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Painful urination

Painful urination means that you experience pain, burning sensation or other discomfort before, during or after urinating. Often this goes along with frequent urination, sudden urge or small amounts of urine each time.

Urinary tract infection is a common cause, but painful urination can also occur in irritation or inflammation of the urethra, prostatitis, kidney or bladder stones and other urinary tract disorders. Therefore, if recurrent symptoms occur it is important not to automatically think about a new bladder infection.

Within Chinese medicine, the nature and timing of the pain, the colour and amount of urine and additional complaints are considered. An acute burning sensation with dark urine is assessed differently from prolonged mild discomfort associated with fatigue, cold or dryness.

Possible Western disorders

Urine pain is a symptom and not a condition in itself. Possible causes include:

Around and after menopause, changes in the mucous membrane of vagina and urinary tract may also contribute to irritation, urge and pain when passing urine.

Possible causes

In case of urinary tract infection, parts of the urinary tract become inflamed. This may cause burning or painful sensation, often in combination with frequent urgency and small amounts of urine.

Also irritation of the urethra or surrounding tissues can cause pain. In kidney or urinary tract stones, the pain is usually much more severe and may radiate from the side or lower back to the lower abdomen or groin. Sometimes there is blood in the urine.

In recurrent pain without detectable infection, other causes can be investigated, including bladder pain syndrome, pelvic floor tension or changes in mucous membranes around the menopause.

How can acupuncture help with painful urination?

In Chinese medicine painful urination is not always treated in the same way. An important distinction is, for example, whether the symptoms are acute and burning or chronic, mild and recurrent.

Treatment may be aimed at:

In the case of bacterial urinary tract infection or other condition requiring regular treatment, acupuncture is used in addition and not as a replacement.

How can Chinese herbal medicine help with painful urination?

Chinese herbs are also chosen based on the underlying pattern. For acute symptoms with clear Heat, for example, treatment may be aimed at reducing Dampness-Heat and supporting urinary discharge.

In the event of prolonged or recurring complaints, the image may change. The original Heat may become less clear, while for example the kidney-yin, kidney-qi or spleen-Qi is weakened. The herbal treatment is then adapted to this combination.

Depending on the pattern, Chinese herbal medicine can be aimed at:

For recurrent urinary tract infections, it is important not to skip regular diagnostics. Regular treatment and possible interactions are also taken into account in drug use and kidney problems.

How does Chinese medicine view painful urination?

Within Chinese medicine, the Kidney and Bladder are mainly involved in the formation, storage and excretion of urine. In painful urination, factors such as Dampness, Heat, stagnation of Qi and various forms of deficiency are also considered.

The most classic acute image is Dampness-Heat in the Bladder. Dampness within TCM refers to moisture that is not properly processed, while Heat can be reflected among other things as burning, irritation and dark or concentrated urine.

However, not everyone with painful urination has this pattern. If symptoms are clearly affected by stress and tension, the Liver may be involved. In chronic or recurring complaints deficiency patterns of the kidney or slit can arise or come to the fore.

The source makes a useful distinction between the nature and timing of the pain. Heavy burning pain is more appropriate with Heat of Dampness-Heat. Sharp, local pain can occur with stones or Blood stasis. Mild, whining or empty feeling discomfort that is present especially after puddling, fits more with an deficiency patterns.

What is a TCM organ system?

A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .

What is a TCM pattern?

A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .

Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.

Most common TCM patterns

Dampness-Heat in the Bladder

Brief explanation

This is the most common acute pattern within TCM in painful urination. Dampness and Heat interfere with the function of the Bladder and mainly cause burning, strong urge and concentrated urine.

In case of prolonged or recurring complaints, the ratio between Dampness and Heat may change. Sometimes especially Dampness remains present while at the same time creating an deficiency pattern.

Common symptoms

Examples of Western disorders

This pattern may be found in cystitis, urethritis, renal pelvic inflammation and prostatitis.

Liver-Qi-stagnation with Heat

Brief explanation

With Liver-Qi stagnation, the movement of Qi according to TCM is less free. If this stagnation is present for a long time, Heat can occur. The urinary problems often have a clear relationship with stress, frustration or emotional tension.

Common symptoms

Examples of Western disorders

This pattern can be recognised for stress-sensitive dysuria and functional urinary tract or pelvic floor complaints.

Heart-Heat

Brief explanation

Within TCM, strong Heat of the Heart can also eventually influence the urinary tract via its connection to the Dunne Intestinal. The distinctive feature is that the urinary tract symptoms coincide with obvious signs of mental distress and Heat.

In the source, this pattern is associated with, among other things, long-term anxiety, anxiety, emotional tension or strong emotional shock.

Common symptoms

Examples of Western disorders

Such a pattern of symptoms can be found in some types of cystitis, urethritis and chronic urinary tract complaints where stress and mental distress are evident.

Kidney-Yin-deficiency

Brief explanation

In Kidney-Yin deficiency, according to TCM, the nourishing and cooling aspects of the kidney have been reduced. This can create relative heat, making the urinary tract easier to irritate.

This pattern is particularly evident in the case of long-term or recurrent complaints and is described in the source among other things in women around and after menopause.

Common symptoms

Examples of Western disorders

This pattern may include chronic or recurrent urinary problems, interstitial cystitis/bladder pain syndrome and urinary problems around and after the menopause.

Kidney-Qi- and Kidney-Yang-deficiency

Brief explanation

In case of prolonged urinary problems, according to TCM, the function of the kidney can be weakened. The pain is usually not sharp or strongly burning, but rather mild, nagging or uncomfortable.

When, above all, Kidney-Yang is weakened, cold and general weakness are more apparent.

Common symptoms

Examples of Western disorders

Such a pattern can be found according to the source for prolonged urinary and bladder problems and some chronic kidney disorders.

Spleen-Qi-deficiency

Brief explanation

Spleen-Qi deficiency is mainly seen in chronic or recurrent symptoms. The pain is usually mild and is described as a nagging, empty or pulling discomfort rather than as sharp burning.

Fatigue and digestive symptoms help distinguish this pattern from acute Heat Patterns.

Common symptoms

Examples of Western disorders

This pattern can be found according to the source for long-term functional urinary problems and some chronic bladder problems.

Heart- and Kidney-Qi/Yin-deficiency with Heat

Brief explanation

This is a more chronic pattern where both insufficient Qi and Yin are present as well as relative Heat. The urinary tract remains sensitive or irritated, while at the same time fatigue, anxiety or sleep problems are at the forefront.

The source describes this as a form in which the communication between Heart and kidney is disrupted.

Common symptoms

Examples of Western disorders

This pattern may be found, according to the source, in recurrent cystitis, interstitial cystitis/bladder pain syndrome and other prolonged urinary tract symptoms where mental distress and fatigue are clearly associated with physical complaints.

Stones, sharp pain and blood in urine

Kidney, urethral or bladder stones can also cause painful urination. The pain can then be sharp or colic and radiate from the side or lower back to the abdomen, groin or genital organs. Blood in the urine may also occur.

Within TCM, Dampness-Heat and Blood stasis can be distinguished. However, for the treatment it is first important to know whether stones or any other physical obstruction are present.

The same applies to visible blood in the urine. Within TCM there are several patterns where pain and blood loss occur together, but blood in the urine should be regularly evaluated and is not explained solely from a TCM pattern.

What can you do for yourself?

Sufficient drinking is important in case of a lot of urinary problems, unless you have been given a fluid restriction due to a medical condition. Strongly concentrated urine may irritate the urinary tract extra.

If you notice that certain beverages worsen the symptoms, it may be useful to temporarily limit them. The source mentions in particular alcohol and coffee in Heat patterns.

In people sensitive to urinary tract infections, it may help to:

In the case of recurrent complaints without infection, tension of the pelvic floor may also be relevant, in which case assessment by a pelvic physiotherapist may be useful.

When to contact your doctor?

A burning sensation when urinating may fit with a simple urinary tract infection, but sometimes additional research is needed.

Please contact your doctor at:

In men, new painful urination also deserves medical assessment, as prostate and urinary disorders may play a role.

Outlook

The course of treatment depends heavily on the cause. Acute complaints by Dampness-Heat have a different course of action within TCM than long-term complaints in which Kidney, Spleen or Heart-Kidney deficiency is at the forefront.

In case of bacterial infection, kidney or bladder stones or any other detectable condition, the course is significantly determined by its regular treatment. In case of chronic or recurrent symptoms without acute infection, a longer treatment course may be required, especially when multiple patterns are present simultaneously.

In the initial phase, one acupuncture treatment per week is a common guideline. In case of acute or severe complaints, temporary treatment can be done twice or three times a week when acupuncture is appropriate, but necessary medical treatment takes priority. When the symptoms become less stable, the frequency can be reduced. Chinese herbs can be used daily between treatments where appropriate.

Contact

Do you have frequent pain or burning sensations when urinating and want to know if acupuncture and/or Chinese herbal medicine can fit in with your symptoms? During a first consultation we discuss your urinary tract complaints and other relevant symptoms. Based on the overall picture of symptoms, we will examine which TCM pattern is likely to be at the forefront and what treatment is appropriate.

In case of acute, severe, unexplained or recurrent complaints, it is important to have regular investigation into the cause.

Further reading

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