My caseload is comprised of about 25% male patients, many of whom experience pelvic pain and have been suffering with it for a long time! They've seen primary care physicians, urologists, proctologists, pain specialists and other -ologists and are often frustrated with little, to no improvement in their symptoms. Often they are over prescribed antibiotics for "prostatitis" despite they lack of any positive tests for an actual infection. Because of their diligence, and maybe their desperation, they do their own research and often find a path to a pelvic physical therapist like me.
I never claim to be the end all be all solution to their issue, but often I can help. You see, pelvic pain can be caused by many factors, one of which is the function or dysfunction of the pelvic floor muscles. These little muscles which have a big jobs-- supporting organs, stabilizing posture, managing bladder and bowel control, and playing a role in sexual function--can wreak havoc if they are tight, angry, tender, not relaxing, or not working together. They can have trigger points, compress or stretch nerves in the pelvic region, or impact voiding. They can refer pain to the bladder, buttocks/hips, lower abdomen and low back. Likewise, if the low back, abdominals, hip muscles are not happy either, they can refer pain to the pelvic area.
And then it becomes a vicious cycle.
And that cycle is exhausting, stressful, and can really do a number on a client's emotional well-being. All of these factors then feel overwhelming and insurmountable--at least that's what many of my male clients share with me!
When I evaluate a client, I am on a search with the client to untangle this web of pain and discomfort. From a biopsychosocial/emotional model we explore all the factors that have either contributed to or caused pain. I always do a full orthopedic assessment to check out the hips, abdominals, and back as well as a pelvic assessment. I'm looking for all the clues that help me paint a full picture of what might be going on.
And then we start gradually and compassionately addressing these pieces. As a PT, I focus primarily on the physical components. That may mean that I use manual therapy, biofeedback, stretching exercises, foam rolling, postural education/modification, and yoga to improve balance, coordination, and function of the pelvic muscles and ususally the hips and back.
We also work on stress management, breathwork, and if needed, I refer clients for counseling, nutrition consultation, or more specialized physicians who DO know what to do to medically manage issues that require it! That may include use of compounded suppositories with muscle relaxants, injections, or other medical interventions. One of my favorite new resources for medical doctors who address both male and female pelvic pain is Pelvic Rehabilitation Medicine. They work collaboratively with a host of practitioners, including pelvic physical therapists to address pelvic pain!
If you or a male in your life is experiencing pelvic pain, consider pelvic PT as an option to explore!