Physiotherapy Management of Chronic Pelvic Pain in Men

Issues like pelvic pain can be hard to talk about because of the stigma surrounding it.  That’s part of the reason why, no matter the person’s gender, this type of pain is often left untreated (in fact, the average case lasts over 7 years before being diagnosed).  However, chronic pelvic pain syndrome can be quite problematic, affecting physical health, sexual health, mental health, and even commonly causes relationship distress. This significantly impairs overall quality of life, so much so that research shows the impact is similar to a heart attack, severe diabetes or Crohn’s Disease.  And although many feel embarrassed to seek medical attention, the truth is that these types of problems are much more common than you would think, in fact as many as 16% of men worldwide have these issues at some point in their lives.   So it’s important to recognize that this is a medical condition that can be resolved, be open and find a healthcare practitioner you can talk to and find a solution for your pain.

What is Chronic Pelvic Pain Syndrome?

It is an unexplained chronic pelvic pain in men, that is associated with irritating symptoms and/or pain in the groin, genitalia, or perineum in the absence of any form of infection.  The pelvic floor is made up of the pubic bone in front, tailbone at the back, and muscles and connective tissue surrounding these bony surfaces. We need the pelvic floor muscles to move well but also stay stabilized. This is important for effective balance and agility, to maintain an erection, to control urination and for bowel function. In other words, a strong pelvic floor optimizes some of our most basic life functions. Many men experience pain in the pelvis at some point in their life. The characteristics of this pain can vary from person to person. Common symptoms include:

  • Difficult, painful, or frequent urination
  • Pain in the bladder, groin, anus or abdomen
  • Inability to obtain an erection or pain during ejaculation
  • Fever and chills.
  • Bloating
  • Diarrhea

Causes of Pelvic Floor Pain in Men

There are several things that can cause pelvic pain or dysfunction in men. The onset can be gradual (for chronic cases) or sudden (for acute cases). The pelvic floor muscles can weaken, become uncoordinated and even develop pain syndromes. These are some of the common causes:

  • Surgery for bladder or bowel problems
  • Increased prostate size
  • Recurrent pelvic infections
  • Being overweight
  • Heavy lifting



Treatment of CPPS involves a multi-disciplinary approach. Basically, patients with CPPS present at the hospital to see their physician (Urologist), who performs a detailed examination and diagnostic tests to determine an appropriate treatment plan. Oral medications like analgesics and antibiotics may be given in the case of an infection, along with other treatment regimens that will be given to make the patient feel better. Depending on what is causing the symptoms, patients are then sent to other members of the healthcare team to assist in other treatment strategies. These other healthcare practitioners may include a physiotherapist, an occupational therapist or even  a psychologist, for example.

Physiotherapy Management

After a thorough physical assessment of the patient and the pelvic floor, a tailored treatment plan to train, re-educate and rehabilitate the dysfunction pelvic floor muscles will be drafted and implemented. Treatment may include:

  • Education with regard to pain management and coping strategies
  • Specialized manual therapy techniques to the pelvis to reduce muscle sensitivity or spasm and facilitate appropriate muscle activation.
  • Manual therapy to your low back and pelvis, getting the joints moving correctly
  • Pelvic floor exercises to release/relax your overactive  pelvic floor muscles
  • Specific and tailored hip, spine and pelvis strengthening exercises for weak muscles
  • Trigger point therapy: Ensure muscles are actively working properly and getting rid of the overactive parts in both the low back muscles, hip muscles, and pelvic floor muscles.
  • Re-education of the pelvic floor, hip, and abdominal musculature
  • Advice on sexual and toileting practices

Pelvic floor muscles, like all other muscles in our body, can be rehabilitated and retrained. Call us at PCA for an appointment today.  Therapy for all conditions is confidential and your physio will discreetly perform an assessment to identify the cause of your pelvic floor dysfunction and apply the appropriate regimen of treatments to correct such dysfunction and  manage the associated pain.

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