Understanding Male Pelvic Pain and What Drives It

December 5, 2024

True or False? Male pelvic pain is always associated with dysfunction of the prostate. The answer is FALSE. While the prostate can be associated with pelvic floor dysfunction at times, it is generally not the primary cause especially for pelvic pain. Approximately 2-16% of men may experience pelvic pain. Pelvic pain may also be associated with bladder, bowel, and/or sexual dysfunction. It can create disturbance in sleep, concentration, energy as well as psychological distress such as depression and anxiety. 

There are medications, procedures, and injections that may help resolve or just diminishes the symptoms. However, if we do not figure out what's actually causing the pelvic pain, it may continue to persist.

So what drives pelvic pain in the male population? It is important to discern what drives it, in order to treat it appropriately. Below are the 4 drivers that are common to cause pelvic pain. A physical therapist can determine through a thorough exam with questions and objective findings to discern what may be the driver. 

4 primary drivers of pelvic pain

Spine: pain referred from the spine may present as pain that occurs with prolonged positions like sitting and/or standing as well as repetitive movements. This is the most common cause and can quickly resolve pelvic pain if addressed. 

Pelvic floor: pain referred from the pelvic floor muscles and may be triggered with any loading.

Neuro: pain that is associated with the central or peripheral nervous system. 

Tissue: pain referred from damage to tissues related to trauma like surgeries, accidents, etc. 

How do we treat each driver?

Spine: determining the directional preference of the spine and where we need more movement. A physical therapist can direct which movement exercises to perform at home to gain more mobility in the spine.

Pelvic floor: releasing and learning on proper loading strategies of the pelvic floor and other surrounding muscle structures of the pelvic girdle.

Neuro: focusing on education for desensitization of the nervous system such as breathing exercises.

Tissue: providing manual therapy to breakdown an restrictive muscles or scar tissue.

In general, pelvic pain impacts quality of life. Many men do not feel they have any support or options on receiving treatment for their symptoms. Pelvic floor physical therapy is an option of treatment. There is an algorithm for assessing and treating pelvic floor and a more conservative approach.

If you have any questions, contact us at Activcore Littleton and we will be happy to schedule a free phone consultation. 

Disclaimer:  The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Chelsea Speegle

Physical Therapist
Chelsea Speegle is a Doctor of Physical Therapy (DPT) who specializes in pelvic health with a particular interest in helping pregnant and postpartum moms. She also specializes in men’s pelvic health. Chelsea works primarily at Activcore in Littleton, Colorado which is located inside the Womens Health Care Associates OBGYN clinic.
FULL PROFILE

BLOGS BY SAME AUTHOR

What is a Diastasis Recti Abdominis and Can I Prevent It?

What is a diastasis? Most people know the diastasis as a separation of the rectus abdominis muscle. While this is not completely wrong, it is also not completely true either. A diastasis is actually a thinning of the linea alba which is a connective tissue sheath that lies in the middle of the abdominal wall and connects the abdominal muscles.

Read MORE

When Can I See a Physical Therapist After Giving Birth?

Easy answer: as soon as you want! Generally we wait 6 weeks postpartum to begin pelvic floor physical therapy. However, this applies to assessing and treating the pelvic floor muscles only. There are other regions of the body (hips, spine, shoulders, etc.) that are affected during pregnancy and the birthing process which can affect your posture, strength, stability and mobility.

Read MORE

Physical Therapy During Pregnancy

You may or may not have heard that you can see a physical therapist for prenatal care. The big question is, what can a pelvic floor physical therapist do for the prenatal population? A lot actually! Pelvic floor PT is not exclusive to the pelvic floor region during pregnancy. Below is a list of some of the things that a pelvic floor physical therapist can treat for an individual who is pregnant that are non-specific to the pelvic floor.

Read MORE

3 Simple Exercises to Start Immediately After Having A Baby

You crossed the finish line of your pregnancy journey! Three trimesters of hormone changes and muscles adapting to the changes of load while the baby gradually grows. But what about the "fourth trimester" or postpartum period? Typically our instructions are to rest and let the body recover for 6 weeks after having a baby. However, what if we included gentle exercises as part of that rest and recovery?

Read MORE

I Had A Baby And Now I Am Leaking... Help Me!

You have probably heard some people say, “Oh it is normal to leak after having a baby, that is just what happens.” While it is common to experience leaking, this shouldn't become your new normal. As a physical therapist who specializes in pelvic health, I am trained to help new moms overcome incontinence. I also work with moms who have been dealing with bladder issues for many years.

Read MORE

Enhancing Men’s Health with Pelvic Floor Physical Therapy 

Pelvic floor physical therapy treatment has been associated with treatment for women especially since the pelvic floor is directly impacted from childbearing and birthing. However, men can also benefit from pelvic floor physical therapy. This blog will discuss some of the symptoms that men may experience in the pelvic floor that can be addressed by a pelvic health physical therapist.

Read MORE

If I Have A Prolapse, Is Surgery My Only Option?

Before I discuss treatment options (including a pelvic fitness program you've probably never heard of), let's learn about prolapse. What is a prolapse? What does it feel like? What causes it?‍ Prolapse is a medical term to describe the descent of an organ. This can happen in different areas of the body but in regards to the pelvic floor, it can occur in the anterior and posterior wall of the vaginal canal. There are 3 main types of prolapses...

Read MORE

How Can Physical Therapy Help Erectile Dysfunction?

Erectile dysfunction (ED) may occur anytime after the age of 20. By age 40, the prevalence increases by 10% each decade. ED can be caused organically such as vascular and neuro dysfunctions, post surgical, post trauma, hormones, and medications. ED can also be due to psychological dysfunction, age, pain-related, activities, situational, and behavior.

Read MORE

Preparing for Sex Postpartum

You just returned from your 6-week follow up appointment with your medical provider and they cleared you to return to activities and sex. What are the first thoughts that go through your mind? Are you excited? Or hesitant? Maybe nervous or scared? Some moms are thrilled and get right back to it. Great! BUT the majority are on the other side...

Read MORE

What's Involved in Birth Prep Appointments with a Physical Therapist?

Yay!!! You’re having a baby! It is a very exciting time for your growing family! For 9 months, the baby has been growing in your abdomen with the body changing to accommodate and nurture the growing baby. But eventually… The baby is going to be leaving their current residence. This may cause some anxiety for you or it may not. Many people take classes prior to feeling more prepared. However, the reality is that every baby, every mother, and every birth is different.

Read MORE

Understanding Male Pelvic Pain and What Drives It

True or False? Male pelvic pain is always associated with dysfunction of the prostate. The answer is FALSE. While the prostate can be associated with pelvic floor dysfunction at times, it is generally not the primary cause especially for pelvic pain. Approximately 2-16% of men may experience pelvic pain. Pelvic pain may also be associated with bladder, bowel, and/or sexual dysfunction.

Read MORE