Acupuncture for Overactive Bladder

How Chinese medicine understands overactive bladder

In Chinese medicine, the Bladder stores urine and releases it at the right time. Its ability to hold depends on the Kidney, which in this view governs the “lower openings” and keeps them firm. When urgency and frequency take over, the question is why the holding has weakened, or what is pushing the bladder to empty early.

The common patterns are:

• Kidney Qi not firm. Frequent, pale, plentiful urine, dribbling afterwards, getting up at night, and often a weak or sore lower back. It is more common with age.
• Kidney Yang deficiency. Similar, with a colder picture: cold hands and feet, a cold lower back, and symptoms that are worse in winter or when you are tired.
• Spleen Qi sinking. A dragging or heavy feeling low in the belly, tiredness, loose stools, and urgency that is worse at the end of a long day on your feet.
• Liver Qi stagnation. Urgency that comes with stress, tension or rushing, and settles when you are relaxed.
• Heart and Kidney not communicating. Night waking with a busy mind, then needing to go once you are awake.

Most people have a mix. A cold, weak pattern is treated by warming and strengthening. A stress-driven pattern is treated by calming and moving Qi. That is why the diagnosis comes first.

What treatment involves

Your first visit includes a lot of questions: how often you go by day and by night, how strong the urge is, whether you leak, what you drink, your sleep, energy and bowel habits, and any pregnancies or prostate history. I also look at your tongue and take your pulse. A bladder diary kept for three days before the visit is a big help.

Acupuncture points are commonly chosen on the lower belly, the lower back and sacrum, and the legs, with others selected for your pattern. Treatment aims to settle urgency, help the bladder hold for longer, and improve sleep where night waking is part of the problem. For a cold, weak pattern, moxibustion can add warmth over the lower belly and back.

Chinese herbal medicine is often useful here, because it works every day between visits. I write a formula for your pattern and dispense it at the clinic, and it changes as your symptoms do.

Treatment at the clinic in Keswick works alongside bladder training and any medication your doctor has prescribed. Plan on 5–10 treatments to judge progress.

Between visits

• Keep a bladder diary. Note what you drink, when you go, and any urgency or leaks. It shows your pattern and whether things are changing.
• Try bladder training. When the urge comes, stop, stand or sit still, squeeze your pelvic floor, and let the wave pass before walking to the toilet. Slowly stretch the time between visits.
• Cut back on bladder irritants: coffee, tea, cola, energy drinks, alcohol and fizzy drinks.
• Do not cut back on water. Concentrated urine can irritate the bladder more. Drink steadily through the day and ease off in the two hours before bed.
• Keep your bowels regular. Constipation presses on the bladder and makes urgency worse.

When to see your doctor first

Urgency and frequency can come from other conditions, so see your doctor to rule these out, and promptly if you have:

• Blood in your urine, even once.
• Burning or pain when you pass urine, fever, or pain in your back or side. These can mean an infection.
• Trouble starting, a weak stream, or a feeling that the bladder does not empty.
• Symptoms that came on suddenly, or new numbness, weakness, or changes in bowel control.
• Great thirst with frequent urination, or unexplained weight loss.
• Pelvic pain, or a bulge or heavy feeling in the vagina.