Overactive bladder (OAB) is typically not painful, but it can cause significant discomfort and a sudden, strong urge to urinate.

OAB causes sudden, involuntary contractions of the bladder muscle, which sends the brain the signal that you need to urinate urgently, even when the bladder isn’t full yet.

Although OAB typically doesn’t cause pain, this urge to urinate can become quite uncomfortable and overwhelming and may affect your quality of life.

Pain is not a diagnostic criterion for OAB. A sense of urgency to urinate, frequent urination, and bladder discomfort are often the main symptoms of OAB.

The urgency to urinate in OAB often occurs suddenly and without warning. It creates a sense of distress that people with the condition might describe as “discomfort” or “pressure,” not typically as pain.

The intensity and frequency of OAB symptoms can vary widely among people. For some, the urge to urinate may be mild and occasionally disruptive, especially at night.

For others, the urgency can be intense and daylong, severely interfering with daily activities and quality of life. The constant need to find a bathroom can be both distracting and inconvenient.

Common symptoms of an overactive bladder include:

  • sudden, strong urge to urinate that is difficult to control, even when the bladder isn’t full
  • frequent urination, often more than eight times in 24 hours
  • waking up more than once during the night to urinate, also known as nocturia
  • accidental urine leakage, especially following a sudden urge to urinate, known as incontinence

These symptoms may vary in severity. Some people with OAB may experience them all, while others may only have strong urges and frequent urination.

While OAB and bladder pain syndrome may share some symptoms, including urinary urgency or frequency and nocturia, they are distinct conditions.

OAB primarily involves a sudden, strong urge to urinate, frequent urination, and sometimes urge incontinence, where involuntary bladder contractions may lead to leakage.

These symptoms typically occur without pain. Bladder muscle contractions often trigger them, even when the bladder isn’t full.

Bladder pain syndrome, also known as interstitial cystitis, involves chronic pelvic pain and constant pressure or discomfort, specifically in the bladder area.

Pelvic pain is a formal symptom of bladder pain syndrome. It’s often accompanied by a frequent, urgent need to urinate.

Unlike OAB, the pain associated with bladder pain syndrome can be severe. It usually worsens as the bladder fills and may be temporarily relieved after urination, but it might return soon after.

However, it’s possible to experience both conditions simultaneously, which may complicate diagnosis and treatment.

People’s descriptions of bladder pain may vary widely. It also depends on the cause of the pain.

In OAB, the pain is often mild or nonexistent. People may describe the discomfort as fullness, pressure, or, in some cases, short-term, mild pain in the abdominal area.

If other conditions are present and you experience pain, this may be local, referred, or both:

  • Local pain: Very common in bladder pain, it is typically felt in the lower abdomen or pelvic area. It may be constant or come and go, varying from a dull ache to sharp, stabbing sensations.
  • Referred pain: Sometimes, pain originates in the bladder but you may feel it in areas other than the lower abdomen or pelvis. For example, some people with bladder pain syndrome may experience pain in the lower abdomen or genital area.

While an overactive bladder is not typically painful, other conditions can cause bladder pain. These may include:

  • Bladder stones: These are solid masses of minerals that form in the bladder. They can cause significant pain, especially if they obstruct the urinary tract.
  • Urinary tract infections (UTIs): Infections in any part of the urinary system, including the bladder, can cause pain, urgency, and burning sensations during urination.
  • Pelvic floor dysfunction: Muscle spasms or tension in the pelvic floor muscles can cause bladder pain, often accompanied by discomfort during urination or sexual intercourse.
  • Bladder cancer: Depending on its stage, bladder cancer can cause discomfort or pain in the bladder, along with blood in the urine and other urinary symptoms.
  • Chemical cystitis: Exposure to certain chemicals can cause the bladder to become inflamed, leading to pain. This can be the result of medication or exposure to chemicals in the environment.
  • Prostatitis: This is inflammation of the prostate gland, often due to bacterial infections. It can cause pain, alongside other symptoms such as painful urination.

OAB is not usually associated with symptoms like pain, but it can cause significant discomfort and disrupt daily life due to frequent urination, incontinence, and a sense of urinary urgency.

Distinguishing between OAB and other conditions, like bladder pain syndrome, is crucial for ensuring effective treatment.

If you’re experiencing symptoms that resemble OAB or bladder pain syndrome, consider talking with a healthcare professional for an accurate diagnosis and treatment plan.