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Pelvic Pain in Men

One in eight men will have musculoskeletal pelvic pain, diagnosed as Chronic Pelvic Pain Syndrome (CPPS), in their lifetime.  Unfortunately, many of them will struggle finding a provider who understands male pelvic pain, can provide a diagnosis, and help direct a treatment plan.

When it comes to musculoskeletal pain, having a physical therapist on your treatment team is vital.  Pelvic floor trained PTs are the experts in the musculoskeletal system and how these muscles, connective tissues, and joints can play a role in bowel, bladder, and sexual organ dysfunction and pain.

Symptoms of CPPS can vary widely from person to person.  The most common symptoms include:

  • Pain in pelvis, perineum, low back, abdomen, low back, genitals, or hips
  • Frequent urination or difficulty emptying
  • Pain during or after ejaculation
  • Pain or difficulty emptying with bowel movements.

When seeing physical therapy, the evaluation should include:

  • a thorough history of pain and other medical conditions
    • A thorough history of bowel, bladder, and sexual functions
    • An orthopedic assessment of low back, hip, and pelvic joints
    • Assessment muscle length of the muscles attaching to the pelvis, hips, and lumbar joints.
    • Palpation for trigger points.  This can include a rectal assessment to palpate the pelvic floor muscles.
    • Assessment of how the pelvic floor, diaphragm, abdominal wall work together.

This assessment helps the physical therapist make a diagnosis and treatment plan.  It also helps the patient to understand his pain and how he and the PT can work together to start managing the pain.

It is important to do this thorough as an assessment as the PT and medical providers need to rule in or out the musculoskeletal system.  Due to the proximity of the pelvic floor to the organs, they can play off each other and bladder or prostate pain can refer to the pelvic floor and vice versa.

If you are experiencing pelvic pain that is not responding to antibiotics or other medical treatments, it is important to seek out an experiences pelvic floor PT who understands CPPS in men.  Often, the musculoskeletal system can be overlooked in medical providers’ offices.  That is where PT can add a valuable insight into your healthcare team.

Sarah is the proud co-owner of Foundational Concepts, Specialty Physical Therapy which opened in March 2013. Sarah lectures at the University of Missouri Department of PT, University of Kansas Departments of PT and Nurse Midwifery, and at Rockhurst University Department of PT. She is board certified in Women’s Health PT and holds certifications in medical therapeutic yoga, lymphedema therapy and dry needling.

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