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10 Bladder Spasm Causes, Symptoms & Treatment Options

Bladder spasms can be caused by an overactive bladder, which leads to the urge to urinate. It can also be caused by a UTI or interstitial cystitis, a painful bladder condition. There are medications to reduce spasms.
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Last updated March 22, 2022

Bladder spasms quiz

Take a quiz to find out what's causing your bladder spasms.

Bladder spasms quiz

Take a quiz to find out what's causing your bladder spasms.

Take bladder spasms quiz

Bladder spasms symptoms

Bladder spasms can lead to an urge to urinate, the actual leakage of urine, or urinary incontinence. Bladder spasms specifically refer to involuntary contractions of the muscle that controls the bladder, called the detrusor muscle. Bladder spasms can also refer to an uncomfortable or painful cramping sensation in the bladder that doesn't result in the urge to urinate.

Most commonly, bladder spasms leading to urinary urgency occur in older adults without a known underlying cause. However, there are some medical conditions that can lead to bladder spasms, including various spinal cord disorders, infection, or cancer. Bladder spasms and urinary incontinence are not a normal part of aging although they are common and anyone experiencing these symptoms should seek medical attention.

Common characteristics and accompanying symptoms of bladder spasms

Symptoms that can be associated with bladder spasms include:

3 causes of bladder spasms

Causes of bladder spasms are described from most to least common below. These may include bladder syndromes or neurologic problems, among others.

Urinary tract infection

A urinary tract infection, or UTI, can involve any or all parts of the urinary system but most often affects the bladder and urethra.

Bacteria from the gastrointestinal tract – especially Escherichia coli (E. coli) – are the most common cause of UTIs. These bacteria spread from the anus to the urethra. Sexual activity can do this, but a UTI is not considered a sexually transmitted disease.

Women are more at risk for UTI than men. Due to female anatomy, the urethral opening is a short distance from the anus. Anyone who uses catheters to urinate is also prone to UTIs.

Common symptoms of less-serious UTIs include lower abdominal discomfort and pressure; burning or discomfort on urination; and cloudy or discolored urine.

Left untreated, the infection could spread to the kidneys and cause a medical emergency.

Diagnosis is made by having the patient describe the symptoms and by testing a urine sample for bacteria.

UTIs are caused by bacteria and so can be treated with antibiotics.

Prevention involves good hygiene and drinking plenty of water.

Symptoms of menopause

Menopause, or "change of life," refers to the time when a woman no longer has menstrual cycles and can no longer bear children.

It is a normal occurrence and usual happens between ages 45 to 55. Menopause can be artificially induced by surgical removal of both ovaries, and by chemotherapy and/or radiation therapy for cancer.

Symptoms usually begin many months before periods actually stop. There will be irregular periods, vaginal dryness, hot flashes, weight gain from slower metabolism, and dry skin.

If not treated, some symptoms may affect quality of life. Hot flashes and hormonal imbalances can disrupt sleep, sexual function, and emotional health.

At menopause, risks of heart disease, osteoporosis, and urinary incontinence increase. Because periods can become irregular while pregnancy is still possible, testing is advisable before any medical treatment is done.

Menopause is diagnosed when an entire year has gone by without the woman experiencing a menstrual period. Blood testing for hormone levels can confirm menopause.

Treatment can be done for any troublesome symptoms, including hormone replacement therapy to ease hot flashes.

Normal abdominal pain

The complaint of abdominal pain and discomfort, with no apparent cause, is one of the most common in medicine. It is a primary reason for patients to visit a medical provider or the emergency room.

The cause of abdominal pain can be difficult to find, because it can just be a completely normal abdominal pain or come from many different sources: the digestive tract, the urinary tract, the pancreas, the gall bladder, or the gynecologic organs.

The pain may simply be caused by overly sensitive nerves in the gut. This hypersensitivity can occur after repeated abdominal injury and/or it may have an emotional cause due to fear of the pain itself.

Diagnosis is made through physical examination, patient history, and simply ruling out any other condition. CT scan is often requested, but can rarely find a specific cause. The benefits must be weighed against the risks of radiation.

Treatment first involves making any needed lifestyle improvements regarding diet, exercise, work, and sleep, in order to reduce stress. In some cases, counseling, hypnosis, mild pain relievers, and antidepressants are helpful.

Mixed urinary incontinence

Incontinence is a medical condition which refers to a person's inability to control when they urinate. can be due to stress or urge. Stress incontinence refers to unintentional leakage of urine caused by coughing, sneezing, laughing, or lifting something heavy, while urge incontinence refers to unintentional leakage right after feeling a sudden urge to urinate. Mixed incontinence is a combination of the two.

You can safely treat this condition on your own before seeking medical consultation. You can try using the bathroom at regular intervals to minimize leaking, as well as doing Kegel exercises regularly to strengthen muscles involved in urine control. If symptoms persist, a doctor may be able to suggest some medications and other more invasive avenues of treatment.

Rarity: Common

Top Symptoms: waking up regularly to pee at night, recurring problem with leaking urine, sudden urges to pee, urges to pee upon exertion or heavy breathing

Symptoms that always occur with mixed urinary incontinence: recurring problem with leaking urine

Urgency: Self-treatment

Bladder spasms quiz

Take a quiz to find out what's causing your bladder spasms.

Take bladder spasms quiz

Kidney infection (pyelonephritis)

A kidney infection, or pyelonephritis, is actually a type of urinary tract infection (UTI) that begins in the urethra or bladder and spreads to the kidneys.

The infection is caused by bacteria that either travel into the urethra or spread from an infection elsewhere in the body.

Women, especially pregnant women, are most susceptible. Anyone who has had a urinary tract blockage, or uses a catheter, or has a weakened immune system is also at risk for a kidney infection.

Symptoms include fever; chills; back and abdominal pain; and frequent, painful urination. If there is also nausea and vomiting and discolored, foul-smelling urine, take the patient to the emergency room or call 9-1-1.

Left untreated, pyelonephritis can cause permanent damage to the kidneys. Bacteria can also enter the bloodstream and cause a life-threatening infection elsewhere in the body.

Diagnosis is made through urine test, blood test, and sometimes imaging such as ultrasound, CT scan, or x-ray.

Treatment includes antibiotics and sometimes hospitalization.

Cauda equina syndrome

Although leg pain is common and usually goes away without surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord, is a surgical emergency.

Call 911 immediately for an ambulance.

Bladder syndromes

Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.

The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.

Painful bladder syndrome is more common in women than in men, but can happen to anyone.

Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.

A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.

Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.

There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.

Bladder cancer

Bladder cancer refers to a tumor that begins growing within the lining of the urinary bladder, rather than cancer that begins elsewhere and later spreads to the bladder.

Risk factors include smoking; exposure to industrial chemicals and fumes; ongoing bladder inflammation, as from chronic infections or catheter use; and not drinking enough water. Most patients are men over the age of 55, but bladder cancer can affect anyone.

Symptoms include urinary frequency; pain during urination; and blood in the urine, though there are many other causes for all of these. Later symptoms may include low back pain, inability to urinate, bone pain, and swollen feet.

Diagnosis is made through patient history; physical examination, including rectal examination for men and pelvic examination for women; urinalysis, to test for traces of blood and cancerous cells; imaging, such as ultrasound; and sometimes biopsy.

Treatment involves some combination of chemotherapy, radiation therapy, surgery, and supportive care, to ease symptoms and improve quality of life.

Acute prostatitis

Acute prostatitis is a sudden-onset bacterial infection of the prostate gland in men.

Bacteria can spread to the prostate through a urinary tract infection, or through a sexually transmitted disease such as gonorrhea or chlamydia. Infection can also start after a medical procedure such as a urinary catheter insertion.

Most susceptible are younger or middle-aged men with a urinary tract infection or STD (sexually transmitted disease;) a pelvic injury from trauma or from bicycling or other sport; an enlarged prostate; or a recent prostate biopsy.

Symptoms include pain and difficulty when trying to urinate; pain on ejaculation; pelvic and abdominal pain; fever; chills; and nausea and vomiting.

These symptoms should be evaluated by a medical provider, because untreated prostatitis can lead to bacteremia of the blood ("blood poisoning,") prostatic abscess, and infertility.

Diagnosis is made through patient history, urinalysis, blood tests, and a physical examination which usually involves a digital rectal examination. Prostatitis does not cause prostate cancer.

Treatment is done with antibiotics, usually as an outpatient.

Acute kidney injury

Acute kidney injury, also called acute renal failure or acute kidney failure, does not necessarily refer to a physical injury. It means that the kidneys have been severely damaged and are suddenly no longer able to filter wastes from the blood.

Anything that interferes with blood flow to the kidneys, or to the urine draining from them, will injure the kidneys. This includes: blood loss; clots; heart disease; high blood pressure; diabetes; infection; dehydration; lupus; toxins; and any number of medications.

An older person who is hospitalized, and/or critically ill, is most susceptible.

Symptoms include decreased urine output; swollen ankles; shortness of breath; nausea; chest pain; and sometimes seizures or coma.

Acute kidney injury is a medical emergency. Left untreated, it can result in permanent kidney damage or death. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through urine tests, blood tests, ultrasound or CT scan of the kidneys, and sometimes kidney biopsy.

Treatment involves hospitalization to treat the underlying cause of the kidney injury, and may include dialysis.

Neurologic problems

Issues with neurologic functioning may also lead to bladder spasms.

  • Spinal cord injury: Traumatic injury to the spinal cord results in many different complications, including bladder dysfunction. Bladder control is complex and involves coordination between multiple parts of the brain, spinal cord, and nerves leading to the bladder. Spinal cord injury can disrupt the storage and emptying of urine, resulting in multiple different problems. One possible problem is hyperactivity of the muscle that controls bladder emptying, leading to spasms and possible leakage of urine or urinary incontinence.
  • Other spinal cord problems: Any spinal cord problem has the potential to lead to bladder dysfunction. One common spinal cord problem that leads to bladder dysfunction is multiple sclerosis (MS); however, any disease that affects the spinal cord can affect bladder function. People with MS may experience bladder spasms. These spasms can lead to urinary frequency and urgency and may lead to a leakage of urine or urinary incontinence at night.

Other causes

Other, less common causes of bladder spasms may include:

  • Infection: The urinary tract, which includes the bladder, ureters, and urethra, can become infected with bacteria. Typically, the symptoms of a urinary tract infection (UTI) include pain or a burning sensation with urination, pain in the lower abdomen, and urinary frequency or urgency. However, people may also experience bladder spasms with urinary tract infections. These may or may not be associated with a leakage of urine or urinary incontinence.
  • Bladder cancer: The most common symptom of bladder cancer is blood in the urine without pain. However, sometimes, bladder spasms causing urinary frequency or urgency are the main presenting symptom of bladder cancer. These symptoms may be present with or without urinary incontinence. These symptoms may be accompanied by fatigue, weight loss, or poor appetite.

Painful bladder syndrome (interstitial cystitis)

Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.

The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.

Painful bladder syndrome is more common in women than in men, but can happen to anyone.

Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.

A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.

Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.

There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.

Rarity: Rare

Top Symptoms: fatigue, abdominal cramps (stomach cramps), depressed mood, pelvis pain, arthralgias or myalgias

Urgency: Primary care doctor

Urge urinary incontinence

Incontinence is a medical condition which refers to a person's inability to control when they urinate. Urge incontinence refers to unintentional leakage right after feeling a sudden urge to urinate. This is caused by abnormal bladder contractions.

Rarity: Uncommon

Top Symptoms: waking up regularly to pee at night, recurring problem with leaking urine, sudden urges to pee

Symptoms that always occur with urge urinary incontinence: recurring problem with leaking urine, sudden urges to pee

Urgency: Self-treatment

Bladder spasms quiz

Take a quiz to find out what's causing your bladder spasms.

Take bladder spasms quiz

Bladder spasms treatments and relief

You should seek treatment without delay if you believe to have injured your spinal cord or are suffering from new incontinence or blood in your urine. Some at-home remedies are available for less severe cases; however, you should likely consult your physician sooner than later if the spasms become more frequent or persist.

At-home treatments

A consult with your doctor will likely be necessary. However, there are a few at-home remedies that may be helpful in dealing with bladder spasms.

  • Exercises: Pelvic floor exercises are exercises for the muscles that help control emptying of the bladder. Sometimes, learning and performing these exercises on a regular basis can help prevent the leakage of urine or urinary incontinence when a bladder spasm occurs.
  • Lifestyle modifications: Bladder training, which involves urinating at timed intervals and modifying liquid intake, can help with bladder overactivity and urinary incontinence. Other lifestyle modifications such as weight loss, smoking cessation, and prevention of constipation can help with overactive bladder and urinary incontinence.
  • Incontinence pads: Pads or protective undergarments do not address the underlying cause of overactive bladder or urinary incontinence. Typically, physicians recommend seeking alternative management strategies as incontinence pads can be expensive, and chronic exposure to urine-soaked pads can lead to skin irritation and breakdown.

Medical professional treatments

Your physician may recommend the following to further treat your bladder spasms.

  • Urine collection: If a physician suspects a urinary tract infection or bladder cancer, they will likely collect a urine sample for testing. Typically, you can collect the urine culture yourself, but a physician may recommend using a small tube through the urethra into the bladder to collect a sterile sample of urine (cystoscopy).
  • Bladder pressure: If a physician suspects you may have a nerve or muscle problem that is causing your bladder spasms, they may do a test that can measure the pressure in the bladder to help diagnose the problem. Typically, this involves the insertion of a small, flexible tube through the urethra into the bladder.
  • Oral medication: A physician may prescribe medication to assist with symptoms of bladder spasms and with leakage of urine or urinary incontinence. There are multiple different types of medications that can help with different causes of bladder spasms or urinary incontinence.
  • Acupuncture: Traditional acupuncture or acupuncture combined with electrical stimulation may have some benefit for people with bladder overactivity and bladder spasms. Your physician may suggest you try these treatments on their own or in combination with other treatments.
  • Medication injections: If oral medications do not work, some physicians recommend using an injection of medication directly into the bladder to help with bladder overactivity and bladder spasm. A small camera (cystoscope) will be passed through a catheter in the bladder, and the medication will be injected directly into the muscular wall of the bladder using this camera.
  • Nerve stimulator: For some women with overactive bladders leading to bladder spasms and incontinence, a nerve stimulator that is implanted in the back can be an effective treatment. Typically, this treatment is reserved for situations where lifestyle modifications and medications have failed, and where urinary incontinence is a big problem.

Seek emergency treatment for the following

If you experience these symptoms, you should seek immediate medical care.

  • New incontinence following trauma: You may have a spinal cord injury, especially if you are aware of any trauma or if your incontinence is accompanied by numbness, tingling, or weakness in the legs.
  • Blood in the urine: While there are many causes of blood in the urine, it may be the first sign of cancer in the bladder and warrants urgent medical evaluation.
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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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