capacity, and it cannot empty fully during urination.
Some symptoms of bladder spasms include:
Many members of MyMSTeam describe problems with their bladder. One member asked, “Does anyone else constantly feel the need to go to the bathroom, and right after you’re done, you’ve got to go again? And when you go, you go very little, and you wait forever to go?”
Another shared, “I’m going to ask my doctor about my bladder control (or lack thereof). I ruined a new $800 mattress, plus the constant up and down is getting unbearable.”
Not only can bladder spasticity affect your kidney health, but it can disrupt your social life, work and family obligations, and mental health. Early medical intervention can help you determine the cause of your bladder spasticity and get the right treatment.
MS can be a direct cause of bladder spasms. MS creates lesions (areas of damage) in the central nervous system (brain and spine) that cause a disconnect between the brain and the body. This can affect the nerves that control the bladder muscle and urinary sphincter muscle.
The bladder muscles line the walls of the bladder itself, and the urinary sphincter muscle tightens to stop the flow of urine and relaxes to let it pass. When the bladder wall muscles spasm, it can cause urine to leak or make you feel like you urgently need to use the bathroom. If the sphincter muscle doesn’t relax properly, it can stop or slow the flow of urine. When MS flares or gets worse, the likelihood of urinary problems increases.
According to Cleveland Clinic, risk factors for having MS include:
Risk factors for an overactive bladder include increasing weight, increasing age, constipation, and recurrent UTIs.
Some medications may worsen bladder spasms. Diuretics (drugs that increase the production of urine) taken for conditions such as high blood pressure can cause bladder problems. Baclofen, a medication commonly prescribed for MS, can potentially worsen bladder problems. It may cause side effects like urinary retention or incontinence.
You can make various lifestyle changes to manage bladder spasms, such as drinking enough water and adopting certain at-home habits.
Try to drink six to eight glasses of water per day while cutting out food and beverages that may irritate your bladder, especially those that are caffeinated, alcoholic, spicy, or acidic. Limit your fluid intake in the hours leading up to bedtime to reduce the number of times you need to get up during the night.
Mental health challenges like anxiety and depression are common with MS and have been linked to bladder problems. In some cases, cognitive changes caused by MS — such as trouble thinking clearly or remembering things — can contribute to emotional distress. Managing stress with meditation or other relaxation techniques may help. If you’re struggling, talk with your healthcare provider about counseling or other mental health support.
If you have trouble emptying your bladder fully, incorporating exercises that engage your pelvic floor may help. The National Multiple Sclerosis Society recommends some other ways to train your bladder at home.
If lifestyle changes don’t improve your bladder spasms, your doctor may help you choose one of many medical treatment options. These include physical therapy, botulinum toxin, intermittent self-catheterization (ISC), surgery, and medications.
Pelvic floor physical therapy can help you regain control over the muscles that surround your bladder. It can be done at first with a professional, and then at home.
In one nonrandomized study from the Brazilian Journal of Physical Therapy, pelvic floor therapy proved effective in reducing the frequency of urination and improving the quality of life for women with urinary incontinence.
Botulinum toxin (sold under brand names like Botox, Dysport, and Xeomin) is sometimes used to decrease the spasticity of the bladder, but it comes with a risk of side effects. “I love my bladder Botox for incontinence, but it’s only lasting five months,” explained one MyMSTeam member.
Botulinum toxin treatment for the bladder usually lasts at least three months. The limiting factor is often cost, as you’ll need to repeat the treatment multiple times each year. The medication’s effectiveness may decrease over time for some people, and UTIs are a possible side effect.
Intermittent self-catheterization entails regularly inserting small tubes into the urethra to empty the bladder, then removing them. One member said, “Ask for intermittent catheters — it helps with the bloating, overactive bladder, incontinence, and hyper-bladder.”
ISC is an important treatment for bladder dysfunction, especially when you struggle to empty your bladder fully, but it can come with some challenges. Learning to properly use a catheter requires patience and care. Additionally, ISC can cause discomfort, UTIs, and bleeding.
Many medications are available to help address bladder problems in people with MS, including antimuscarinics, mirabegron, and desmopressin. Disease-modifying therapies for MS may help keep bladder symptoms from getting worse by reducing MS relapses.
All medications come with possible side effects, but your doctor can help you weigh a medication’s potential risks and benefits before trying it. Speak to your healthcare team about which medication might work best for you.
Several major and minor surgeries for the bladder and surrounding area can treat bladder spasms in those with MS. “I am going to have major bladder surgery on Monday due to my MS,” one MyMSTeam member shared.
Surgery may be as minimally invasive as implanting a small device called InterStim Therapy, which can stimulate the nerves to help control bladder movements. Surgery for bladder spasms can also include permanent catheterization, expansion of the bladder, and other major procedures.
Bladder problems with MS can affect your quality of life. If you’re living with bladder spasms, think about expanding your medical network to include a urologist, gynecologist, and pelvic floor therapist. There are many treatment options available to manage this frustrating, yet common, symptom of MS.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
Have you experienced bladder spasms while living with MS? Let others know in the comments below.
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A MyMSTeam Member
I've been catheterised most of last 8 years because of this but the catheter has now caused squamous metaplasia in my bladder. I've tried without catheter but have to go every five minutes for minutes… read more
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