Intrapelvic Physiotherapy for Prostatitis
What Is Intrapelvic Physiotherapy for Prostatitis?
Intrapelvic physiotherapy is an alternative treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). It is helpful for men with pelvic floor muscle disorders and pelvic tension. It is estimated that 50% of CP/CPPS cases are related to pelvic floor muscles and not the prostate itself.
The pelvic floor muscles are like a hammock that attach to the front, sides, and back of the pelvic bone and sacrum. They support the bladder, prostate, and rectum. When these muscles are too tight or weak you can have symptoms that cause urinary and bowel dysfunction, sexual problems, pain, and uncoordinated muscle spasm.
Men who can benefit from intrapelvic physiotherapy may have pain and tension related to trigger points, scar adhesions, spasms, pelvic floor weakness (hypotonicity), bowel or urinary trouble, incoordination, or muscle hypertonicity (tight pelvic floor muscles). Most treatment programs are individualized based on the patient’s pelvic floor dysfunction, symptoms, and how they respond to the treatments.
The following are treatment programs and techniques that may involve intrapelvic physiotherapy for prostatitis:
- Trigger Point Release Therapy
- Renew XY Health Program for Men
- “NPAT” Treatment Program for Prostatitis
- Wise-Anderson Protocol
There is usually a psychological or behavioral training component to the programs because pelvic floor tension may be triggered by anxiety or other psychological stressors for many men. For other men, the stress of dealing with a long-term chronic condition makes them vulnerable to stress and anxiety, which can aggravate exisiting prostatitis symptoms. This is also why stress management techniques are also beneficial and combine well with intrapelvic physiotherapy for prostatitis.
How Does Intrapelvic Physiotherapy Work?
Intrapelvic physiotherapy involves exercises and tools for relaxing the pelvic muscles. It is a long process of healing and usually requires some ongoing work. Your pelvic tension has built up over time, and it will take some time to learn to relax those muscles.
A therapist or doctor will conduct an internal and external examination to evaluate the function of your pelvic floor muscles. He or she may also examine your bones and muscles of the lower back, hips, and joints since they can stress your pelvic floor exercises.
If your muscles are tight and weak, your therapist will have you treat the tension before treating the weakness. You may learn to do something called reverse Kegels. Regular Kegel exercises, which involve tightening and drawing up your muscles are not recommended for CP/CPPS due to pelvic tension. They can make your pain and tension worse. Reverse Kegels, however, use several techniques to consciously relax, gain control over, and open up the pelvic muscles. Once your muscles are able to fully relax you can start strength exercises.
Depending on your treatment program, you may also do pelvic exercises and stretches. Your therapist may perform myofascial trigger point release. Many men with CP/CPPS have trigger points. Trigger points are painful and tight areas of muscles that are stressed or injured. One feature of trigger points is referred pain. That means that when you press a trigger point it can refer the pain to another spot on the body.
A therapist or doctor uses fingertips to press the painful points, applying sustained pressure into the myofascial connective tissue. This can help men whose pelvic pain is caused by abnormal tension in the pelvic floor muscles. When the therapist presses the trigger points, it helps to stretch the pelvic floor muscles and “reset” them to their normal length.
Some of the treatments can be done externally, but some of these muscles must be reached through the rectum, so the person performing the therapy will insert a lubricated and gloved finger into the rectum. Some treatment protocols, such as Wise-Anderson, use a trigger point wand to reach these spots internally. After you learn how to treat your pelvic floor muscles you may continue your care at home.
Stress, anxiety, and other psychological issues contribute to pelvic tension, so intrapelvic physiotherapy usually involves looking at and treating your psychological health too. You may have some cognitive behavioral therapy or stress management techniques incorporated into your therapy.
Looking at your whole-body health will benefit your healing. Consider your diet and other lifestyle factors (in addition to stress) that could be contributing to your pelvic pain. Getting proper nutrition, knowing what foods to avoid, getting more exercise, and losing weight are all natural ways that can complement intrapelvic physiotherapy for prostatitis and help with relieving your prostatitis pain.