Male Pelvic Pain : Self-help strategies

We understand that finding help for your pelvic pain can be difficult. Even knowing what to call the problem can be confusing with a mix of different names often used including Chronic Prostatitis, Chronic Pelvic Pain Syndrome or Chronic Urogenital Pain Syndrome.

It is important to first see your doctor to exclude other conditions or other serious disease. There are many causes of pelvic pain in men and some require medical assessment and treatment.

If your pain has been fully assessed by your doctor and no serious disease has been found, you may be uncertain what to do now. You may understand that you aren’t in danger, but still not know how to manage your pain. You are not alone. Actually there are many men with the same problem. An Australian study of men in 2009 found that 8% had urogenital pain of some kind.

A pain may start in a pelvic organ such as your bladder, bowel, or prostate. It may also start in muscles, or joints following an injury. it may start following prolonged stress with tension in muscles. Whatever the original cause of pain, if it doesn’t settle then the pain can become chronic. Generally it is considered ‘chronic’ if it is still present after 3-6 months. No-one understands why a similar condition in some men might lead to chronic pain, while in another man might go away completely.

Once a pain has become chronic, the pain situation is usually more complicated. There may still be the original problem, but there is now pain from tight painful pelvic muscles and a change in the nerve pathways that send pain messages to the brain. Both of these types of pains are pains that can’t be seen from the outside and don’t show on scans or during operations. Often the pain from pelvic muscle spasm can become the worst part of the pain. It truly can be a cramp on the inside of the pelvis.

Once muscles and nerves in the pelvis start behaving abnormally, other organs can develop problems too. There may be difficulty passing urine, with bowel function or with sexual function.

Once you know that your pain is not dangerous, there are many self-help techniques you can use to manage your pain. The suggestions below are all techniques used successfully by men like yourself.

Learn more about your pain

Everyone is different and it is important to learn more about your individual condition – why you have pain; where it is coming from; and what makes it better or worse. Remember that no matter how the pain started, if you have pain on most days, it is likely that tight, tender and painful pelvic floor muscles are part of the problem.

Learn how to locate and then relax the pelvic floor muscles

This allows the muscles to work normally again. The pelvic floor muscles are all internal muscles that can’t be seen externally, so you may not be familiar with their position, size and function. Reducing the tension in the muscles of your pelvic floor will help reduce your pain. The following link will show the pelvic floor muscles in a 3 dimensional tutorial

Use special stretches to relax and stretch out the tight internal pelvic floor muscles

When internal muscles are tight and painful, muscles on the outside can become painful too. Loosening the outer pelvic muscles will help reduce tension and pain in and around the pelvis. These stretches are all best done daily.

Use guided relaxation to help you with muscle relaxation

A suitable downloadable MP3 file or CD especially for men with pelvic pain is available from www.pelvicpain.org.au/shop. The download and CD come with an instruction booklet to help you get back in touch with these muscles in a positive (and less painful) way.

Use whole body relaxation

To reduce tension in other muscles as well as your pelvic floor muscles. Whole body relaxation is good for stress management and for identifying muscles that you may habitually and completely subconsciously hold tight and tense. Guided relaxation exercise for the whole body can also be found on the CD or MP3 audio download for daily practice.

Calm your nervous system

With techniques like pacing your activities, managing your stress, improving the quality of your sleep, daily ‘appropriate’ exercise, and a healthy diet.

Good bowel habits

Take pressure off the pelvic muscles. Bowels should work easily without straining and emptying should not be painful.

Good bladder habits

Good bladder habits are essential. Check that your fluid intake is about right. Around 6-8 drinks a day suits most men. If you go to the toilet frequently, or have bladder pain when your bladder fills or empties, then you will benefit from further advice from your doctor or a continence physiotherapist. The Australian Physiotherapy Association at www.physiotherapy.asn.au can help you find a continence (bladder) physiotherapist.

Jason A. Ferris*, Marian K. Pitts*, Juliet Richters,  Judy M. Simpson, Julia M. Shelley and Anthony M. Smith. National prevalence of urogenital pain and prostatitis-like symptoms in Australian men using the National Institutes of Health Chronic Prostatitis Symptoms Index. BJU Int 2009 105;373-379