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  • Writer's pictureDr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic

How Dry Needling can help Leaking Pee

Dry Needling for Urinary Incontinence at Flow Physical Therapy in The Woodlands, TX
Leaking Pee is not normal and can be treated with Physical Therapy

First, a little bit of background information!

Leaking pee, more formally known as stress urinary incontinence (SUI), is characterized as an involuntary leaking of urine during moments of increased intra-abdominal pressure. This increase in abdominal pressure can be directly caused by sneezing, coughing, jumping, and lifting (you know, everyday things).

The prevalence of stress urinary incontinence has been reported to be as high as 49%(!) in active women and 15% in all women between the ages of 30-60. Further complicating this is that 80% of women will not even be treated for symptoms associated with incontinence. 

But why won’t women be treated? Well the most common reason is an overwhelming feeling of embarrassment. This directly leads to increased psychological burdens, including social isolation and even insomnia. 

And of course, when a patient is diagnosed with stress urinary incontinence, many of these patients are also going through postpartum changes affecting the pelvic floor. Postpartum changes and pelvic floor dysfunction directly related to vaginal delivery during childbirth directly lead to a higher prevalence of immediate incontinence; furthermore, long term studies on leakage due to Caesarian deliveries are not available at this time. Other common findings occurring simultaneously with SUI are constipation and natural age related changes. 

But why all the talk about women? Where are the men? The truth of the matter is simply the anatomical differences do make women more susceptible to leaking urine; however, men are not immune to this condition. Further leading to gaps in knowledge are men as less likely to report symptoms of incontinence to their MD and consequently there just aren’t many robust randomized clinical trials on the treatment for SUI in males. 

Anatomical Considerations with Urinary Incontinence

The muscles of the pelvic floor play an important role in pelvic organ support, sexual function, and urinary function. Thus, an understanding of the involved muscles and the interaction with urination is critical for treatment strategies. 

This is where this can become very technical and quite, ahem, boring; however, the nuts and bolts are that the muscles of the pelvic floor, the hip, and the low back play an intimate role in stress urinary incontinence. This can be in the form of muscular:

  • Weakness

  • Overactivity

  • Tightness

  • Discoordination

(Notice, only one of the above reasons is due to weakness of the associated pelvic floor musculature. I would venture to guess this is why Kegel exercises are not always the answer and may not provide the solution people think it should. This concept alone is a major reason you need a pelvic floor specialist to perform a proper internal pelvic floor assessment to determine the true cause - and not just be told to perform Kegel exercises … But I’ll step down from my soap box because that is a totally different topic).

Back to the original topic shall we? Where were we? Ahh yes, the muscles of the pelvic floor…

Clearly, deficits in either pelvic floor muscular function, muscular tone, or muscular innervation can all be root cause factors to SUI. 

So what if we had a treatment approach that could address all of these causative factors?

It has been well established that dry needling can be used to treat muscles, ligaments, tendons, subcutaneous fascia, scar tissue, peripheral nerves, and neurovascular bundles for the management of neuromusculoskeletal syndromes. Which leads to the obvious clinical question of can electric dry needling be an effective conservative treatment option for women struggling with symptoms of SUI?

Short answer, Yes!

Long Answer – let's dive deeper! (I’ll try to keep my long answer short-ish)

Research studies have been published examining this very topic of dry needling as it pertains to treatment of urine leakage. These studies include a systematic literature review (a type of article that analyzes multiple randomized control trials in one study) which included 4 studies and the results indicated that electric dry needling should be considered as an effective treatment to decrease urine incontinence in women. Additionally, high level randomized control trials have examined dry needling as a conservative treatment for stress urinary incontinence. And much like the previous, the experimental group (the group in favor of dry needling specific to SUI) had an effectiveness rate of 90% - indicating the benefit of dry needling as a conservative method. 

Ok, enough with the jargon - what does this mean for the patients?

Well for starters, the research supports the use of electric dry needling for patients who are leaking pee. This doesn’t mean that needles haphazardly inserted into the muscles will magically create positive change. This means that a provider with expert knowledge of the specific musculature, neural structures, and anatomy involved can make the correct clinical decision on where to insert needles to create the necessary changes to the neuromuscular structures involved.

And that is exactly what we do at Flow Physical Therapy and Wellness in The Woodlands, Texas. We have an Osteopractic Physical Therapist who has post-doctorate diplomas in electric dry needling, as well as differential diagnosis, spinal manipulation, cupping/IASTM, and much more. 

So if you are in the 49% of active women struggling with leaking pee, or in the 80% of women who haven’t reported their symptoms, or one of the many men who are too bashful to report any symptoms - we want you to know that conservative and  research-proven options do exist to treat urinary incontinence. 

Click the button below to take your first step to jumping on your trampoline, picking up your children, and sneezing in public without the fear and anxiety of leaking. 

Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic

Owner of Flow Physical Therapy and Wellness


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