There is no curative treatment, the goal is symptom relief
Evaluate for comorbities, psychosocial needs
Lifestyle modification (trigger avoidance)
Bladder training
Application of heat or cold over the bladder or perineum
Consider pelvic floor muscle physical therapy
Pharmacologic options
Amitriptyline generally first line
Alternatives include pentosane polysulfate sodium, antihistamines, cimetidine, sildenafil, adjuvant analgesia (acetaminophen, NSAIDs)
For refractory symptoms, options include
Bladder hydrodistension
Intravesical therapies (such as local anesthestics)
Intradestrusor botulinum toxin
Sacral neuromodulation
Cyclosporine A
Treatment of last resort is urinary diversion
Amitriptyline generally first line
Alternatives include pentosane polysulfate sodium, antihistamines, cimetidine, sildenafil, adjuvant analgesia (acetaminophen, NSAIDs)
Bladder hydrodistension
Intravesical therapies (such as local anesthestics)
Intradestrusor botulinum toxin
Sacral neuromodulation
Cyclosporine A
Treatment of last resort is urinary diversion
Interstitial cystitis
Bladder, urethral, or genital tract cancer
Acute cystitis
Urinary Tract Infection 
Pyelonephritis
STI
Prostatitis
Benign pelvic mass