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As we head into Movember, it’s a good opportunity to account for cancer awareness in men and men’s general health.  One thing that we commonly see at Rebalance Physical Therapy are men coming to us with diagnosed or undiagnosed chronic prostatitis. 

Most people think of prostatitis as a problem for men that is only caused by an infection, but prostatitis can be any type of inflammation in the prostate gland.  There are several forms of prostatitis but one form, in particular, may not be associated with inflammation and may not be able to be treated with an antibiotic. This form is called chronic nonbacterial prostatitis syndrome or chronic pelvic pain syndrome (CPPS) and may or may not be accompanied by inflammation. The symptoms of CPPS are varied, but commonly include some of the ones listed below. See if you answer yes to the following questions—if so, there is a longer questionnaire on pelvic pain symptoms that you can complete.  Take this information to your doctor so that they can better assist you in an official diagnosis.

  1. 1. Have experienced pain or discomfort in any of the following areas that you are unable to resolve?
      • In the rectum
      • Between the genitals and the anus
      • Behind your pubic bone
      • In the scrotum
      • below your waist or in the low back
      • in your abdomen or pelvis
  2. 2. Have you had trouble emptying your bladder or had the sensation of not fully emptying your bladder?
  3. 3. Do you have to get up in the middle of the night to void?
  4. 4. Do you experience burning with urination or genital pain after urination?
  5. 5. Do you have pain with bowel movements? Do you feel changes in your pain either improved or worsened when you have a bowel movement?
  6. 6. Do you experience frequency or urge to urinate more than others you know?
  7. 7. Do you experience sexual dysfunction or pain associated with sexual function either during or afterward?

Maybe you have experienced these symptoms yourself.  Maybe you have a partner who has experienced these symptoms.  Perhaps you have been prescribed medication but are still suffering from debilitating pelvic dysfunction symptoms.

Often, men with this condition undergo several rounds of antibiotics despite negative cultures for infection and have no relief of their symptoms.  This problem can be associated with or made worse with sitting, exercise, urinating, or sexual function affecting erection and ejaculation.  When men experience these problems, they are often told, after multiple courses of medications have failed, that there is nothing they can do to alleviate the problem. Unfortunately, these patients end up in a state of chronic pain that lasts indefinitely.  In many cases of CPPS, however, these men have muscular and nerve-related issues to their pain and pelvic dysfunction symptoms that are treatable!  At Rebalance, we see men with this presentation in our clinic every day.

If you are not currently being seen by a provider and are answering yes to some of these questions, consider contacting us to discuss your symptoms so that we can help direct you to get the care you need. Our team of experienced Pelvic Health Physical Therapists can help pinpoint contributing factors to pelvic symptoms and help correct imbalances in the body to help patients manage their pain. We recommend that patients consult a physical therapist to determine if they have a muscle contribution to their pain, but also recommend they also get a proper medical diagnosis and be appropriately tested if needed.

These questions are included on the National Institute of Health Chronic Prostatitis Symptom IndexThe full test can be found here.  Total your score and consider where yours falls: mild, moderate, or severe. Pain is considered mild from a score of 0-7, moderate from 8-13, and severe from 14-21.

Written by Stephanie Muntzer, MPT, PYT, RYT200, CPI, SFMA, FMSc

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