Intrapelvic physiotherapy for prostatitis is an alternative treatment for men with pelvic pain and tension that is related to pelvic floor muscle disorders. About half of all chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) cases are related to pelvic floor muscles and not caused by problems with the prostate itself.
What exactly are these pelvic muscles, and what do they do? The pelvic floor muscles work kind of like a hammock. They attach to the front, sides, and back of the pelvic bone and sacrum to support the bladder, prostate, and rectum. These muscles are important for healthy and normal sexual function, urinary health and bowel function. When these muscles because too tight, weak, or damaged it can lead to symptoms of pain, urinary and bowel dysfunction, sexual problems, and uncoordinated muscle spasm. Intrapelvic physiotherapy helps to relax and strengthen these muscles for better function and relief of symptoms.
Men who can benefit from intrapelvic physiotherapy may have pain and tension related to:
- trigger points,
- scar adhesions,
- pelvic floor weakness (hypotonicity),
- bowel or urinary trouble,
- incoordination, or
- muscle hypertonicity (tight pelvic floor muscles).
The therapist will work with a patient to create an individualized treatment program based on the patient’s pelvic floor dysfunction, symptoms, and how they respond to the treatments.
The following treatment programs and techniques may involve intrapelvic physiotherapy for prostatitis:
- Trigger Point Release Therapy
- Renew XY Health Program for Men
- “NPAT” Treatment Program for Prostatitis
- Wise-Anderson Protocol
Most programs that involve intrapelvic physiotherapy usually include a psychological or cognitive behavioral training component because for many men anxiety or other psychological stressors trigger the pelvic floor tension or make it worse. Having a long-term chronic pain condition that does not respond to treatment makes men vulnerable to stress and anxiety, and this can aggravate existing prostatitis symptoms. This is also why stress management techniques are also beneficial and combine well to treat tension with intrapelvic physiotherapy for prostatitis.
How Does Intrapelvic Physiotherapy for Prostatitis Work?
Intrapelvic physiotherapy is a long process of healing that involves doing exercises and tools for relaxing the pelvic muscles. It usually requires ongoing work. You have developed your pelvic tension over time, so it will take some time to learn to relax those muscles and identify and then change the behaviors that led to it.
At first, a therapist or doctor will conduct an internal and external examination to evaluate the function of the pelvic floor muscles. He or she may also examine the bones and muscles of the lower back, hips, and joints since they can stress the pelvic floor and will also be involved in the exercises.
If you have both tight and weak muscles, the therapist will have you treat the tension first before treating the weakness. Your therapist may teach you to do something called reverse Kegels. You may know of regular Kegel exercises, which involve tightening and drawing up pelvic muscles. But these kinds of exercises can aggravate pain and tension worse, so they are not recommended for CP/CPPS patients with pelvic tension. On the other hand, Reverse Kegels, employ several techniques to consciously relax, gain control over, and open up the pelvic muscles. Once you are able to fully relax the muscles you can start doing strength exercises. At that point, your therapist might have you doing pelvic stretches and exercises.
Many men with CP/CPPS have trigger points, which are painful and tight areas of stressed or injured muscles. A distinctive feature of trigger points is referred pain. That means that upon pressing a trigger point you feel the pain in another spot on the body. Sometimes therapists perform myofascial trigger point release, which is another alternative therapy for prostatitis (and other conditions in the body).
When doing myofascial trigger point release, a doctor or therapist uses their fingertips to press into the painful points, applying sustained pressure into the myofascial connective tissue. Pressing the trigger points helps to stretch the pelvic floor muscles and “reset” them to their normal length. This can be helpful to men who have abnormal tension in the pelvic floor muscles responsible for their pelvic pain.
Some of the treatments can be administered externally, but some of the damaged or tight muscles can only be reached via the rectum, so the person performing the therapy will insert a lubricated and gloved finger into the rectum to perform the treatment. Some treatment programs, such as Wise-Anderson, use a trigger point wand to reach these internal spots. Your therapist can train you to treat your pelvic floor muscles so that you may continue your care at home.
A number of factors contribute to pelvic tension, including stress, anxiety, and other psychological issues. That is why most intrapelvic physiotherapy therapist and programs consider and treat both the mind and body. Psychological components of treatment may include cognitive behavioral therapy or stress management techniques.
Treating your chronic CP/CPPS with an approach to whole-body wellness will help your healing. Look into your lifestyle and diet, avoiding possible triggers to your pain. Learn to manage stress and other factors that could be contributing to your pelvic pain and tension. Getting more exercise and losing weight can be tremendously helpful. All of these natural, drug-free ways complement intrapelvic physiotherapy for prostatitis and help with relieving your prostatitis pain and leading to better health overall.