How Do I Know if Physical Therapy Can Help My Prostatitis?

June is the month that we take a little time to acknowledge the amazing men in our lives. We celebrate our fathers, our step-fathers, our grandfathers, and many other men that have taken on a father-like role in our lives. During this time of the year, it is important to highlight the unique aspects of health that men face.

Pelvic health physical therapy is a specialized healthcare service that serves BOTH men and women! Yes, men DO have pelvic floors. Therefore they can experience pelvic floor dysfunction and/or pain. This means men too need holistic care for their pelvis!

One of the most common pelvic issues experienced by men is prostatitis. It affects approximately 8.2% of men and accounts for 8-15% of visits to urologists. Prostatitis is a broad medical diagnosis that is caused by infection and/or inflammation of the prostate gland.

What are the types of prostatis?

The National Institute of Health divides it into four categories:

Acute bacterial prostatitis: an acute infection that causes pelvic pain and urinary tract symptoms, such as urinary frequency and urgency (often at night), decreased ability to empty the bladder, and burning sensations/painful urination and ejaculation. This local infection may lead to more general systemic symptoms. This includes chills, fever, fatigue, pain in the lower back and genital area, nausea/vomiting, and malaise. This category is best treated by a medical physician with antibiotics.

Chronic bacterial prostatitis: a condition that causes recurring infections in the prostate, resulting in inflammation and frequent urinary tract infections (UTIs) with symptoms often presenting the same as the category above. This category is also best treated by a medical physician. HOWEVER, pelvic floor physical therapy may help these individuals manage their pelvic pain, as chronic infections, inflammation and/or pain can result in tissue and neurophysiological changes.

Chronic non-bacterial prostatitis or Chronic Pelvic Pain Syndrome (CPPS): is a benign, although painful, condition that is associated with inflammation of the prostate that is NOT due to bacterial infection. This is the most common form of prostatitis, accounting for nearly 90% of cases. Individuals who fall into this category may experience pain in the lower back, lower abdominal area, genitals, perineum, or rectum, urinary frequency and urgency, nocturia (waking up at night to urinate), weak or hesitant urinary stream, and burning or painful urination and ejaculation. Pelvic floor physical therapists can provide effective natural, holistic treatments that help these individuals regain their quality of life and prevent unnecessary medications and medical procedures/surgeries!

Asymptomatic inflammatory prostatitis: inflammation of the prostate without any associated infection or symptoms (often found during the evaluation and treatment of other pelvic conditions). Because there is an absence of infection or symptoms, this category usually requires no treatment.

How can Pelvic Health Physical Therapy Help Prostatitis?

If you have seen a physician and infection has been ruled out but you continue to have persistent pelvic pain and urinary symptoms, consulting with a pelvic health physical therapist may assist you in managing or even eliminating your condition over the long term and meeting your personal goals. Pelvic health physical therapists assess individuals as a whole integrated movement system. They evaluate muscles, joints, ligaments, connective tissues, nerves, postural alignment, quality of movement, etc. So the goal is to discover and treat the underlying causes of pain and dysfunction. Pelvic health physical therapists achieve this through:

• Patient education
• Postural re-education
• Relaxation and breathing exercises
• Soft tissue mobilization/myofascial release/trigger point release
• Joint mobilizations
• Nerve mobilizations
• Massage: abdominal, deep tissue
• Home exercise programs: body awareness, stretching, motor control, and strengthening
• Biofeedback

Pelvic pain and urinary symptoms can be difficult issues to deal with or talk about. It can be embarrassing, debilitating, fear-inducing, and socially isolating. It doesn’t have to be a lifelong problem. In conclusion, Body Harmony Physical Therapy have specialist physical therapists to evaluate and treat male pelvic floor dysfunction and chronic pelvic pain. Call us at 212-233-9494 to schedule your appointment or speak to a pelvic floor physical therapist to see if physical therapy is right for you.

Written by: Serenity Serafini, DPT

Edited by: Keely Faridi, PT

References

Sharp, VJ. Takacs, EB. Powell, CR. Prostatitis: Diagnosis and Treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406. https://www.aafp.org/afp/2010/0815/p397.html

Chronic nonbacterial prostatitis (chronic pelvic pain syndrome). Harvard Health Publishing. August 2007.
https://www.health.harvard.edu/newsletter_article/chronic-nonbacterial-prostatitis-chronic-pelvic-pain-syndrome

Kulovac B, Aganović D, Prcić A, Hadziosmanović O. Management of chronic nonbacterial prostatitis/chronic pelvic pain syndrome. Bosn J Basic Med Sci. 2007;7(3):245–249. doi:10.17305/bjbms.2007.3053
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736117/