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Bladder Spasms and MS: Understanding the Connection

Posted on August 30, 2022
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Scarlett Bergam, M.P.H.

Multiple sclerosis (MS) is a neurological condition that disrupts the signals between your brain and body. These improper signals can cause muscle spasms across the body, leading to sexual, bowel, and urinary dysfunction. Bladder spasms can cause urinary incontinence and other symptoms in up to 90 percent of people with MS and are increasingly common as the condition progresses. One MyMSTeam member asked, “Is anyone going through incontinence problems?”

If you have MS, it’s important to understand how it can lead to various bladder problems, including bladder spasms. Speak with your neurologist if you are experiencing any of these issues.

Symptoms of Bladder Spasms

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:

  • Urinary incontinence (leaking urine)
  • Urinary hesitancy (trouble beginning to urinate)
  • Poor or weak urine flow
  • The inability to fully empty the bladder, which can lead to urinary tract infections
  • Urgent need to urinate
  • Frequent need to urinate, including at night

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 does bladder spasticity hurt your kidney and neurological 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 treat it accordingly.

Causes of Bladder Spasms in People With MS

MS can be a direct cause of bladder spasms. MS creates lesions 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 muscle lines 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. As MS gets worse, the likelihood of urinary problems increases.

Risk factors for MS include being female, having a vitamin D deficiency, having certain viral infections, having certain genetics, and being exposed to certain environmental factors. Risk factors for an overactive bladder include increasing weight, increasing age, constipation, and recurrent urinary tract infections (UTIs).

MS medications are not known to worsen or cause bladder spasms. However, diuretics (drugs that increase the production of urine) taken for conditions such as high blood pressure can cause bladder problems.

Lifestyle Changes To Help With Bladder Spasms

You can make various lifestyle changes to manage bladder spasms, such as drinking enough water and adopting certain at-home techniques.

Stay Hydrated

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.

Take Care of Your Mental Health

Take care of your mental health, as anxiety and depression have been linked to bladder problems. Try meditation and other relaxation techniques, and seek out counseling when necessary and if accessible.

Practice Some At-Home Techniques

If you have trouble emptying your bladder fully, try this manual technique recommended by one MyMSTeam member: “I can still void spontaneously with my bladder full by placing pressure on my stomach/bladder by hand. It never completely empties, but it gives me another half an hour.”

Incorporating exercises that engage your pelvic floor may help. The National Multiple Sclerosis Society recommends some other ways to train your bladder at home.

Medical Treatments for Bladder Spasms

If you have tried these lifestyle changes and your bladder spasms have not improved, your doctor may help you choose one of many medical treatment options. These include physical therapy, Botox, intermittent self-catheterization, surgery, and medications.

Physical Therapy

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.

Botox

Botulinum toxin (Botox) is commonly used to decrease spasticity of the bladder and comes with very few side effects. “I love my bladder Botox for incontinence, but it’s only lasting 5 months,” explained one MyMSTeam member. Bladder Botox is meant to last at least 3 months. The limiting factor is often cost, as a single vial of Botox costs $400, and multiple vials may be necessary for one procedure. Further, over time, the body can begin to produce antibodies against Botox, limiting its effectiveness.

Intermittent Self-Catheterization

Intermittent self-catheterization (ISC) entails 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.”

Using ISC once or twice per day can relieve many bladder spasticity symptoms.

Surgery

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 member shared.

Surgery may be as noninvasive as implanting a small device called InterStim Therapy that can stimulate the nerves to control bladder movements. Surgery for bladder spasms can also include permanent catheterization, the expansion of the bladder, and other major procedures.

Pharmaceuticals

Many medications are available to help address bladder problems in people with MS. One member explained, “Baclofen helps me with my bladder issues.”

Speak to your health care team about what medication might work best for you.

Talk to Your Doctor

Bladder problems can affect your quality of life. If you are living with bladder spasms, think about expanding your medical network to a urologist, gynecologist, and pelvic floor therapist. There are many treatment options available to manage this frustrating, yet common, symptom of MS.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 191,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you experienced bladder symptoms while living with MS? How have you improved your bladder function? What advice do you have for other people living with MS? Share your tips and experiences in a comment below or on MyMSTeam.

All updates must be accompanied by text or a picture.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Scarlett Bergam, M.P.H. is a medical student at George Washington University and a former Fulbright research scholar in Durban, South Africa. Learn more about her here.

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