UTI’s or urinary tract infections are an infection in any part of the urinary system and are often extremely painful.  

Women are 30 times more likely to suffer from UTIs compared to men, with 4 out of 10 women developing at least one more UTI within 6 months of their last one.  

The urinary system includes the kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.  

Symptoms of a UTI:
-Pain or burning when urinating
-An urge to urinate often, but not much comes out when you go
-Pressure in your lower abdomen
-Urine that smells bad or looks cloudy
-Blood in the urine. This is more common in the younger population and is something that needs to be addressed urgently.
-Feeling tired, shaky, confused, or weak. (This is more common in the older population)
-Having a fever, which may mean the infection has reached your kidneys
-Lower back pain over your flank, which again can indicate the infection has gone up into your kidneys


UTI’s are tested for via a urine sample to assess for any bacteria and treated with antibiotics.

But what happens when you have the symptoms of a UTI but your urine sample comes back negative? Many people can often be left worried and wondering why they are struggling with these symptoms.


Pelvic floor dysfunction

Pelvic floor dysfunction can cause almost all the symptoms of a UTI, including urethral burning, urinary urgency/ frequency, pelvic or bladder pain, as well as other symptoms.

Your pelvic floor muscles are a group of muscles positioned at the bottom of your pelvis that lift and support the position and function of your pelvic organs, prevent incontinence of bladder and bowel and is also important in sexual function. Ideally these muscles should be strong, coordinated and flexible but this isn’t always the case. When these muscles aren’t working together in a way that they should, issues arise and that’s what is called pelvic floor dysfunction.


Many pelvic floor issues can mimic the symptoms of a UTI, but a common issue is a hyperactive pelvic floor. This is where the muscles are under constant tension and don’t fully relax to their usual resting state. Not only does a hyperactive pelvic floor mimic the symptoms of a UTI, they also go hand in hand together – UTIs make you more likely to develop a hyperactive pelvic floor and a hyperactive pelvic floor makes you more likely to develop UTIs.  


This occurs via a cycle of your body responding to the threat by staying in a constant state of contraction in order to try and protect the body. Then, when it comes time to going to the toilet to urinate, the pelvic floor muscles may not be able to relax enough or fully which can cause incomplete emptying of your bladder, which makes your more prone to developing another UTI.


Treatment for a hyperactive pelvic floor may vary. As Osteopaths, we look at the whole body to see if there are any possible contributing factors coming from somewhere else other than the pelvic floor. We can do specific pelvic floor work which may involve direct contact on the pelvic floor and the surrounding joints to try and help lengthen and relax the area, breathing techniques, a bladder diary as well as an at home exercise rehab plan with the focus on desensitising the area. 


There are many other pelvic dysfunctions that can mimic UTIs not just a hyperactive pelvic floor, so if this sounds like something you have been dealing with and you are struggling to get on top of this constant discomfort, it could be time for you to have your pelvic floor examined for any potential dysfunctions. 


Wolff, B.J. et al. (2019) “Pelvic floor myofascial pain in patients with symptoms of urinary tract infection,” International Journal of Gynecology & Obstetrics, 145(2), pp. 205–211. Available at: https://doi.org/10.1002/ijgo.12784.