Chronic Pelvic Pain/
Non-Bacterial Prostatitis

Everyone has a pelvic floor – so everyone is susceptible to pelvic pain, including men. In some cases, no specific cause can be identified. This is known as chronic pelvic pain. Here, we discuss common symptoms, the role of the pelvic floor, and how pelvic health physiotherapy can help.

What is Chronic Pelvic Pain/Non-Bacterial Prostatitis?

Pelvic pain is often thought of as a woman’s issue – but it happens to men too . In fact, it is quite common. Sometimes, a specific cause can be identified, such as prostatitis or a urinary tract infection. However, sometimes no cause can be identified. In this case, the condition is simply referred to as chronic (long-lasting) pelvic pain or non-bacterial prostatitis. Common symptoms include: 

• Urinary urgency or frequency

• A feeling of pain or a “golf ball” in the rectum

• Pain upon ejaculation

• Decreased libido

• Testicular, groin or penile pain 

The pain can be experienced in many different ways, and in many different places. Let’s break this down further.

Muscle, Nerve and Joint Pain

Men often experience pain in the hip and low back pain that originates from pelvic floor dysfunction. Myofascial work internally, together with mobilizing the joints of the pelvis and spine, often gives relief. Strengthening the muscles both inside and outside the pelvis is important to supporting the area.

Nerve Pain

Pudendal neuralgia is a nerve condition that may cause shooting, sharp or burning pain in the perineum, scrotum, testicles, and penis. Men often report that they feel like there is a golf ball between the anus and scrotum. The pain is usually worse when sitting down or during activities that increase pressure in the perineum, like cycling. Men may also experience pain during sex or difficulty gaining an erection. Releasing the nerve from tight muscles, gently mobilizing the nerve, at-home exercises, and postural changes can provide significant relief.

Tailbone Pain

The muscles that attach to the tailbone can tighten after a fall/injury or from poor posture. These overly tense muscles can cause low back pain and compress the large joints in the pelvis (called the sacroiliac joints), limiting movement of the pelvis. This can make walking and standing quite painful. Treating the soft tissues around the joints can improve pain and sitting tolerance, and at-home exercise helps continue progress.

Bladder/Urinary Conditions

Overactive bladder, interstitial cystitis and chronic non-bacterial prostatitis are three conditions that cause irritation to the bladder and urethra (duct through which urine leaves the body in men), causing urinary urgency (the need to empty the bladder immediately). In addition, overly tight pelvic muscles can cause significant pelvic pain.

If you are experiencing chronic pelvic pain, talk to your doctor so that a proper diagnosis can be made. Effective treatments are available, including pelvic health physiotherapy.

What Is The Role of The Pelvic Floor in Chronic Pelvic Pain?

The pelvic floor is a group of dome-shaped muscles, ligaments, and tissue that are located at the bottom of the pelvic bones. A strong pelvic floor is vital for our health, and is needed for many daily functions, including:

• Supporting the pelvic organs

• Stabilizing the low back and hip joints

• Maintaining bladder and bowel continence

• Optimizing sexual sensation and arousal

People living with chronic pelvic pain often have multiple areas of tension/tightness within the pelvic floor muscles. When this tension persists over a long period of time, it compromises the natural circulation of blood flow within the tissues of the pelvis. As a result, the pelvic muscles can become painful and sore and the nerves that supply these muscles can become irritated. Pain may radiate to different areas of the pelvis including the low back, abdomen, and hips.

How Can Pelvic Health Physiotherapy Help Me?

We understand that it can be difficult to open up about pelvic pain and related challenges. You may “grin and bear it” – but know that help is available. Finding effective ways to manage your pain and optimize your pelvic floor can help you get back to the activities you love, pain-free. After seeing a doctor to get a diagnosis, a good next step is reaching out to a Pelvic Health Physiotherapist , who has specialized training in pelvic health issues.

The initial goal of Pelvic Health Physiotherapy in treating hypertonic (overly tense) pelvic floor muscles is to normalize the pelvic floor muscle tone. Once a normal pelvic floor resting tone is reached, treatment is aimed at strengthening your pelvic floor muscles and increasing their mobility and flexibility. In addition, your treatment program will aim to:

• Optimize blood flow to the nerves that supply the pelvic floor and bladder.

• Educate you on at-home exercises to help you relax your pelvic floor muscles. Over time, this will become second nature.

• Address psychosocial factors that may be contributing to your pain response. Learn more

How Do We Approach Treatment For Chronic Pelvic Pain?

At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering people to take control of their bodies. We pride ourselves in our client-centric approach, ensuring that you feel comfortable and supported throughout the entire process. Think of us as your partner on your journey to pelvic health wellness.  

The first step: your Pelvic Health Physiotherapist will take your full medical history and discuss your symptoms. With informed consent, they will perform a complete physical assessment of the affected muscles and tissues. This can include an internal examination to reliably assess pelvic floor muscle tension, flexibility, and weakness. Based on the examination, your Pelvic Health Physiotherapist will work with you to put together a treatment plan specific to your symptoms.

We use a variety of clinically-proven techniques, from manual therapy to pelvic floor exercises, to help improve the function of your pelvic floor to better support your bladder muscles, hip/joint stability, and sexual function.