Male Pelvic Pain: It’s Time to Treat Men Right

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male pelvic painTony is one of those people who seem superhuman. In his early 30s, he’s lean and athletic. When he isn’t chasing after one of his three young children or helping to run a successful family business, you can find him surfing, hunting, snowboarding, golfing, swimming, or playing basketball.

It’s hard to believe that at one time, this guy who has such a passion for living was all but convinced that his life was over. But there was a time, not all that long ago, when he was sure that he’d never participate in another sport that he loved, let alone be able to work or even have relations with his wife.

It was on an unseasonably warm afternoon in February  back in 2003 when Tony’s full and happy life took an unexpected detour. On that day, as usual, he was in active mode, attempting to pull off the perfect handstand when all of a sudden, he felt a sharp pinching pain in his lower abs.

Three doctors later, he was diagnosed with an “abdominal strain” and prescribed core-strengthening exercises. The exercises made his pain worse, and in a matter of weeks his symptoms exploded. The sharp pain in his abs snowballed into pain with sitting, constant perineum and groin pain, and a burning pain at the tip of his penis.

Unable to find any answers from the doctors he visited, he turned to the Internet. That’s when the fear and panic set in. After spending hours online, he discovered that his symptoms were a match with a disorder called “pudendal nerve entrapment”or “PNE.”

After reading a litany of stories about PNE, he was convinced that he needed surgery as soon as possible to free his entrapped pudendal nerve. Otherwise, according to the information he was uncovering, his symptoms would continue to worsen. He even contacted one of the doctors mentioned in the online forums who performed the surgery. The doctor encouraged him to fly out and schedule the surgery with him right away.

“I was terrified,” he recalls, “I was reading all of these horror stories, and I believed that if I didn’t get surgery as soon as possible, I would end up impotent and incontinent. Even with surgery I was afraid of what my life was going to become.”

However, before he signed up for surgery, he decided to see one more doctor in San Francisco. Thankfully, that doctor was one of the few in the country in the know about male pelvic pain. The doctor explained that trigger points and muscle spasms in the pelvic floor—and in Tony’s case, in the abdomen—have the potential to cause all of the symptoms he was experiencing. The doctor then prescribed pelvic floor PT to treat his pain. Finally, he was getting what seemed like a reliable explanation for what was happening to him. Plus, there was a treatment option available that was much more conservative than going under the knife.

“I admit at first I didn’t believe PT was going to help me,” he says. “But I decided I would just do it as a final effort before I got the surgery.”

After the first session with Stephanie, Tony felt a slight bit of relief. Ultimately, with regular PT sessions—at first twice weekly and then weekly—his pain and symptoms began to diminish, until eventually they were gone altogether.

“Today I have zero pain,” he says. “But it didn’t go away overnight,” he is quick to add. “It took time, patience, and a lot of commitment. And there were times during my sessions with Steph when I would break down because I was still so anxious about all that I had read on the Internet.”

Tony began PT with Stephanie in January of 2004, and by January of 2006, he was completely symptom-free. Today he is living an unrestricted, active life without pain.

Unfortunately, Tony’s struggle with pelvic pain is all too common. Research shows that between 8% and 10% of the male population suffers from pelvic pain. But that number is likely higher because studies also show that 50% of men will deal with prostatitis at some point in their lives, and pelvic pain in men is consistently misdiagnosed as prostatitis.

Tony’s ordeal is also common in that, because he couldn’t get answers from his doctors, he turned to the Internet for information, a move that led him down a dark road of misinformation. The reality is  that men with pelvic pain have an even harder time getting a proper diagnosis and treatment than women with pelvic pain.

For one thing, the medical community systematically misdiagnosis any pelvic pain symptom in men, —whether perineal pain, post-ejaculatory pain, urinary frequency, or penile pain—as a prostatitis infection, despite the absence of virus or bacteria.

The absence of a virus or bacteria simply means a switch in diagnosis from “prostatitis infection” to “chronic nonbacterial prostatitis.” Typically, from there the doctor writes out an Rx for a few months worth of antibiotics and the drug Flomax, and the patient is sent on his way.

In the beginning, because antibiotics have an analgesic effect, patients will actually feel a tiny bit better. But before long the effect wears off, and they’re right back where they started; in pain with no relief.

What’s so maddening about this misdiagnosis loop is that in 1995, the National Institute of Health (NIH) clearly stated that the term “chronic nonbacterial prostatitis” does not explain nor is even related to the symptoms these men suffer. To describe the symptoms they actually do suffer with, the NIH adopted the term: “chronic pelvic pain syndrome.”

The symptoms the NIH listed as being those of pelvic pain are: painful urination, hesitancy, frequency, penile, scrotal, rectal, and perineal pain, as well as bowel and sexual dysfunction. (In addition, in male pelvic pain patients, it’s common for them to feel as though they have a golf ball or tennis ball in their perineum.)

Despite the NIH’s edict, and more than 15 years later, men with pelvic pain are still getting that diagnosis to nowhere: “chronic nonbacterial prostatitis.”

Just ask Derrick.

A successful CFO, and an upbeat family man, Derrick is happily married with three children. It was in early 2002 that he began experiencing perineal pain, post-ejaculatory pain, and pain with sitting.

For nearly three years he was left to flounder in the misdiagnosis loop of chronic nonbacterial prostatitis. During that time, he endured several painful and misdirected tests and procedures at his urologist’s office. At one point, he even believed he had cancer.

“I was pretty frustrated and it was psychologically pretty challenging,” he says. “I was in my early 30s, but I felt very old.  It impacted my sex life and all of my relationships.”

Because of the effect it was having on his life, Derrick sought help from a psychiatrist. It was his psychiatrist who referred him to a doctor in San Francisco who diagnosed him with pelvic pain and sent him to Liz for physical therapy.

“PT has been the only thing that has helped my pain and discomfort,” he says. “Now it’s something that I must manage through therapy every two to three months, but I’m okay with that.”

As both Tony and Derrick discovered, the right PT is the best treatment for men suffering with pelvic pain.

For the most part, there are four rungs to the ladder of pelvic pain treatment whether for a man or a woman. They are: working out external trigger points, working out internal trigger points and lengthening tight  muscles, connective tissue manipulation, and correcting structural abnormalities.

For male patients, the internal trigger point release and muscle lengthening (internal work) is done via the anus because this is how the PT can gain access to the pelvic floor muscles. (Click here to read more about the right PT for pelvic pain.)

Despite the proven fact that PT is the best treatment for pelvic pain in men, it’s often difficult for men to get into the door of a pelvic pain PT clinic. That’s because not all pelvic floor PTs treat men. This is the second major reason men have an even harder time than women getting on the road to recovery from pelvic pain.

Today, the majority of pelvic floor PTs are women. And, many of these women are uncomfortable treating the opposite sex. For some female PTs, it simply boils down to them not being comfortable dealing with the penis and testicles. Among their qualms: What if the patient gets an erection? How do I deal with that?

Coming from a practice where 15% to 20% of our patients are men with pelvic pain, here’s our advice. If a male patient does get an erection, address it with a simple: “Don’t worry, it happens.” And move on. The bottom line is if you’re in the medical profession, you shouldn’t be intimidated by human anatomy. If you’re afraid to fly, don’t become a pilot. If you hate the water, don’t join the Navy. If you’re a vegan, don’t become a butcher. You get the picture!

Pelvic pain does not discriminate between sexes, and neither should those who treat it. Unfortunately even prominent organizations qualify pelvic pain as a “women’s health” issue. This needs to change.

To be fair, for some female PTs, their discomfort stems from the fact that they have received little to no formal education on how to treat the male pelvic floor. Frustratingly, there is very little education available to PTs on treating the pelvic floor in general. And what education is available is typically focused on the practical treatment of the female pelvic floor. For instance, when PTs take a class they practice on other PTs. So female PTs practice on other women, and when they return to their clinics, they’re not confident treating the male pelvic floor. While this is more understandable than simply not treating male patients because of a social discomfort, it’s still not acceptable.

The good news is that, in general, men are actually less complicated to treat than women. For one thing, there is no vestibule to deal with. The vestibule is an organ that’s full of nerves with the potential to become angry. In addition, the male pelvic floor doesn’t have mucosa that’s exposed to outside bacteria or other agents; therefore,  men aren’t as vulnerable as women to UTIs and yeast infections, which can exacerbate the pain cycle. Lastly, male patients aren’t dealing with the large fluctuations in hormones that female patients deal with.

Conversely, what male patients and female patients do have in common is that with the male pelvic floor, as with the female pelvic floor, musculoskeletal impairments such as hypertonic muscles, connective tissue restrictions, pudendal nerve irritation, and myofascial trigger points commonly cause the symptoms of pelvic pain in men.

Another commonality is that lifestyle issues contribute to male pelvic pain just as they do to female pelvic pain. For instance, in Tony’s case, his activities that might have contributed to his pain included a history of doing upwards of 200 sit ups a day,  and his regular long bike rides. Plus, at a young age he was told to “pucker” or hold his pelvic floor in order to avoid getting hemorrhoids.

As for Derrick, not only did he sit for long hours every day at a desk, he also had a long commute to and from work.

“In addition to solving my pain issues, PT helped me understand how my problems might have started to begin with, and it taught me to avoid certain potential triggers,” says Tony, who no longer rides a bike, does sit ups, or holds his pelvic floor. In addition, he has set up a standing work station to give him the option of not sitting at work.

For his part, Derrick has cut back on his sitting, and when he does have to sit, he takes frequent breaks to stand up and move around.

Both men are thankful they were put on the right path to pelvic floor PT, and both men have the same resounding advice for other men who are suffering from pelvic pain and are looking for relief. “Try pelvic pain PT!” they both advise. “PT saved my life,” adds Tony.

 

What Pelvic Pain!? : Click here to read a detailed account of how PT got Tony better.

 

Now we want to hear from you!

If you are a man with pelvic pain, please share your experiences with us.

All our very best,

Stephanie and Liz

 

 


279 thoughts on “Male Pelvic Pain: It’s Time to Treat Men Right

  1. Thank you for posting Tony and Derrick’s stories.

    I have to say, Tony’s story sounds all too similar to the path I’ve been on for the past six months. Low back pain sent me to an orthopedist. Orthopedist sent me to PT for core exercises. Core exercises led to increasing symptoms, and new, even more concerning symptoms consistent w/ pelvic pain.

    Since then, it’s been a frightening and frustrating cycle of bouncing between the internist, the PT, and the orthopedist, each pointing to each other, while symptoms continue to increase in spite of, or perhaps because of, treatment.

    It’s even more of a challenge to find some specialist who might be able to render a diagnosis, much less do so within a reasonable time and within one’s insurance plan.

    Until I’m able to do so, call me “Sleepless (and feeling helpless and hopeless) in Seattle…

    • Hi David,

      I’m so sorry to hear about the difficulties you are having in your healing process. Do you believe you are getting the proper PT for your symptoms? Sometimes when PT isn’t working, it’s because it’s not “the right” PT.

      • Hi….plz help to get rid….i was diagnosed as cpps 1 year ago…from then my days are going on hell…i love my life n enjoy every moment bt failed to do so.nw my mind feel like i hv no more joy left …i hv serious pain in pelvis…i did every exxercise ..yoga…theraphy…medicine..bt no relief…i got some hope after ur success….can i get help ….

      • Hello Wayne,

        Unfortunately we do not have a recommendation in Eau Claire, but we can recommend a therapist in Onalaska:

        Gunderson Lutheran Med Ctr
        Donna Hoffman, MD and Colleen Walz, PT
        Onalaska WI
        (608)775-1840

        Best,

        Liz

        • Where is the best pelvic pain PT in Gerogia or Florida..the stories above in the article are exactly what I am going through now..I spend about eight hours of my day laying in a tub of hot water..will PT help if I have pudendal nerve entrapment??!..this has been gradually getting worse for the past 2 years..34 year old male from Georgia..please help!

          • Hello Brandon,

            Below are therapist recommendations in Florida and Georgia:

            Ashley Arango, PT and Katherine Marsh, PT
            Florida Hospital Pelvic Health Rehab
            Orlando FL
            (407) 303-8280

            Tracy Sher, PT
            Florida Hospital
            Altamonte Springs
            (407)257-1403

            Pamela Downey, PT
            Miami FL
            (305) 666-3232

            Jenny Hunt, PT
            Provenance Rehabilitation of the Greater Atlanta Area
            Alphretta GA
            678-819-8720
            provenance.rehab@gmail.com
            Lone Howell, PT
            Physiotherapy Associates Lawrenceville
            Auburn GA
            (770) 995-5242

            Regards,

            Liz

          • I am in Florida and suffering from perineal pain and wondered if there are more PT providers than you listed in 2015?

            Thanks

  2. Thanks for this info:

    I’ve had pelvic pain / coccydynia since shortly after my L3/L4 hemi-laminectomy last August 2012.

    I found a great PT nearby who does external and internal treatment and it has helped a bunch. I found her on coccyx.org. She thinks I have predominantly levator ani syndrome (due to the tightness and tenderness there upon massage). I don’t have any penile, testicular or urinary troubles.

    My dilemma now is that my progress has leveled off after 3 months. And I’m still confused about a chicken and egg concern: is it my pelvic muscles that spasm and hurt (and pull on the coccyx) -or- is it the coccyx that may be hyper mobile and therefore pulling on the pelvic muscles causing them to be sore? How can I tell the root cause?

    My local Pain Management Doc is referring me back to a famous NY/NJ Coccyx Doc for more injections, possibly even a coccyx area nerve ablation (after test injection). I had a ganglion impar block there, with minimal effect, three months ago.

    Every day I go back and forth – where is the pain now? Is it higher up the butt crease or more in the rectum area (e.g. golfball feeling); it varies often. Even my loving wife helps with the internal massage and can feel the levator ani tightness. I have also heard that Botox on the levator ani can help.

    So far, I am gradually pursuing all avenues while keeping up with the PT (she may even try internal TENS next). It is a long and uncertain road.

    Thx,
    Phil (56 year old in NJ)

    P.S. There is a Herman Wallace male pelvic floor PT seminar in NJ next month; good to see that word is getting out about us men.

    • Dear Phil,

      I’m glad you’ve found a PT that has been able to help you. Without doing an evaluation I can’t tell you whether your coccyx is hypermobile or if the muscles are the primary cause of your symptoms. Your PT should be able to tell you. However, given your history, I doubt that your coccyx is hypermobile. You didn’t injure the coccyx directly and joint hypermobility in men isn’t that common. I would bet your pain is coming from the surrounding musculature and possibly the rectal branch of the pudendal nerve. A ‘golf ball’ feeling is almost always tight levator ani muscles. Since you didn’t have any success with the ganglion impar block why are they recommending more nerve blocks and/or ablations? I would be surprised if additional blocks were helpful. Has anyone suggested trigger point injections to the pelvic floor muscles? Botox? If your PT is telling you that your pelvic floor muscles are still very tight I would pursue trigger point injections and/or Botox injections next. Just as a side note, if you have any nerve-like symptoms I would skip the internal TENS altogether, it will likely aggravate any nerve pain.

      All my best,
      Liz

      • Hi Liz:

        Thanks for the comments. I know that the comments area of a newsletter is not a place for a medical diagnosis, but a couple of more tidbits about my dilemma (that others may share): I did develop the coccyx area pain after recovering from my surgery at which time I spent a couple of weeks leaning back, resting in various chairs. Well, they say that puts extra pressure on your coccyx (they told me later). That plus my seated Xrays show a slight “posterior listhesis” of the bottom bone of the coccyx upon my leaning back. On the other hand the ganglion impar injection didn’t really help. But if they do ablation they would only do so if the test injection shows excellent temporary relief.

        To your point about the pelvic muscles, I am going to a Colorectal Doc in a couple of weeks; he supposedly does Botox injections so that is a definite option. I don’t know if he does trigger point injections; I’ll ask.

        Thx for the feedback about the TENS. My PT person suggested it. I’ll chat more with her about it next week.

        What I may have in common with many people who have pelvic problems is that the symptoms move around. Sometimes it aches in the rear rectum area prior to “pooping”. Other times, the pain is higher up, as I’ve seen some describe as a high “dry” rectum pain (not related to pooping). Other times, it is almost perineal or golf ball like. And when the PT (or my wife) does an internal massage, yup, the left side levator ani are tight and sore. Always, if I don’t use my coccyx cushion when seated, I ache in the total butt crease area for an hour afterwards for sure. And when I first wake up I usually feel fine for a while (including during my morning walk). Generally, the pain just moves all around and drives me crazy – since it seems both pelvic muscle and coccyx related.

        Thank you for all the good work you do in this challenging area!

        Phil in NJ

  3. What would be your treatment when someone ( male ) also has CRPS/ RSD along with this issue.Cannot sit very long and standing & walking hurts in groin area and then with CRPS in both ankles down, I cannot walk or stand but momentarily.

    • Dear George,

      Our treatment is administered in the supine, sidelying, or prone position so we would treat you like any other patient. The CRPS in your ankles wouldn’t really change my treatment very much except that I would likely progress the treatment fairly slowly until I saw how your body reacted to the treatment.

      All my best,
      Liz

  4. Hi Liz
    I am a 68 year old man who has been a long-distance runner and bicyclist all my adult life. Two years ago I started having severe pelvic pain.Like most, I began treatment by a urologist and spent several months taking various antibiotics and pain medications and having invasive test that revealled nothing. I then found an experienced PT who I trust and who has helped me tremendously. My problem has been that over time the condition has become quite manageable two different times only to, for no apparent reason, relapse into severe, non-stop pain. It is likely only incidental, but both relapses occurred this time of the year (late Apr. and early May) and last year, at least, did not significantly improve until late Fall. I no longer cycle and my runs are now short, slow and increasingly infrequent. I still do strenuous day hikes sometimes as often as 2-3 times in a week in the No. Ga mountains. This last relapse has now lasted several weeks and seems to be getting progressively worse instead of better. I have always been aware of the role that stress plays but ironically, was much improved the first three months of the year eventhough I was having a very stressful situation workwise (I practice law)and now, even though work and my personal life are relatively stress free, the pelvic pain is giving me fits. Also, I cannot figure out where stretching, yoga etc. fits in. My understanding, is that both should be very helpful long term and, in the past, felt that stretching and yoga helped with the improvement I was having but now, although they ease the pain immediately but after a few hours and through the next several days seem to make it much more severe. I am sort of stumped at where to go and what to do at this point. Any help you could give me would be much appreciated.
    Thanks.
    Stumped
    from Atlanta

    • Dear Michael,

      You should be careful with stretching because stretching muscles with active trigger points can actually exacerbate pain. Therefore, if you’re noticing increased pain after stretching, chances are you are stretching muscles with active trigger points. I would consult with your PT as to which muscles in your pelvic girdle have active trigger points so you know which muscles to not stretch until those trigger points are eliminated.

  5. Hi Liz,
    I started to have pain around the butt around 10 months back. A long flight later on all I knew was that my whole lower back was jammed strangely and I was having nerve tingling in both legs. Started PT a month later and over the past half an year it has fixed most of the issues except that pain while sitting has remained as well as sexual problems like weak ejaculation. So I have been referred for pelvic pain and would come to know about it in the coming week after a visit to the urologist. I have started to become more certain that it is pelvic pain.

    Would you know a good PT for pelvic pain in men in Bellevue or Redmond, WA area? If not then around seattle. Also, are there any resources online for stretching muscles around the perineum (PC muscles etc).

    Thanks!

    • Dear John,

      It sounds like you are on the right track. Below are two PTs that we refer to in your area. As for stretching muscles around the perineum, I would advise that you first talk to a qualified pelvic floor PT before you begin stretching exercises.

      Vora Sagira PT Bellevue WA 4256885900
      Allen Tina PT Seattle WA 2065982889

      Please feel free to write in with any additional questions you may have.

      All my best,
      Liz

  6. I have been suffering from rectal and perineal pain for approximately 2.5 years. At the start of a new office job, after being a HVAC service tech for 20 years. I have been to 2 different PT’s who have done internal and external work. I deligently did home core strengthening exercises for approximately a year. The pain is worse than ever. I had 2 nerve blocks with no improvement. I am now being treated by a urologist who said that my prostate is inflammed. The pain is unbearable and has changed my life. The second PT did visceral manipulation but no improvement. I am at my wits end.
    John from Chicago.

    • Dear John,

      I’m so sorry to hear about all that you are going through. It sounds like sitting is exacerbating your pain. Also, core exercises may not have been appropriate, depending on what kind of exercises they were and whether or not you had any trigger points located in your abdominal wall. I see that you are in Chicago. One of the best pelvic floor PTs is located there. Here name is Rhonda Kotarinos. I would recommend that you see her. This is her info: http://www.rhondakotarinos.com/. I know that you have already tried PT, but not all PTs are the right fit for every patient. It could be that the PTs that you saw were not the right fit for you.

      All my very best,
      Stephanie

  7. Hi. This is a great article. I have this problem. It’s robbed me of my life. I live in Houston, a city with a world-class medical community. Yet, I still have not found a PT that treats men. Please let me know where I can get some help if you can.

    • Dear Mike,

      I am so sorry to hear that you are having such a hard time finding a qualified PT to treat you. Please see the list below; it is a list of PTs that took our course in TX. Perhaps one of them will be able to help you. Another resource is the Yahoo message group, Happy Pelvis: http://health.groups.yahoo.com/group/happypelvis/; perhaps one of the group’s members will be able to refer you to a PT. All my best, Stephanie

      Nieves Alfredo MD Chattanooga TN 4234901136
      Kubic Melissa PT Chattanooga TN 4237788660
      Hathaway Lorien PT Plano TX (972) 579-8100
      Bobb Valerie PT Dallas TX (214) 820-1860
      Fournier Stephanie PT Irving TX (972) 579-8155
      Woerner Marie PT Fort Worth TX (817) 735-2100
      Sauder Sara PT Austin TX (512) 335-9300
      Brooks Heather PT Longview TX (903) 323-6573
      McNeely Cody PT Austin TX (512) 335-9300
      Anderson Amber PT Plano TX (225) 603-3796
      Dehne Pamela PT Austin TX (512) 231-5210
      Frits Sandra PT Irving TX (972) 412-4926
      Irizarry Stephanie PT Copell TX (972) 745-9060
      Parry Constance PT Dallas TX (214) 590-5813
      Dobinsky Angela PT Austin TX (512) 335-9300
      Francis Peggy NP San Antonio TX 2106144544
      Hakeem Fatima PT Sugar Land TX 7137996193
      Mire Charmaine OT Houston TX 2815888249
      Peters Angie PT Montgomery TX 7137996193
      Reardon Sara PT Dallas TX 2146452080
      Suire Robin PT Pearland TX 7137996193
      Bannister Tami PT Irving TX 9725798155
      Walker Carolyn PT Waco TX 2544055203
      Basler Colleen PT Austin TX (512) 219-5377
      Brinker Anna Dallas TX

  8. My husband is suffering from Pelvic Pain. We are both only 26 years old, and this has been going on for over a year now. We saw over 20 doctors including 6 different urologists and even went to the Mayo clinic in Arizona (where we live) without any definitive help. He was put on intense antibiotic treatment for 6 months, alpha blockers, any other random medicines the doctors could think of, had a cystoscope surgery, and more other invasive tests than I even knew existed: none of which helped. His pain has been constant for these last 14 or so months of hell during which he’s had bouts so severe that he couldn’t even leave the house for weeks at a time. He’s lost his job and even slipped into a very severe depression from all of this. After about 14 months of symptoms, out of complete desperation we finally flew across the country to the Cleveland Clinic in Ohio who for the first time mentioned CPP and were able to send him to a PT section of the clinic to try and help.

    So first let me just say that my husband and I have been those people that thought our life was over and searched the internet desperately only to find, like the guy in the story, some of the scariest prognosis. So thank you so much for being one of the sites that may provide some hope and actually help people — you could be changing more people’s lives than you know (I only wish we had found something like this sooner — it certainly may have changed ours).

    Secondly I have a general question about overall improvement once the correct diagnosis has been made. When my husband was in Cleveland he spent 2 straight weeks receiving treatment everyday. He came home a changed person — he could walk up the stairs without pain for the first time in a year – he could sit for more than 10 minutes, hug me without wincing, and even urinate without screaming — they seem like such little things, but after an entire year of hearing yelps of pain every time he went to the bathroom, the silence has brought me to tears more than once. He was not completely pain free when he came home by any means, but we had some confidence for the first time that this was helping.
    However since he’s been back from this treatment, his symptoms are slowly getting progressively worse again. We struggled a little to find a PT here that we liked and thought was doing the right things (it’s so hard to tell), but he is only being seen 1-2 times a week here instead of everyday. Is it normal for symptoms to go backwards like that after reducing treatment to less than half? Is it likely that they will eventually come back around if this is the case? Or do you think perhaps we need to find a different PT? (We live in Gilbert, AZ if you have any suggestions). Furthermore, about how long does it usually take for someone in his condition to feel symptom free? I know everyone is different, but is there any ballpark of usual time frame before we should start exploring other options like shots or botox in the nerves?

    Thanks very very much!

    • Dear Erin,

      I think it’s very encouraging that your husband has had some significant relief after 2 weeks of PT in OH. It’s quite rare that 2 weeks of treatment, even every day, is going to completely eradicate a patient’s symptoms. The purpose of getting a lot of treatment in a short period of time, as your husband did, is hopefully to reduce some of the symptoms, even if it’s temporary, to know that this particular treatment is the correct direction to pursue. Usually, with only 2 weeks of treatment, the symptoms will start to creep back without consistent and correct treatment. This is why it’s very important for the PT in OH to have good communication with your local therapist so he can receive the same treatment consistently. With consistent and correct treatment 1-2 times per week your husband should be able to continue to make progress. In the Phoenix area I can recommend 2 Physical Therapists from the same practice. Either Loretta Robertson or Diana Munger from Desert Physical Therapy would be good choices. As far as recovery time goes, it is dramatically different for each patient depending on their initial injury or trigger, how long they’ve been in pain, their treatment plan, their behavior, etc. On average, I would say that most of our patients are receiving consistent treatment, meaning 1x/wk for 3-6 months, and then maybe every 2-3 weeks for another 3-6 months. It may be beneficial to explore other treatment modalities, like nerve blocks, botox, or trigger point injections sooner rather than later. It all depends on his impairments (what’s wrong with his muscles and nerves) and how he responds to PT. I often recommend other adjunct modalities while I’m treating my patients. It can expedite the treatment process. Hope that’s helpful!

      Please feel free to send any additional questions you may have and keep us posted on your husbands process!

      All my best,
      Liz

      • Hi,

        I am the original poster here. It has been about 5 months since this post and unfortunately my husband’s condition is about the same. He has some better days and some worse but still no days without pain completely, and although there was a 2 week period where he had consistently light days, since then things seem to remain constant in this state. I had a question though, we recently had a physical therapist suggest that my husband try skin rolling at home on the shaft and even tip of his penis. This is not something they do in the office, but since much of his pain is referred in the tip, they suggested that maybe the myofascial tissue there also needed treatment. In trying this, my husband discovered that there is one very particular place on the shaft of his penis that he can apply pressure that causes a severe pinching pain in the tip. This is one of the more rare, but more severe pains he has with his condition. We will discuss this with his PT as well, but I am curious – are there any trigger points in the shaft of the penis itself, or is it possible that the tissue there needs work? We’ve never had a PT work that area in particular but that may be because of how sensitive the area is. I am just wondering if this is something you have seen before or if god forbid we might still not have the correct diagnosis / treatment going on and there might be yet something else wrong?

        Thanks very very much for you time and any response or information you can provide!

        • Hi Erin,
          I’m sorry to hear about your husband’s case. I pray the situation gets better. I’ve been having pains as well for the past 5 years but not as bad as his (from your description). After 5 doctors & no answer,I researched the best urologist in the country & Ohio came up as a top 10. Im considering going since I now have insurance. DO you mind giving me the reliable contact & info on how to start the whole process in Ohio?
          Thank you much.

  9. Anybody know PT who treats males for pelvic pain in Northwest Arkansas? I developed severe pain in my groin, testicles, and bladder suddenly on April 14th 2013. I’ve been to two urologist with the original diagnosis being prostatitis and second being chronic epidiymitis but ultrasound and physical examinations show nothing concerning. Physical examinations also show no indication of hernia. Guess at this moment from my own research is nerve damage, entrapment, or pelvic floor disorder. Hoping to get help and get well.

      • Thank you for the contact. I got in contact with Laurel Sexton in Fayetteville, AR whose been helping me for a few months now. She’s been very engaged and I’ve seen some improvement. She sees me about 1 to 2 per week and I have some home stretches that take me about 15 minutes to do every day, but still deal with constant pain. Not sure how long this usually takes, but I’ve been dealing with it for nearly 8 months now. Any thoughts on the average period for seeing significant improvement? I’m currently at an average score of 16 down from all time of 24 using the NIH Chronic Prostatitis Symptom Index. Thanks again for any advice you can provide.

          • Yes, based on the write-up you linked I do believe the methodology and level of care is good. We’re just not making as much progress , if any, at this point. Is there an opportunity to schedule consultation and maybe even joint case review between my PT and your office if all parties are open to it?

          • Dear Bill,

            Yes, we can do that. But first, we need to start with a (complimentary) phone consult with you. But, please understand, without having evaluated you, it will be a challenge for us to help.

            Give our office a call to schedule the phone consult.

            All my best,
            Stephanie

          • Been just a little over a year since my problems started and not a day goes by without pain and discomfort, but overall I’m doing better. I’m still pursuing physical therapy with Laurel and grateful for her help. M average CPSI score has lowered from 16 (all time high of 24) at last post down to a average of 13.5. I haven’t forgotten the offer on the complimentary consultation, but hoping that I’ll continue to see reduction in symptoms as time goes on. Has any of you engaged the prostatis.org community? You might be able to help out there.

  10. I found your helpful blog while researching my own issues. I am in my mid-thirties and I’m into year 2 of having the symptoms and treatments given to men: Told I have non-bacterial prostatitis/chronic pelvic pain(after months of antibiotics). My urologist now wants me to try a six month regimen of flomax, continued antibiotics, continued NSAI, and sitting in a bath twice a day.

    My main problems now continue to be hesitating when urinating, constant throbbing pain in my penis (even when doing nothing but sitting), lower back pain, pain near the butt, and swollen testicles/problems with ejaculation.

    My doc mentioned if all of the above does not work he may wish to try a regimen of prostate massage and therapy but he didn’t find that of use to a lot of individuals. After 2 years of dealing with this, I wish we would try the therapy.

    Do you know of anyone in the Richmond, VA area?

    Thanks.

    • Dear Brandon,

      I would def. recommend that you see a knowledgable and experienced pelvic floor PT as it sounds like your pain could very well be pelvic-floor related. The following are two PTs who have taken our class; however, I am not sure if they are knowledgable about male pelvic pain.

      Oxford Kathy DPT Richmond VA 8043309105
      Morris Lydia PT Richmond VA 8042850148

      If you can not find a PT to treat you, you might want to consider traveling for good pelvic floor PT or at least an evaluation from one.

      Please feel free to call us for a free 15-minute phone consult.

      All my best,
      Stephanie

      • Stephanie,

        Thank you very much for taking the time to respond. I have scheduled an appointment with Lydia Morris who I’m told does handle males. This will be in October (first available for a new patient). Again, thank you for the info.

  11. Some of the article above describes my own experience. I initially sensed a sort of numbness behind the glans of my penis. This then became sore and the inflammation spread to my perenium. After a few more weeks of this I also started to suffer from erectile dysfunction. My doctor tested me for prostate problems and prescribed me anti-biotics. When these failed to work, and having no other markers related to prostate problems I was treated by the Sexual health clinic. They were perplexed by my symptons but prescribed me antibiotics which also did nothing. Seeing another Urologist, he diagnosed me with non-bacterial prostatitis and I was treated with a prostate massage. This also failed to work. Finally another Urologist suggested I had Pelvic pain syndrome.I’ve been put down for ultra sound therapy but no appointment yet. Anyway this is a precis of the last 11 years of pain! Anybody who gets this condition gets my utmost sympathy, not least because some doctors will tell you it’s all psychosomatic…incredibly annoying!

      • Hi Stephanie,

        I’m a UK (England) based male desperately seeking help. Is there any PT’s you can recommend here? I see your Elliot Maria recommendation above but that seems to be females only. I’m located near Birmingham but would be willing to travel!

        Thanks very much for any help.

        • Hi James,

          Maria is the only PT that we refer to in the UK; she does; however, see men I believe. Give her a call and double check!

          All my best,
          Stephanie

  12. I’m a 30 year old man that’s been dealing with this for the last 2.5 years or more and experienced all the symptoms listed on the website as well as numbness throughout my lower back, pelvis, and legs. I have been in PT for almost 8 months of PT time and over a year real time, and I have seen great gains, return of feeling and sensation almost entirely. The one thing that frustrates me most, like most of these men, is the ED that i’ve been experiencing.

    After ejaculation, I get the pain an recurrence of symptoms in my perineum from my scrotum to my tailbone and into my legs and back, which then takes time to calm down and dissipate. Should I keep masturbating while in treatment or should I stop until I reach a certain level in my treatment.

    Also, it’s pretty obvious to me that nerve regeneration and growth is what is taking a while and I read about cold laser therapy to help speed the healing of the inflamed areas and nerves. Do you have any information or recommendations about this as well.

    I am seeing a wonderful Pelvic Physical Therapist in Burlington, Ma Elizabeth Lewis

    • Dear Chris,

      It’s hard for me to make a recommendation on what you should or shouldn’t do since I haven’t evaluated you myself. If you have trigger points in your ischiocavernosus and/or bulbospongiosus, then I would recommend that you limit masturbation until those trigger points are eliminated. Ask Elizabeth whether or not you still have trigger points in these muscles.

      There is no decent literature that says laser therapy will help speed the healing of nerves. The best thing to do to expedite nerve healing is to create a healthy environment for them. That means to minimize any restriction around the nerves, i.e. tight muscles and connective tissue, maximize blood flow, and minimize further irritation/damage to the nerve with activity/behavior.

      All my best,
      Liz

  13. Thanks for a helpful set of articles, which are some of the few I’ve found which capture the frustration I feel. Do you have any recommendations for a PT to treat males in Boston area?

    I was diagnosed with chronic prostatitis after a flareup of many of the symptoms you list (pain in tip of penis, constant aching in anus and perineum radiating to scrotum) and going through the typical charade of having a urologist prescribe antibiotics even though we both knew it was nonbacterial. The flareup was triggered by an international flight during which I sat for about 14 hours straight. Before the flareup I had experienced minor symptoms off and on for 4 years.

    After turning to the internet I tried perineal hyperprotection by constantly sitting on a pad and suspending the perineum (obsessively). This has relieved most symptoms, but as a 29-year-old it comes at a social and professional cost. I would be very grateful for any recommendations you have for PT in the Boston area.

    • Dear Mark,

      It does indeed sound like it’s time for you to be in the hands of a qualified and knowledgable pelvic floor PT.

      However, we do not know of any pelvic floor PTs in the Boston area; however, below is a list of pelvic floor PTs that we refer to in Mass. There are also good PTs in Chicago and NYC. If you do not find a knowledgable and experienced PT in your area, please consider traveling for PT. Many folks do have to take that route because of the lack of qualified PTs out there. All my best, Stephanie

      Herzig Niva
      Newton
      MA
      6172441990

      Lewis
      Elizabeth
      Gloucester
      (978) 761-3149

      Botsis
      Ingrid
      Farmington
      (508) 271-2076

  14. I am 58 yr old male and have had plevicpain (it comes and goes different days, but generally feels like I am constantly sitting on a hard pen lengthwise…eg. small golf ball). It is also sore around the bottom of my hip bones where I sit. It has been sore for 4+ months. It coincided with a hip replacement, so I thought they were related…but now I don’t believe they are related. My GP suggested I might have prostatitis and suggested Aleve and warm sitzbaths. This doesn’t seem to help. Can you recommend any good doctors or PTs near Palo Alto, California (30 miles south of SF) that I could further explore this with? Thanks! Don

    • Hi Don,

      We (The Pelvic Health and Rehabilitation Center) actually have an office in Los Gatos, CA. We have a great deal of experience treating male pelvic pain, and would be happy to schedule a 15-minute free phone consultation with you to discuss how we might be able to help. Give us a call 415 440 7600.

      All my best,
      Stephanie

  15. My dad has been experiencing the types of pain described in this article and most recently pain in his lower abdomen. I think he had every examination, test and scan known without a successful diagnosis of the problem. It was after spending hours on the internet that I believe he has what you describe here. However, my dad is 89 and has never been particularly athletic or exerted himself physically. My dad is a worry wart and some of my research has me thinking his problem is due to stress which tightens the the muscles in the perineum which causes the type of pain described here. I am wondering if you have experienced this kind of problem in older men and this kind of pain brought on by stress rather than physical exertion.

    • Dear Guy,

      Yes to both of your questions. Your Dad might benefit from seeing a pelvic floor PT. Where are you located? Perhaps we could recommend one to you in your area.

      Best,
      Liz

  16. Hi there, I have been dealing with symptoms similar to CPPS for a year now and it all began after I had been masturbating in a jacuzzi with a jacuzzi jet (water shot up my urethra). Ever since then, life has been hell… It all began when I was 18 years old… I’ve seen loads of doctors just like tony in the story above and I’ve also been doing PT, but I’m still not sure if this is the right treatment because I’ve been doing PT for 4 or 5 months now and I’m still having symptoms. My symptoms have gotten better fuctionally (urination etc.). As a result my mood improved a lot ( I used to be super depressed and constantly dreading over how I ruined my life and future chances of happiness). Ocassionally I’ll read some frightening info on the internet that will make me feel those feelings again, but for the most part, I’m okay now… however after ejaculation, I still get pain and recurring symptoms in my perineum, my lower abdomen, and into my legs and back. This takes time to calm down and dissipate (few hours to a day).

    It’s just tough having this happen at such a young age when you feel like you should be in your prime and all of your friends/peers dont understand… will I ever find any relief? Do i even have CPPS? what else i can do?..

    • Dear Marcus,

      I’m so sorry to hear about all that you are going through. But, seeing as you are finding relief through PT and b/c your symptoms began after a very specific incident I would say that they are pelvic floor related and that you are on the right path with PT. Does your PT do manual, hands on work? Internal and external. Not all PTs are created equal so you want to be sure you’re getting the right PT. Also, PT does take time to work, it is a slow and steady process that takes months and even years to fully work.

      I would also recommend that you talk to a therapist about what you’re going through. You are NOT alone, many people have come to us or contacted us with masterbation injuries; it’s nothing to be embarrassed about. It happens. But I think you need to talk to someone regularly who can help you put things in perspective. It’s hard to find peers who understand what you’re going through even at older ages, as no one can really understand chronic pain unless they’ve been there.

      You will find relief and continue to get better and better. Just make sure you’re getting the right PT. Also you have something major going for you and that is your youth.

      I would recommend that you continue to get PT each week; but as I said be sure you’re getting the right Pt, read this blog to learn about “good” PT: http://www.pelvicpainrehab.com/patient-questions/401/what-is-a-good-pelvic-pain-pt-session-like/

      Also, be good to yourself; take hot showers, ice if that helps, and by all means, stay off those scary Internet sites!!!

      Keep us posted on your continued progress, which I promise will happen!

      All my best,
      Stephanie

      • i’ve never explored using ice as a treatment option, I’ll definitely try it out! thanks for the advice.

        In my case, can I view this condition as something that can treated in the same way a “sports injury” would be treated? For instance, if I ice it, heat it, massage it (PT) eventually it will go away? or is it too late in the game for these treatment options? I’ve had my symptoms for over a year now and I know that after a certain period of time icing/heating something like a sprained ankle will no longer be effective.

        Also, what should i look for in a therapist/psychologist, someone who specializes in pain management, or ?

  17. Hi,
    I am a healthy and fit 58 year old man. The pain started for be about 14 months ago just before a flight to Asia. Sitting is murder and the pain radiated down both legs at times. Sex life is dieing. Had numerous courses of antibiotics, PSA tests, even a CT scan. Result, I have an enlarged prostate but not spectacularly so. Now they have me on an alpha blocker but sitting in this office chair I feel about the same… Are there any PT folks in the Philadelphia area I might contact?
    DJ

    • Dear DJ,

      I’m so sorry to hear about all you are going through. Below are two PTs that we refer to in your area:

      Sheth Hina PT Philadelphia PA 267-282-1301 hinashethpt@gmail.com

      Rejba Amy MSN, CRNP Philadelphia PA 2158638100

      All my best,
      Stephanie

      • Now my doc has me on Avadart and Tamsulosin. While that has improved my prostate condition, it has not taken away the sitting pain. Do you have anyone on your list in Bucks County , PA? Specifically in the Langhorne, Newtown, Horsham area?

        Thanks!

      • I guess I need to pursue this again having had not luck elsewhere. Same pain is back and becoming hard to deal with. Sex life is non-existent. Like sitting on a rock all day with pain radiating down my legs. I came up negative with antibiotic treatments, a CT scan, Avadart and Tamsulosin were no help. It disappeared while I was on 2 weeks of vacation but came back within days of my return to work. Is the list for therapists in the Philadelphia area same as before? I believe I will have to follow through with this now..

        • I have been going to Hina Sheth’s outfit in the Philly area for 2 months now. Where I had pain all the time I now have pain intermittently. The therapy is continuously calibrated to me and what the effects are on my situation. I feel a lot more positive than I did when I first started visiting this blog. Its not fun, believe me, the internal therapy is downright painful. But the end results seem to be positive. There is light at the end of the tunnel.

  18. Do you know of anyone near Salt Lake City, UT that would do PT for my husband? He is having extreme sensation loss, penis/testicular/scrotum pain intermittently. We have seen neuro/uro/ortho. All can’t help but thought it might be PN/PNE. I am anxious to find a PT here that could possibly help. Thanks.

  19. I have been dealing with chronic pelvic pain for about 3 years now.
    My main symptom is perineal pain that is moderate and a sensitve urethra in the perineal and testicular area.

    Have been the route with the uros, done the antibiotics with no real progress though things are a bit better now than a year ago.
    I have been doing some self internal massage and at times it may be of benefit but would really like to see a PT that knows their way treating these issues.
    I llive in Vancouver Canada and so far no one I have seen knows how to do this work.

    Your recommendation of someone local would be really helpful

    • Dear Alvin,

      I’m sorry but we do not know of a PT in Vancouver, is there any other location that is accessible to you as we have many PT referrals for Canada in general. Best, Liz

  20. i am 26 years man.i have been suffering same issue since my childhood. I used to feel pain in childhood 3 or 4 time. Pain was frequently increased year by year,i thought its naturel but from last year i have been feeling pain everyday.i thing my sexual power is getting less….what can i do for that pls help me.

    • Dear Hally,

      I’m sorry about all that you are going through.

      If you’ve read the blog post, then you know that PT can help with male pelvic pain, if that is indeed what your issue is.

      Where do you live, perhaps we can refer you to a PT in your area?

      All my best,
      Liz

  21. Hi..great blog

    Will I be able to weight train again. I have experienced groin, testicular, pelvic and lower back pain, and I think some perineum, following a fever developed following antibiotic Urethritis treatment.

    The biggest worry is the frequency of urination, and feeling like I may need to go again shortly, or that I had not finished.

    Is there someone in the UK who will treat men?

  22. My symptoms are pain from my right hip to my right testicle. At times it can spread to my low back. Over the last two years I have seen my family doctor a number of times, multiple urologists, pain management specialist, GI clinic, PT, general surgeon… The list goes on. I have tried multiple stints of aggressive antibiotics with no success. Yesterday I scheduled an MRI to rule out a tear. The mental struggle of searching for answers is as grueling as the pain. I ran into your site and am looking for PT in Des Moines, IA. Thanks for what you are doing!

  23. Hi,
    Ive been having pelvic pain! It’ started off as high buttock pain I went to a physical therapist and he knocked that out . The pelvic pain comes and goes sometimes it’s in the lower abdominals, left pelvic, and sometimes I feel a tingling annoying feeling at the tip of my penis. I was really stressed out at one point and now I’m wondering if my body did this to me from stressing. I’m starting to get discouraged because I just got a new job and I’m getting married soon. Does the pain go away completely with therapy? I want this mess to leave my body because I’m a very active guy and this is just breaking me down? Does constipation also come with this??

    • Hello Dee,

      Yes! Stress, anxiety, and other emotional imbalances can negatively affect existing pelvic floor dysfunctions. Thankfully pelvic PT can successfully address your symptoms with great results; often eliminating or greatly decreasing your pain. Because of the pelvic muscles’ structure, and it’s role in supporting important organs such as the bladder, and rectum, patients often experience secondary symptoms in these areas. These symptoms can include urinary and bowel dysfunctions such as increased urinary frequency and difficulty with evacuating bowels. I would recommend that you see a PF physical therapist in your area.

      Best,

      Stacey

  24. And oh yeah my jaws get a weird tingly feeling when I’m lifting something at work. Please help me please. Could you tell me what all this is? I’m scared something is seriously wrong with me. I’m in houston tx.

  25. Dear Liz and Stephanie,

    I have been dealing with pelvic floor issues for several years. I lived in Chicago and I was treated by Maureen who was an associate of Rhonda Kotarinos.

    I now live in L.A.and have had trouble finding a good PT. Can you recommend one. I live on the west side by Santa Monica.

    Also, I was doing much better this fall however I had a pituitary tumor removal on November 4th and ever since the surgery my pelvic floor has felt out of whack. Part of my problem is that I spent several weeks sitting / slouching in a chair in our family room. The chair doesn’t have a lot of support and I think the way I’ve been sitting has aggravated my condition. I can tell that my lower back is aching more and I probably need to get some good pt and engage in a proper stretching and exercise program.

    I had also considered making a trip to SF for an evaluation but maybe I can find the help I need in Los Angeles. Would love your thoughts. Regards eric

    • Dear Eric,

      We are planning to open a clinic in Los Angeles in April, and would love to treat you. In the meantime, there is a wonderful PT who actually specializes in male pelvic pain at USC. His name is Daniel Kirages and this is his info: Phone:
      (323) 442-2900
      Email:
      kirages@usc.edu

      Also, you are correct in your assumption that your back pain/posture issues could be contributing to your flare as that is very common! I believe that Dan Kirages can also help you with that issue as well!

      All my best to you,
      Stephanie

  26. Hi Liz and Stephanie,

    Ive been having pelvic pain! It’ started off as high buttock pain I went to a physical therapist and he knocked that out . The pelvic pain comes and goes sometimes it’s in the lower abdominals, left pelvic, and sometimes I feel a tingling annoying feeling at the tip of my penis. I was really stressed out at one point and now I’m wondering if my body did this to me from stressing. I’m starting to get discouraged because I just got a new job and I’m getting married soon. Does the pain go away completely with therapy? I want this mess to leave my body because I’m a very active guy and this is just breaking me down. Does constipation also come with this??

    • I’m sorry that you’re suffering with pelvic pain. Yes, stress can definitely contribute to your pain, but usually is not the only cause of pain. It’s hard for me to say whether PT could completely eliminate your pain since I haven’t evaluated you, but I will say that we’ve completely eliminated pelvic pain with PT in many patients over the years. Yes, constipation is a very common symptom of pelvic floor dysfunction. All my best, Liz

  27. Can you recommend a physician in the Austin area who can evaluate and diagnose this condition in men? “A light in the tunnel?”

    As with most of the commentators, I’ve been suffering the plethora of symptoms discussed and have been examined and dismissed by numerous physicians during my journey searching for the the cause of my pain.

    Thank you,
    Carl

  28. Hi:

    I am a 43 year old male in relatively good physical health. I do strength training 2 days weekly and walk most days of the week. I had a violent cough that lasted for one month recently and have had chronic pain in my perineum/rectum/scrotal area ever since. I was concerned so I had a colonoscopy which was unremarkable. I saw a urologist this week who performed a DRE and indicated my prostate felt normal. PSA was .5. Urologist prescribed a two week course of antibiotics and a generic type of Flomax. I don’t believe these drugs will help at all. I have a golf ball sensation in my anal region and feel myself getting more stressed over it by the day. Spitz baths, heat and ice have provided no relief. Do you have a PT suggestion in SC and NC? Regards, Will

  29. I am a 35 year old male and started my pelvic pain battle 6 months ago. I have been cautious to not get trapped in the misdiagnosis loop. I have been to a urologist and my primary care doctor wants to refer me to a GI now. I told my doctor it’s not a plumbing issue. My symptoms are a match to PNE and I feel perfectly healthy. The only problem is the constant pain that I have been feeling. Sitting is by far the worse trigger. I feel the tightness in my pelvic muscles and have been trying to focus on staying relaxed. I have periods of good days where I feel almost normal and I go through days of great discomfort. I have no idea how to locate a PT around where I live in Central Wisconsin. If you have any referrals, I would be eternally gratefull. Thank you, Brady

    • Dear Brady,

      Below is info for a wonderful PT that we refer to in your state; however, as I am not familiar with WI I do not know if she is Central or not. For that reason I’ve also included all of the PTs who have taken our class that practice in your state. Best, Liz

      Hildenbrand Sherese OT Mequon WI 2622401202 cpwc@milwpc.com Continence and Pelvic Wellness Clinic

      Other PTs who have taken our class:

      Walz Colleen PT Onalaska WI 6087751840
      Bartelsen Beth PT Nashotah WI 2625696306
      LaBorde Linda PT Waukesha WI 4143020770

    • P.S. Brady it is a good sign that you have good days. This means your body is able to get to those low to no pain levels. This definitely bodes will for a a recovery with the right treatment.

  30. I am a healthy 50 year old man. The pain started about 1 months ago just a few days after passing a kidney stone. I have been dealing with sciatic type symptoms in my left leg, which is relieved by pirformis stretches and self massage with a tennis ball, for about a year. The PT I was seeing (for the sciatica)concentrated in stretches, abdominal and back strengthening exercise, and was apprehensive of manual therapy. The tingling in the thigh seem to spread to a feeling of having a rash in the groin to a moderate discomfort a feeling of sitting on a large pencil in the perineum about a few days of passing the kidney stone. The moderate pain seems to have gotten better but it still lingers. There are days were I avoid sitting for extended periods that the discomfort almost disappears. I saw a urologist this week who performed a DRE and indicated my prostate felt normal and was not sensitive to the touch, and UTI was not detected. Could the passing of the stone cause an irritation or swelling in the perineum that affected the pudendal nerve? Can it be related to the pirformis problem? Since the problem is very recent I hope it could be addressed before it becomes chronic or harder to treat. I live in Southwest Florida how do I find a PT with specific experience in this area to get an evaluation? I think most PT are afraid of hands on manual therapy, especially in this area. Do you have referrals in this area. Thank you manny

    • Dear Manny,

      Although I can’t tell you exactly what is the cause of your symptoms; I will say that it is possible that the passing of the kidney stone tipped you over into a pelvic floor issue whereby your pelvic floor muscles are likely involved. You need to see a pelvic floor PT because as you have already realized this is a highly specialized disorder that not even many physicians know how to treat. Below is a list of the PTs that we refer to in Florida. All my best, Liz

      Sher Tracy PT Altamonte Springs (close to Orlando) FL 4072571403 sherpelvic@gmail.com Florida Hospital

      Downey Pamela PT Miami FL (305) 666-3232

      Arango Ashley Orlando FL (407) 303-8280 Ashleyann83@gmail.com Florida Hospital Pelvic Health Rehab
      Marsh Katherine Orlando FL (407) 303-8280 Katherinemarsh@flhosp.org Florida Hospital Pelvic Health Rehab

  31. I am a 43 yr old male that up until August of last year spent a considerable amount of time on a motorcycle. It was actually one of my favorite things to do. During vacation on the bike I reached a point that I could not sit any longer, I was not sure I was going to be able to make the trip back. Since then I have seen my regular doc, and a urologist,they both said everything appeared OK. I did do a 3 week run of antibiotics just in case I had a prostate infection. I also did about 8 PT visits that I don’t know if it helped. I constantly feel like I am sitting on a golf ball and it is uncomfortable to sit/stand for any length of time. When I wake up in the morning I feel fine but as soon as I start moving around it starts all over again. Does this sound like something that your PT could correct? Can you recommend someone in the NW Indiana,Illinois area that can treat this? I don’t want to think about never being able to ride again.

    Jim

  32. Do you know a PT in the San Diego California area that you would recommend?
    You can send the information to my email address

    • Hi Daniel,

      Below is our recommendation for a therapist in San Diego. Also, we now have a clinic in Los Angeles.

      Cindy Furey, PT
      Comprehesive Therapy
      (858) 457-8419

      Best,

      Liz

    • Hello Mike,

      Yes we do! Their contact information is located below.

      Nelly Faghani, PT
      Prime Physiotherapy
      (416)725-7525

      Carolyn Vandyken, PT
      Physiotherapy Association of Cambridge
      (519)624-8798

      All my best,

      Stacey

  33. Thanks for the article, I’m in my mid 30’s one year ago I experienced a swift pain in my scrotum area while weightlifting. The pain was a dull pain that worsened when I sat down and was localized in the perineum and scrotum area. There was a noticeable “bulge” in the perineum area, but would typically only be noticeable with erections.

    After numerous CT scans, MRIs and visual inspections my sports doctor diagnosed me with a sports hernia and received double sports hernia surgery from a “leading expert” in sports hernia surgeries in May of 2013. Today the nagging pain persists and may have gotten worse.

    Have observed PNE symptoms to include scrotum vein discoloration and swelling? Do you recommend any PTs in Georgia?

    • Hello Joe,

      We recommend the following therapists in your area:

      Lone Howell, PT
      Auburn GA
      (770)995-5242
      lone_howell@msn.com
      Physiotherapy Associates Lawrenceville

      Jenny Hunt, PT
      Alphretta, GA
      (678) 819-8720
      provenance.rehab@gmail.com
      Provenance Rehabilitation of the Greater Atlanta Area

      They will be able to assess the symptoms that you have described.

      Regards,

      Stacey

  34. My 38yr old husband is in month three of this cycle of pelvic pain after an intense “cross fit” workout…main symptoms have been pain while sitting,esp.driving and problems with urination frequency, sore rectal area. The mental anguish has surely compounded the issue. We feel desperate for answers other than chronic prostatits. A PT for external therapy have some relief
    But hope we are on right track with this site. Any PTs in our area, Dayton Ohio or even Columbus or Cincinnati Ohio?

    • Dear Sarah,

      I’m so sorry to hear about what your husband is going through; below is a list of the PTs who have taken our class:

      Morris Michelle PT Perrysburg OH (419) 383-5040 mmorris83@ymail.com University of Toledo Medical Center
      Arbogast Hannah PT Kettering OH (937) 208-7055 hlarbogast@yahoo.com Miami Valley Hospital
      Dubbs Jill PT Rocky River OH 2162272610 Lakewood Hospital
      O’Dougherty Betsy PT Lakewood OH 2164458000 Cleveland Clinic

      All my best,
      Liz

    • I had it go away for like 4 months and then it is back again. It is the worst condition I have ever had to face in my life. Hernia repair surgery recovery pain doesn’t touch the pain I have had with this horrible condition.

  35. First of all I want to say that this blog is encouraging for people like us who had been struggling with this poorly understood condition.

    I’m only 26 and my main problem is pain after ejaculation (like two hours later). If I avoid sex or masturbation for a couple of days, the pain goes away and I can be pain free for many days until I ejaculate again.

    I refuse to think that I have chronic prostatitis because my urologist haven´t be able to find any pathological sign in my semen, urine or prostate. On the other side, I have always been a very tense person and I have noticed that I often tense my lower abdomen and my butt when I’m under stress. Do you think I can benefit from PT? My problem is that I live in Mexico and is hard to find a PT for pelvic pain here. Do you know any PT in Mexico?

    Thank you very much for being so committed to help people that were helpless and hopeless.

    • Hello Antonio,

      Unfortunately we do not have a therapist referral in Mexico. Given the description of your symptoms, pelvic PT may be a good treatment option for you. Please contact our office if you would like more information about our out of town program. (415) 440-7600.

      All my best,

      Liz

  36. Hallo Stephanie and Liz

    I was a avid cyclist that experienced perineal discomfort that come and goes.I do remember however after a particular race that it was like if i have hurt my perineum with a cut out saddle.
    I went to a urogolist and he treat me with antibiotics and after a 6 week rest it was better but i did however have discomfort when riding but not sitting on a normal chair.
    The urogologist told me that i can continue riding and dont have to stop cycling.About 15 months later i was diagnozed with testicular cancer and one testicel was removed and i received 2 treatments chemo(carboplatim)….It was a miracle how the cancer was detected.I underwent a drugtest after a cycling competion and have a raised hcg level that after a sonar was showing a tumor the size of a pea not older then 2 months.
    After the treatment my pain is worst and my doctor said that the chemo treatment has make the nerve worst.
    Now my pain started when i woke up in the morning and increase if i sit ,bend or pick up stuff.
    the pain is in my perineum ,sometimes srotum and penis.
    I already undergo internal anus massages 4 times but stop it.I have tried a lot of diffrent kind of medicine and are the moment on lyrica and welbutrin(antideprisant} we stop the anti inflamatorys.
    also received 1 painblock .
    My dr is sugesting that we implant a neorostimilator.
    What do you think my problem is?
    Kind regards
    Charles from South Africa

    • Dear Charles,

      I’m sorry about all that you are going through, but I’m sorry without evaluating you I can not answer your question. Please read the articles on the blog to get more information about pelvic pain and available treatments.

      Best,
      Liz

  37. I hope I found the right place for answers. Thank you so much for writing about Chronic Pelvic Pain in men. I live in Atlanta and cannot find Urologists that even think this exists. I will be in Ocala, FL. next week. If you have names of doctors in Atlanta and Ocala, FL., that would be great.

    My symptoms started as pain in the tip of my penis and warm, aching feeling after having intercourse. Then my symptoms turned to continuous achy, hot feeling in my entire groin area. Then I had symptoms where my penis feels like it is being pulled in and firm when in a flaccid state. It is freaking me out. I am an athletic person (49 yrs old), but very high stress and anxiety type person. Started PT this week and hope this will relieve the pain. My pereneum area (area from rectum to penis) is sore and very tight. That is the focus of the PT. I mostly want to know if there is something more serious going on or if there are better methods to get rid of the ache. Intercourse is now becoming scary, since I don’t know how I am going to feel afterward and I don’t know why my penis is getting this firm pulled in state when just sitting around. This firm state makes my penis look scary too. Not smooth, basically a lumpy look. Tough to explain, but scary for me to see. No pain in the penis now, just scary looking.

    I had been doing Kegels non stop a year ago and found myself doing it without thinking all day long. I have since stopped, but still feel like everything is all tensed up and no end in sight.

    • Hi John,

      These are very good questions to ask your current therapist. He/she will be able to answer more accurately, since he/she has examined your pelvic floor musculature. It may just be tightness in your muscles, and connective tissue that are creating your symptoms. Below are therapist recommendations near Atlanta.

      Regards,

      Allison

      Lone Howell, PT
      Physiotherapy Associates Lawrenceville
      Auburn, GA
      (770)995-5242

      Jenny Hunt, PT
      Alphretta, GA
      678-819-8720
      Provenance Rehabilitation of the Greater Atlanta Area
      provenance.rehab@gmail.com

  38. It is refreshing to read an article like this. As a man, I have felt very alienated with this condition. It started 7 months ago, after doing squats in the gym with bad technique, and then following it up with sitting in a very hard uncomfortable chair for several weeks, it created the perfect storm. After several weeks of tests and other things being ruled out I read some stuff on-line about PN/PNE and I knew it was me. I fortunately made the connection between sitting for long periods and worse pain. I avoided sitting (used a stand-up desk) and after a couple months the pain went away.

    Just recently (last month) the pain came back with a vengeance, starting with lower back pain, then the classic symptoms perineum pain, penis shooting pains, lower abdominal pain, and general pain in the groin area. It has gradually become worse and now it hurts when I sleep on my back. I think the trigger this time was using the Elliptical trainer. It was the only thing that I think could have triggered it. Please be careful people, I have read that they are bad for the hips and are an unnatural movement.

    I feel totally lost now, I have seen physios, osteopaths, doctors, chiropractors, but I feel like it is getting worse.

    Does anybody know a specialist who can help in the Calgary, Alberta area in Canada?

  39. Hello Stephanie and Liz

    I was fortunate enough to just discover your website and have been suffering from PNE for two years now. Could you recommend a PT that treats men in New Hampshire. Thanks in advance

    • Hi Phil,

      Alison Cody, PT is located in Nashua, NH. Her contact information is below. We are also excited to announce that PHRC will open an office in Boston, MA in early spring of next year! Please refer to our website in the coming months for more information.

      St. Joseph’s Hospital
      (603)598-2401

      Best,

      Liz

  40. Could you suggest a good PT for pelvic pain (chronic pelvic floor pain is my dx)in the Charleston WV area or within 50 mile radius

    • Hi Mark,

      We do not have any recommendations for a therapist in Charleston WV, nor for a therapist within a 50 mile radius. I can refer you to a therapist in Bridgeport, WV.

      Marnie Clemens, PT
      Bridgeport, WV
      (304) 842-6008
      Clemens Physical Therapy

      Best,

      Allison

  41. Hi, I’m dealing with constant discomfort in perineum/anus region for 5 months now alongside Sexual disfunction and urinary and bowel symptoms because of pelvic tension. I can literally feel the tension all day and i’m only in my beginning 20’s. Unfortunately I’m in Europe, do you have any other recommendations for a PT in europe besides Maria in the UK? I’m dutch, but always can travel for help.

    Second question i have is their a standard normal resting tone that is used by PT’s or is that different from one person to another. Its a bit confusing because i read over and over people saying their PT’s are saying that a tension level of 2-3 is normal but studies i read say there is no standardisation of a normal pelvic rest tension level, what’s your view about that?

    • Dear Wesley,

      We agree with the studies that say there is no standardisation of a normal pelvic rest tension level.

      As for PTs in Europe. We are familiar with Bill Taylor in Scotland; his info is Taylor Bill PT Edinburgh Scotland physiobil@btinternet.com Taylor Physiotherapy Sports Injury Clinic.

      Also below is the name of a PT we are familiar with in Ireland:
      Whelan Maeve PT Dublin IRE milltownphysioclinic@eircom.net Milltown Physiotherapy Clinic

      All my best,
      Stephanie

  42. Hi, thanks for taking questions. I am male, 55. i have always been slow to start urinating. and after a truck accident in 2000, it has slowly over several years, very difficult to initiate flow. i have seen 3 urologists over the last 2 years. the uros found i have a stretched bladder but had no explain for my pain i have when relaxing to start flow.
    after much work with 2 PT’s i can feel the spasm on my left side and the PT can feel it during internal work. ” the spasm is just below and to the left of the prostate”
    my question, what muscle would that probably be in that location?
    i can feel it myself if i insert my thumb in my anus as well, i can push on it and there is no sensation. my PT said she didnt think it was anything else other than spastic muscle.
    i personally think there was a spastic muscle there before the 2000 truck accident, probably back in childhood is when it got started. and i am now aware of a chronic pain in that area, i think most of my life i was ignoring it, avoiding it.
    and why isnt there more treatments with botox for something like this ? wouldnt botox atleast do the job temporarily?
    I understand it is available for women ?

    • Hi John,

      Botox is a good option for patient who are unable to tolerate internal manual therapy as is temporarily numbs the area. However since it is not actually curing the cause of the dysunction, botox is not always recommended. Without having evaluated you it is difficult to answer your other question, but your current therapist should be able to inform your which muscle is spasming.

      All my best,

      Malinda

  43. Finally the pieces have started to come together after so many years. I can not believe the difficulties I encountered to understand for myself and the doctors who finally have started to listen to this hellish experience.
    In 84 while in service I was a passenger in a head on collision. It left me with low back issues and my left leg compressed by a 1/2 inch. (X-rays showed leg bones same length). Then years later an unrelenting bacterial infection (I had to use military doctors whose care wasn’t that effective) that lasted for many years. The bacterial infection was from 91until 95. Then the non bacterial guesses started. Finally in 2011 a visit to Cleveland clinic got me in the right direction with these internal trigger point issues. Then back home Levator Ani was mentioned and I started sporadic treatments. Now 2014 puborectalis muscle involvement also what a mess. I am at least getting care for this nitemare. I am finally getting some relief and have good days with the bad. It was interesting getting the VAMC to accept this unconventional care and treatment but my fight opened the door for others now getting this same care.

  44. thanks for your articles regarding PN and PNE. I have been suffering for the past 5 weeks with pain and the “kicked in th e balls feeling” and I am currently looking for a pain doctor to help the initial aspect of living day to day. While I am going to try a nerve block, I would love to at least try PT to see if this can help. Can you recommend someone in Northern Virginia or Washington DC? Thanks.

  45. Hello. I am 45, live in Atlanta and have been dealing with testicular pain since mid-March. I cannot any one thing to what brought this on. I have been to 3 Urologists and 1 Pain Clinic, and I am getting nowhere. My wife found this site and forwarded it to me. A neighbor of mine was dealing with pelvic pain up until May, at which time he started going to a PT that specialized in treating men. He raves about how good he feels now, and he is pain free. His PT is names Lone, but her office is an hour from me. I was wondering, do you have a list of PT’s in the Atlanta area? I am very hopeful that this works, as my wife and I are in a downward spiral because of this pain. Thank you for what you are doing for this cause!!!

    • Dear Todd,

      Thank you for your comment. Below is the list of therapists we recommend in GA.

      Jenny HunT, PT Alphretta, GA (678)819-8720 Provenance Rehabilitation of the Greater Atlanta Area
      Blair Green, PT Atlanta, GA (770)500-3848 One on One Physical Therapy
      Kathleen Ellis, PT Leesburg, GA (229)669-8391 Phoebe Putney Memorial Hospital

      Best,

      Stacey

    • Todd,

      I lost my wife and son because of it. I tried to take my own life. The pain from this condition can be excruciating at times. I did PT the first time and it helped me eventually get pain free for about 4 months, but now it had returned again with some of the same problems as before. I’m afraid of losing my job because of it. It hurts when I sit down. Can’t get back into PT specialist for months. Good luck! Let me know if you find anything that works.

  46. I have all these symptoms! Would you please tell me if there is any PT in punta gorda florida area or sarasota,fl.? I’m seeing urologist and gastronologist currently. Much appreciated,ken

  47. First of all, thank you for a well written and informative article. I for one am glad to see some progress being made in this area. It seems men have issues with pelvic pain that go largely undiagnosed and untreated. I have lived with pelvic pain off and on for years, and quit mentioning it to any of my primary care physicians, because quite frankly, they don’t know what to do other than perform a quick DRE and say “Your prostate feels fine”.

    My symptoms have flared up again, which consist of a feeling like a knot or fullness in my lower rectum after a bowel movement, a feeling of warmth or soreness in my lower rectum/perineal area and some difficulty staying clean there after a bowel movement. These seem to have become a little more frequent as of late. Also have some occasional discomfort after intercourse. I am generally in good health, but do have a history of kidney stones and have had a lumbar diskectomy. I live in the Hampton Roads area of Virginia. Anyone here you might suggest that I can see in this area?

  48. I am sitting here crying after reading this because it completely describes all the pain and issues my husband has had for over a year now. As you say in the article and doctors w/ Rx’s. That’s exactly what happened. He went to a urologist, the did a prostate exam gave him pills and said bye. Then months later he went to another urologist and the same thing, then he went back they said well then try this one. He tried Flomax, Rapaflo and nothing. Finally we went to an acupuncturist hoping that maybe a different route would work. She has been wonderful as she has been researching and studying to try and help him. She is the one that sent us here. As after several sessions it was apparent that her work was only a temporary fix, and she didn’t want him to keep coming in for something that wasn’t going to help long term. It seems that the doctors today don’t want to take the time to diagnose, which is why she has impressed me so much. She cares about him. He has become so depressed constantly in pain, up several hours in the night time because he is unable to urinate, and so often he is able to get erections but unable to sustain them which then adds to the depression. I would love to be able to follow up and see if there is anyone in our area here that does this work? We are in the Las Vegas, NV area. Any assistance would be appreciated. Thank you.

    • Hello Chris,

      We are sorry to hear about your husband’s situation. Based on your description of his symptoms, I believe he may be a good candidate for pelvic physical therapy. Below is the list of therapists that we recommend in Las Vegas.

      Best,

      Liz

      Tina Baum, PT
      Tina Baum Physical Therapy
      (702) 877-2000

      Lindsay McGinn, PT
      Tina Baum Physical Therapy
      (702) 877-2000

  49. Hi, Thank you for providing this forum. Im so glad I found this! Im a 40 old male and I have been experiencing all the symptoms of PNE for 4-5 weeks after doing an intense whole body weightlifting workout including squats. Some of the key symptoms Im having are major perineum pain, constant testicle / scrotum heaviness, sporadic pulse / shock like sensations in scrotum, penis pain. , also it feels like something is being restricted to my penis. All worse when sitting!! Yesterday I self diagnosed myself with having PNE. This is after going to countless Drs including 3 Urologists , sports med dr, gp, etc. They all have no clue!!! They were saying it was psychological and I knew it wasnt. After all my research I feel the best treatment for me is Physical therapy by a PNE specialist. Do you recommend and PNE Physical therapists in the central NJ area ( Monmouth County ). Thank you so much in advance !!!! Im going to confirm my self diagnosis this week with a local Urologist that I found on the internet that is familiar with PNE

    • Hello Mark,

      welcome to our blog! Yes, I can provide several therapist recommendations in NJ. Their information is below.

      Best,

      Casie

      Michelle Dela Rosa,DPT
      Columbus, NJ
      (609) 379-0900

      Jamie Besante, PT
      Beachwood, NJ
      (609) 978-3110
      Southern Ocean Medical Center

  50. Please help me finding a pelvic pain therapist for men in maryland area. Thanks for ur help. I live in Rockville MD. I have had a dull ache in testicles and sharp pains in my penis for six months.

    I saw Restore Motion in a post above but they don’t accept insurance. Do you know of some PT areas that do accept insurance?

    • Hello Al,

      Below is the list of therapists we recommend in your area. Since we are not affiliated with other practices or therapists, we cannot verify their insurance policies.

      Best,

      Melinda

      Stacey Devine, PT
      Eldersburg, MD
      (410)404-4772
      Devine Intervention Physical Therapy

      Marci Marshall, PT
      Frederick, MD
      (301)698-9214
      Women’s Wellness Works

      Miriam Graham, PT
      Rockville, MD
      (301)881-9313
      Restore Motion

  51. Hello – my 23 year old son has Chronic Pelvic Pain syndrome which seems to come and go. So far he has not really met anyone who has helped a great deal — he has some relief from PT, but often has very severe spasm so that urinating and defecating are very painful — leading to hemorrhoids, more pain.
    Any suggestions for people to see, including urologists, and PTs, in Philadelphia? He is in school there.

    Thank you!

    • Hello Karen,

      I recommend Amy Rejba MSN, CRNP in Philadelphia. Her information is located below.

      Best,

      Allison

      Amy Rejba MSN, CRNP
      Pelvic and Sexual Health Institute
      (215)863-8100

  52. Hello, my name is Shane and I think I’ve been dealing with CPPS symptoms for about two months. Dull ache started in the left testicle and then moved to my tailbone/lower back. Urinary symptoms include mild burn and urinary frequency. Ive experienced a lot of gas and bloating during the last two months as well. Is that a common symptom? Ive been seeing a chiropractor recently, but hasn’t done much for the back pain. Seems to het worse when I feel constipated. Doctors have done multiple urine tests and tell me everythings fine. Xryas seem to give them a constipation diagnosis. Very confused whats causing all this….but nonetheless, i’ve recently tried to find a PT that specializes in Pelvic Pain in Michigan. Who would you recommend? Thanks!

  53. Having a flare up of pelvic pain
    Stomach pain, burning during voiding, penis pain, ache between legs
    All the usual symptoms
    Had success with a therapist a year and a half ago
    She has left the state
    Could you recommend a therapist in NJ?
    I live in Somerset (Central) NJ
    I heat or ice better
    Is rest better then exercise

    • I found a heat pack/heated up wheat bag best. I took it pretty easy and didn’t exercise much at all. internal Trigger point therapy worked a treat for me.

    • I didn’t see an answer for the exercising benefits or downfalls when we have pelvic pain. Is it better to rest or to be up and active, like light walking? I lost my wife and son because of this wretched curse and tried to take my own life.My wife constantly told me I was lying about it even after my official documented diagnoses.I almost lost my job too. I got better with some PT and time and then 4 months of improvements turned right back into pain again. The pain isn’t as bad is it was yet, but I’m afraid of how bad it can get. It happened after I decided to alleviate some sexual tension by taking care of myself.It’s been almost a year since I’ve been away from my wife. The first time, my pain was a good 9 out of 10 and unbearable. I couldn’t stop peeing every 2 minutes, I could not defecate without laxatives, I couldnt sleep because of the pain and nocturia. Now, it is about a 5 out of 10 without the nightly peeing and constant urination. Unfortunately, I can feel my defecation issues starting up again. I love how dismissive most doctors are to it. They don’t seem to give a $@!$. I am taking Lexapro for my depression and Ambien to help me sleep at night. I am so frustrated and scared about this coming back again. I really thought there was some serious hope for me and started pulling my life back together again after all my symptoms went away. Now, I just don’t feel so hopeful. I have to make another appointment with my urologist just so I can get back in to do my PT again. My urologist better not want to do anymore tests after it took forever and lots of money to diagnose it the first time. I,once again,will not go out and socialize anymore because it hurts to sit and I sit for 8 hours every day at work. I’m in pain by the time I get home. I did buy a theracane and A Headache in the Pelvis to try to do some self help until my PT visits, but I’m starting to feel pretty down lately. In addition, my mom and dad have fell ill recently too. My only family, my brother, lives 9 hours away. How do I go out and meet new people when all I can focus on is pain and trying to make myself take a $@!$ all the time? Honestly? Then no hope of a cure in the future because the medical community doesn’t really care about how many good people’s lives this is ruining.

      • Author Stephanie Prendergast says:

        I am sorry to hear of your trouble. You previously made improvements in physical therapy and you likely will again. It is important to stay hopeful and let your medical team help you find the right combination of therapies that will work for you. People are working daily to raise awareness in the medical community about pelvic pain but we can understand your frustration.

  54. Thanks for this informative post. I’ve been dealing with a condition for about 6 months that matches most of these accounts (misdiagnosis as prostatitis, antibiotics, etc), and recently I found a good PT in Chicago (not Rhonda Kotarinos) who has introduced me to trigger point PT which seems like the way to go. However, I live most of the year in Berlin, Germany, and only come back to Chicago for about a week every month or two, so not often enough for sustained treatment. Do you have anyone you refer people to in Berlin? Thanks!

  55. Hello…
    My 25 year old son has had excruciating pain in the tip of his penis for 15 months. We have been to the Rochester Mayo Clinic as well as 10 urologists trying to find a cure. All Ct scans, MRI’s blood tests etc etc come back negative. Is there a PT in the Hartford CT area you can recommend? He is so depressed he can barely make it to work.
    Thank you.

    • Hello Debra,

      I am sorry to hear about your son’s situation. We currently do not have a therapist recommendation for Connecticut, but I can recommend a few therapists that are about two hours away.

      Best,

      Alison Cody, PT
      St. Joseph’s Hospital
      Nashua NH
      (603)598-2401

      Niva Herzig MS,PT
      Core Dynamics PT
      Englewood NJ
      201-568-5060

      Jamie Besante, PT
      Southern Ocean Medical Center
      Beachwood, NJ
      (609) 978-3110

      Casie

    • You might try seeing Dr. Mark Conway in Nashua, NH.
      Dr. Conway is a gynecologist who also treats men for pudendal neuralgia. He will call to discuss prior to your sons visit.
      The nerve can be tested in his office and although the test is uncomfortable, it is nothing compared to the pain this nerve can generate.

      • Hi Kate,

        Yes Carl is correct, Dr. Mark Conway would also be a great resource for your husband. I’ve inlcuded his information below.

        All my best,

        Stacey

        Mark Conway, MD
        OB/GYN Associates of Southern NH at St. Joseph Hospital
        30 Daniel Webster Highway
        Suite 11
        Merrimack, NH 03054
        Phone: 603-883-3365

      • Hi Carl… Is pudendal neuralgia what my son may have? He has had nerve blocks administered by his pain clinic Dr which didn’t help. The next course of action we were told to take are Ketamine infusions and if those do not help then the nerve stimulator implant. My son does get relief when he is injected with lidocaine around the pelvic region. The pain is more than he take… His mental state is beginning to frighten me. If Dr Conway can help I will pack our bags and take up residence in Nashua.
        Thank you so much for your feedback.

        • It certainly wouldn’t hurt to rule it out before going to the implant. I have one implanted for very similar reasons, that the docs can think of no other way to help. While the implant did at first offer some improvement over time relief is not so pronounced as when first implanted.

          Call the number and speak with Julie. She’ll put a note to Dr. Conway who will call first if you are having to travel. Well worth the time to wait for his call but he will be in contact and should speak directly to the young man.

          Best wishes,
          -Carl

          • An additional word about stimulator implants.
            Having two of these implanted for different reasons, namely failed back surgery multiple times and going on 3 years of severe pelvic/genital nerve pain, it is to be considered the last resort. The doctors he sees will be frustrated by the inability to “cure” so will use the tools they have within their specialty.

            Until he’s seen and talked frankly with neurology, pain management and about any other specialist you can think of, taking the step of having a permanent implant would be imprudent. It is a long term commitment with discomforts of it’s own.

            Please understand that these have helped me to some degree but also that any surgery comes with a price and while all the docs can use for measurement is “What is your percent of improvement?”, that number moves around. 50 percent one day can be 10 on another day.

            Take care,
            -Carl

          • Carl..
            Is there an email address my son can contact you? It would do him a world of good to speak with someone who understands what he is going through.
            I do my best…. But I am emotionally involved so I may not be his best sounding board!
            Your advice has been very helpful. We have made the first step in contacting Dr. Conway. Right now on the schedule for a January 28 phone call. Now I understand what you meant about “worth the wait”!
            Thank you for your kindness.

          • Haha. Well you and my son definitely have that in common!
            I will pass your email along to my son.
            Thank you again for your kindness.
            Debbie

        • Hi Debra,

          My husband (who is 28 now but started having this trouble at 25) sounds very similar to your son. We’ve seen over 50 doctors, including a visit to Mayo Clinic and Cleveland clinic with all negative test results, he’s taken on a very scary mental state at times, is in intolerable pain, and feels like he has absolutely nowhere to turn.

          I’m responding because I see that you mentioned Ketamine, and I am curious if you tried this or who recommended it. This is sort of an off-the-wall thing we have been considering for my husband, but I’ve never met anyone else that has tried it for CPPS. So I was just curious on the details.

          Also I cannot stress enough – definitely give physical therapy a try. This got my husband from about a 9 to a 5 on the pain scale, which has been a godsend in our day to day lives. I would definitely recommend that you try that before any other form of surgery. If you are forced to travel to find a therapist, I can say that we went to the Cleveland Clinic in Ohio and they had a whole team of Physical Therapists who specialize in this, so between them all my husband was able to get in about 10 visits with different therapists from the same office in 2 weeks, and the progress he saw there was tremendous – enough to see for sure if therapy will be helpful, plus they took our insurance which was fantastic.

          Finally, having taken care of my husband through this for the past 3 years, I can only say I have been where you are and I am sorry for you as well; there are no words to describe how hard it is to watch a loved one go through this – hang in there!

  56. Hi everyone, I too have suffered badly from CPPS, mine hit me suddenly after doing a strenuous workout at the gym. It had been coming on for years I just didn’t recognise the symptoms, I had the MRIs and urologists checks, my early symptoms were burning after urination and straining on the toilet for No.2s. When it finally hit me properly it was debilitating, burning and incredible pain in my perineum, penis, testicles, sciatic pain and so on. My saviour was Jane Brownhill a physiotherapist in Melbourne Australia, this business is called Mens and Women Physiotherapy in Malvern. Im nearly fully recovered after 12 months now and now know what a tense pelvic floor feels like, so I have learnt to relax these muscles, my issue was chronic tensing of the pelvic floor muscles. Good Luck everyone, there are people out that can make a huge difference,

  57. Hi,

    I am having 2 symptoms:
    1.) Frequent urination and urge to urinate right after urination.
    2.) pain in pubic area at the base of penis.

    All my tests< CT scan for stones, Urine culture for infection, and cystoscopy for everything else came negative.

    Can you please comment on my situation. Are my symptoms consistent with pelvic pain and will PT help? And you please give some PT recommendations for Austin, TX area?

    Thank you very much for all the help.

  58. Like many other posters I have been treated by a Urologist for Prostatitus which never really goes away and the pain is getting more frequent and intense. Finally, they referred me to a Pelvic Floor PT within their group. I have not yet met with her for my initial session but her bio only mentions female pelvic floor rehab. I have searched the internet for other therapists with no success, can you recommend someone else in Western New York, near Buffalo

    • Hello Pete,

      Unfortunately, we do not have a therapist recommendation for Western NY. We can recommend therapists in Canada, and New York City. Their information is below.

      All my best,

      Stacey

      Carolyn Vandyken, PT
      Physiotherapy Association of Cambridge
      Cambridge, (Toronto) Ontario Canada
      (519)624-8798

      Stacey Futterman, PT
      Five Points Physical Therapy
      New York, NY
      212 226-2066

      Diana Kafka, DPT
      Beyond Basics Physical Therapy
      New York NY
      (212)354-2622

  59. Hi there. There was a poster requesting any referrals in the Somerset County NJ area but I didn’t see any reply to there post. I am looking for the same thing if you wouldn’t mind.

    I appreciate it.

    • Hello Ken,

      Sure, here are our recommendations for New Jersey.

      Best,

      Melinda

      Michelle Dela Rosa, DPT
      Connect Physical Therapy
      Columbus, NJ
      (609) 379-0900

      Angela Ryan, MD and Ely-Maskal Nancy, PTA
      Physical Medicine and Rehabilitation Center
      Englewood NJ
      (201) 567-2277

      Jamie Besante, PT
      Southern Ocean Medical Center
      Beachwood NJ
      (609) 978-3110

      • I found someone in the Somerset Nj area
        Raritan Bay has three facilitates
        The one I use is in Old Bridge
        The therapist I use is Nicole
        She is very good
        There is also one in Perth Amboy and Woodbridge
        Just call physical therapy
        I believe it]s called The Life Program

  60. Hi, I am a 28 year old in Los angeles who has been suffering with pelvic pain for almost two years now. I have tried most everything, including surgery when a doctor thought my pain was from a vericocele. Ive seen a lot of doctors, endured many uncomfortable procedures, and have spent a lot of money; so as you can imagine this whole thing has made me quite frustrated and depressed. I no longer am the outgoing active person I once was.

    I think it is time I try a Pelvic Floor PT. Do you have some recommendations for the LA area. A male therapist would be ideal for my own comfort level, but am open to other suggestions.

    Thanks!

    • Hello Jordan,

      Please contact our LA office for more information. Sarah will be able to assist you. (424) 293-2306

      All my best,

      Casie

    • Hello Sam,

      Our therapist recommendations are below:

      Niva Herzig, MS,PT Englewood NJ (201) 568-5060 Core Dynamics PT
      Jamie Besante, PT Beachwood NJ (609) 978-3110 Southern Ocean Medical Center
      Michelle Dela Rosa, DPT Columbus NJ (609) 379-0900
      Nancy Ely-Maskal, PTA Englewood NJ (201) 567-2277 Physical Medicine and Rehabilitation Center

      Best,

      Casie

    • Hi, you gave us the name of the PT in S. Nevada, and my husband has been on the waiting list to see her for over 6months as she is the only one in this area. As he is having more pain recently, I wanted to see if there is anything you can suggest for him to try to ease any of the pain while we wait to get into see someone.

      Lately he has been having more severe pain from the base of his scrotum back toward his rectum/anus.

      Any help would be appreciated.
      Thank you,

      • Hello Chris,

        Unfortunately, I cannot recommend treatment options without first evaluating your husband. However, I can offer you other therapist referrals. Are you able to travel elsewhere?

        Liz

          • However those are trips here and there. We could travel but I dont’ think there is anything somewhat close enough for regular treatments.

          • Hello Chris,

            Carl is correct, perhaps the local therapist can provide alternative options. Cindy Furey, PT is located in San Diego. Perhaps she can evaluate your husband and start treatment, as well as equip him with patient education tools, and a home program. Although your husband will still need a local therapist, Cindy may be able to coordinate your husband’s care. Also, our Los Angeles office has a specialized out of town program for patients. If this interests you, please contact us for more information (424) 293-2305. Below is Cindy Furey’s information.

            Cindy Furey, PT
            Comprehensive Therapy
            San Diego, CA
            (858) 457-8419

            Best,

            Liz

      • You might contact the therapist again and ask if they are working closely with any local pain management physicians. If so, perhaps the physician will be able to recommend appropriate intervention to slow the spread of painful areas and reduce intensity.

        All the best,
        -Carl

  61. I’m 34 years old, Married. Just bought a new home. And last January, the symptoms started. Frequent urination, burning during and after urination, dribbling after urination has been completed, a sensation that the bladder cannot be completely emptied, pain in the shaft of my penis, pain during or after sex. Took all the tests, STD, urine, PSA test, cystoscopy, CT scan, all of came up negative. I’m at a loss, and feeling hopeless, and severely depressed. My wife and family are worried about me. I’m certain that the next time I see my uroligist, diagnosis will be CPPS. Has anyone tried Elmiron to relieve bladder pain symptoms? I work at a call center, which most of the time I’m sitting down. The pain gets worse if I sit down for a long period of time. If physical therapy is the way to go, I’m willing to try. I live in Oshkosh, WI. Any around my area?

    • Hello Corey,

      Below are therapist recommendations in your area:

      Regards,

      Elizabeth

      Beth Bartelsen, PT
      ProHealth Care Musculoskeletal Institute
      Nashotah WI
      262-569-6306

      Debbie Callif, OT and Sherese Hildenbrand, OT
      Continence and Pelvic Wellness Clinic
      Mequon WI
      262-240-1202

      • Corey, It has been almost exactly one year since my first visit with Debbie Callif in Mequon WI. I strongly suggest talking with her. She has turned my life around. At age 34 I all of a sudden started to experience many of the same types of symptoms. I visited multiple doctors that all were trying to treat me for the wrong thing. After a year of dealing with it and getting depressed by hopelessness, I found help through this forum. It’s hard to believe all the crazy symptoms that are caused by minor issues in the pelvic muscles. I only visited Debbie 5 or 6 times. She helped me take control and showed me how to heal. It takes patience though! I am not 100% today all the time simply because I get lazy at times when I feel great. I do know how to resolve the problem though because of Debbie. I strongly suggest going the therapy route. You will soon find out drugs are not necessary to fix your problems. Best wishes to getting past this and fealing normal again. -Brady

    • I am having the same issues and am doing physical therapy. I just had my second session and can see a little improvement. It will be worthwhile
      4

  62. Hi, I am a dual citizen living in Australia. I have had chronic pain for 16 years ; it has destroyed my life in every way. I cant find anyone in Australia who knows anything; any assistance would be greatly appreciated. Please email me.

    • Hello Raymond,

      We recommend the following therapists:

      Alyssa Tait, PT
      Equilibria Health
      Brisbane Australia
      61 7 32770226

      Angela James, PT
      AJ Physio
      Bondi, South Wales Australia
      02 9369 4111

      Best,

      Liz

  63. Aprox 4 months ago I started to have testicle pain. Symptoms started after my ND diagnosed me with a bacterial infection. He said it was odd that the infection I had would cause this pain. I was treated for the infection. But symptoms still did not go away. I was then diagnosed with having s parasite. ND thought that I picked this up when I went on s tropical vacation 2 months before. I was treated for this and in 8 weeks the parasite was gone. However the pain in testicles remained. It is now 4 months and symptoms of pain are at the worst yet. I have gone from pain that runs down my grown to my testicles. To now where I can not sit very long. I try heat and ice to help me. But the pain is still there. I have withdrawn myself from my family as I am in constant pain.
    The treatments from my ND were 5 hour drive away and with the stress of not feeling well along with a death in the family and the family pet having surgery I think everything emotionally turned to just add the stress on me. My medical doctor had me do a testicular ultrasound which showed nothing. I have for years been told I have prostitus but my symptons do not match as I have no problems using the washroom, nor do I get up at night, etc. I am scheduled to see a urologist in 2 weeks but he wants me to do a rectal ultrasound.
    About 2 weeks ago I came across an article about pelvic floor dysfunction. The symptons they said I had most off. Constipation, straining in bowel movements, feeling of being able to empty bowel, painful sex and ejaculation, pain in genitals, etc. once I read this I called a local physiotherapy office. Which my daughter had just gone to for a shoulder problem to see if they had someone who did work with male pelvic floor and they do. Booked an appointment and see them in less then 2 days from this writing. But it has been just over 12 days since I booked it. Hoping that she can help me as I don’t want to take drugs to get through the day. I am being as positive as I can on everything but it is difficult. As my job calls for me to sit slot I am willing to listen and do everything the PT asks. Will follow up with everyone.

      • No. Just pain now between my penis and testicles. It came after having sex with my wife. I have had 4 treatments and seen benefits. I know I will have to have more to get over my last set back. Before that I was feeling great.

    • Hello Nathan,

      Marcy Crouch, DPT is located in Portland. Here is her information:

      Marcy Crouch, DPT
      OHSU
      808 SW Campus Dr, Portland, OR 97239
      (503) 418-4500

      Regards,

      Liz

  64. Hi. Ive been suffering from weird symptoms as listed below. Been to many urologist but no improvement. Could this be CPPS?
    1) larger overextended hanging flaccid penis
    2) inflammation low hanging of scrotum
    3) constant pain in pelvic, leg, abdomen. Worsens with erection
    4) **stuck erections at night that wont go down. Or semierections that wont go down causing severe muscle pains and cramps in leg, abdomen, sometines to shoulder hence havent had a 7 hour sleep for months now

    Have you heard anyone with CPPS with following symptoms?

    Any PT u recommend in Edmonton or Calgary Canada?
    Thanks

    • Hello John,

      Below are therapist recommendations for Edmonton and Calgary Canada:

      Kira Ellis, PT
      Calgary, Alberta Canada
      403-249-5253
      kira@lakeviewphysio.ca

      Alana Lazareck-Devlin, PT
      Calgary, Alberta Canada
      403-288-8877

      Safa Rahman, PT
      Calgary, Alberta Canada
      403-943-9900

      Sarah Kalinocka, PT and Dianna MacDonald, PT
      Edmonton, Alberta Canada
      780-735-4761

      Mary Wood, PT
      Edmonton, Alberta Canada
      780-443-4473

      Best,

      Liz

  65. Thanks for the good reading. I have been diagnosed with Chronic prostitits going on for the last 5 years. It flares up for months at a time then goes away of a couple of seeks only to return with a vengance. Sometimes there is a positive semen/prostate fluid culture and antibiotics used to clear it up in a week or so. Now, the cultures have come up clean and a DRE is totally normal. My next step is to go to the Dr. Wise submersion clinic in Sonoma. I would have booked a treatment session with one of your offices, but I just found your site today….My clinic starts tomorrow. But its good to know their are local options for future support.

    Now here is my question: I have been reading up on Trigger point injections. Does your network of therapists use this approach at all? The idea of identifying the trigger point and injecting it with a lidocane and or botox solution sounds like a good fix to at least get you on your feet. How wonderful would it be to walk out of an office pain free? It may not be a permanent solution, but it would reduce the pain/inflammation enough to get a leg up on permanent healing combined with PT.

    If Trigger point injections is ver boten talk around here I understand. Please feel free to respond via email as I would like to know more and have my life back. My wife, kids, dogs all miss me.

    Forgot to mention, I have had Ct scans, my bladder distended to check for IC, Direct injections into the prostrate (that was a waste of money) Ultrasound, every test for STD’s infections and fungal growth (candida?) etc. Stress is my trigger and I cant take pain meds due to regulations, plus…. Im allergic to NSAID’s. In other words…..I live in a hot bath some times just to have a few hours of no pain.

    • Hello Jamie,

      Physical Therapists cannot administer injections of any sort, but we do work internally to release trigger point and connective tissue restrictions. We find that some of our patients cannot tolerate treatment well, at which point alternative options such as botox injections are considered. Although it is not appropriate for all patients, we have found that botox injections can help increase a patient’s tolerance to therapy, thus improving their consistency, and overall success with treatment. However it is important to first receive an evaluation from a pelvic floor therapist before considering injections. Aside from not being a permanent fix, a therapist should first evaluate which muscle/tissue to inject, and if it is even necessary. Please contact our office if you are in the area, and would like to receive a second opinion.

      Regards,

      Rachel

  66. I have been suffering with pelvic pain which radiates to my lower back/anus/sides and tip of my penis, I have pain when pressing into my pelvic area especially if I am lying down, I try not to sit to much but this is almost impossible when you have to commute for 3 hrs and you have a desk job, the problem started after a large amount of stress and anxiety, I have had numerous tests with my urologist and he firmly believes this is chronic pelvic pain.I have had this for 4 yrs and sometimes it is unbearable, i am currently trying meditation and exercise but the last few days have been bad 🙁 . Please can you confirm if there is a PT located in the Houston area who I can contact. God Bless

    • Hello Jamie,

      I’m sorry to hear about your situation. Pelvic PT will be a good resource for you. Please see the list below; it is a list of PTs that took our course in TX. Perhaps one of them will be able to help you. Another resource is the Yahoo message group, Happy Pelvis: http://health.groups.yahoo.com/group/happypelvis/; perhaps one of the group’s members will be able to refer you to a PT.

      Nieves Alfredo MD Chattanooga TN 4234901136
      Kubic Melissa PT Chattanooga TN 4237788660
      Hathaway Lorien PT Plano TX (972) 579-8100
      Bobb Valerie PT Dallas TX (214) 820-1860
      Fournier Stephanie PT Irving TX (972) 579-8155
      Woerner Marie PT Fort Worth TX (817) 735-2100
      Sauder Sara PT Austin TX (512) 335-9300
      Brooks Heather PT Longview TX (903) 323-6573
      McNeely Cody PT Austin TX (512) 335-9300
      Anderson Amber PT Plano TX (225) 603-3796
      Dehne Pamela PT Austin TX (512) 231-5210
      Frits Sandra PT Irving TX (972) 412-4926
      Irizarry Stephanie PT Copell TX (972) 745-9060
      Parry Constance PT Dallas TX (214) 590-5813
      Dobinsky Angela PT Austin TX (512) 335-9300
      Francis Peggy NP San Antonio TX 2106144544
      Hakeem Fatima PT Sugar Land TX 7137996193
      Mire Charmaine OT Houston TX 2815888249
      Peters Angie PT Montgomery TX 7137996193
      Reardon Sara PT Dallas TX 2146452080
      Suire Robin PT Pearland TX 7137996193
      Bannister Tami PT Irving TX 9725798155
      Walker Carolyn PT Waco TX 2544055203
      Basler Colleen PT Austin TX (512) 219-5377
      Brinker Anna Dallas TX

      Best,

      Liz

  67. Hello, I have been living in hell for nearly two years. I have weird pain and discomfort around genital, Numbness, fatigue and sexual dysfunction. Done all multiple blood test in hospital, MRI scan and Prostate examination, abdominal Scan, Spinal CT, Pelvic MRI ALL NORMAL. Took antibiotics and inflammatory medicines to no avail. I became depressed and don’t know how to solve this out??? It seems like some kind of spasm/tension in this area with weakness and lack of blood circulation??? I don’t know what to say is crazy. Can you please help me in any way. please write me and tell me how you solved this out??
    Thanks and God bless

    • Hello Eamon,

      It is difficult to say without an evaluation, but there may be some pelvic floor tension associated with your symptoms. If that is the case, internal manual therapy would help to treat your symptoms. We have found that our patients greatly benefit from this type of treatment and are able to have significant improvement. Maria Elliot, PT is located in London, and would be a great resource for you. Please find her information below.

      http://www.simplywomenshealth.co.uk/

      Regards,

      Liz

  68. Hi,
    Today I arrived mentally and emotionally back to the conclusion that my life is impossible with these symptoms. I’m unable to live anything like an active life anymore, and my sense of self-worth is almost zero right now. Reading this article has given me a spark of hope again.

    Please, can you recommend anyone who specializes in this treatment in the Atlanta area? Thanks!

    -Paul

    • Hello Paul,

      We encourage you consult with a local pelvic floor therapist as soon as possible. He or she will also be able to connect you with additional mental and emotional providers. In the meantime, we also encourage you to look for support groups online or in your area. Understanding that you are not alone will help immensly in your recovery. Below are our therapist recommendations for Atlanta. We truly wish you the best in your recovery.

      Lone Howell, PT
      Physiotherapy Associates Lawrenceville
      Auburn GA
      (770) 995-5242

      Jenny Hunt, PT
      Provenance Rehabilitation of the Greater Atlanta Area
      Alphretta GA
      678-819-8720

      Kindly,

      Stephanie

      • Paul,

        I live in Atlanta and I have tried just about everything for my pelvic pain. I would be happy to talk to you about what is helping me. I have been to Jenny. She is pretty good, but there is a lot of work that we need to do each day on our own to get past this. My current key to success is stretching or Yoga, Myofacial release with a little ball the size of a lacrosse ball, learning to breathe correctly. I call literally feel the release of my pelvic muscles by breathing into my pelvic area. I am a high stress person. I am always clenching. Releasing the muscles and relaxing them will create success. I have literally researched and tried just about everything. Even some crazy things, like shocking the muscles in my thighs with electrical currents. I am open to share all.

        • John,

          Thank you for that information! I had actually considered at one point applying a low level electric current as well! Incredibly, I found a younger urologist who is aware of this in some way, and she referred me to a PT who knows about the things you describe above. She is doing what she can in our 30 minute sessions once a week, but it’s clear to me that some very interior muscles have been traumatized. I was in a meeting two weeks ago with someone and was shocked when suddenly I realized I was clenching my entire midsection as tightly as possible like a fist. You’re right about the need for personal work. Since I started these PT sessions, I am realizing it’s going to require at least two hours a day of self-work to make significant progress. I’m definitely open to hearing about anything with which you’ve had success.

  69. Hi Paul,
    I’ve been dealing with this problem for over three years now, but began having success beginning last year with pelvic floor PT and this year with decompression and injections.
    Along with pelvic therapy, you might want to contact the doctor below as he does pudendal nerve blocks and testing.

    M. Dave Redmond, M.D.
    Physiatrist, Fellowship in EMG/NCS
    Midlands Orthopaedics, P.A.
    1910 Blanding Street
    Columbia, SC 29223
    803-256-4107
    or

    If you would like to speak with me about the path I and others I speak with have take, comment with your email address.

    Best wishes,
    -Carl

  70. Hi,

    I am 23 years old and have been battling with CPPS for 3.5 years. My original symptoms were urinary urgency and frequency, supra pubic pain/pressure, and burning when urinating. Symptoms now are rectal pain (golf ball), perineal pain, and difficulty sitting. I originally sought help from two urologists and a GI doctor who prescribed antibiotics even with no presence of bacteria. I have had a cystoscopy, an MRI, CT Scan which all showed no signs of infection or pathogen. I have tried flexeril, tryciclic antidepressant (elavil?), and flomax. None of which have provided relief. I have seen two physical therapists who seemed overwhelmed with my symptoms and were not able to help me.

    I echo the sentiment of the other posters. I believe the true suffering in this condition is the state of mind where it seems as though no one can help you.

    I recently started a new job in Chicago. Would you be able to recommend anyone in the Chicago area who specializes in mail pelvic pain?

    Thanks,
    Paul

    • Hello Paul,

      I’m sorry to hear about your situation. Yes! Kotarinos Physical Therapy is located in Chicago, and anyone of their pelvic floor specialists would be able to assist you. Below is their information:

      Kotarinos Physical Therapy
      1 Trans Am Plaza Dr #170, Oakbrook Terrace, IL 60181
      (630) 620-0232

      Best,

      Liz

  71. Hello, i am happy to find this website. I developed “prostatitis” at 25. I was working out a lot and was sitting for hours at a time at work. Usual doctor visits, antibiotics, and supplements i tried to no avail. I had golf ball syndrome, E.D, urinary problems etc. Over a course of about 7 years the pain went away, along with most of the symptoms. My erections came back but were never quite the same. I was ok for about 10 years, with only minor problems here and there until last week. Another 6 months of lifting weights and boxing and it’s back. I was saddened when i looked on the internet that almost 10 years later no real advancements have been made! Really??

    I saw your website, did some reading and found pelvic floor drops on a Youtube video.I could feel relief right away when doing them. I was shocked to find as soon as i stopped that i could feel the muscles clench violently! That’s all it took to convince me that this is what’s going on. . I have done the pelvic drops for about 4 days and the tightness is already starting to subside.

    Aside from asking you if you can recommend someone in the Cincinnati area i would like to know a couple of things. Why did my symptoms for the most part just disappear for so long without treatment? And two, is it likely the weights and exercise that is causing the problem? I really appreciate what you are doing here, it is a true godsend.

    Thanks,
    Andrew

    • Hello Andrew,

      I’m glad to hear that you’re finding some relief with the pelvic floor drops! Are you able to travel? We do not have a therapist recommendation located in the Cincinnati area at this time.

      All my best,

      Liz

        • Hello Andrew,

          Kotarinos Physical Therapy is located in Chicago, and anyone of their pelvic floor specialists would be able to assist you. This is the closest referral to you at this time. Below is their information:

          Kotarinos Physical Therapy
          1 Trans Am Plaza Dr #170, Oakbrook Terrace, IL 60181
          (630) 620-0232

          Best,

          Liz

    • Hello Nathaniel,

      Yes! There are a couple great providers that are located in Dallas. Below is their information:

      UTSW Medical Center
      Sara Reardon, PT
      Dallas TX
      214-645-2080

      Baylor Landry
      Valerie Bobb, PT
      Dallas TX
      (214) 820-1860

      Best,
      Liz

  72. Hello, thanks for your article. I’m 31 years old and have been dealing with prostatitis for 2 months now. It all started after a long road trip at the end of summer, but I have also suffered from SI joint dysfunction and Coccyx pain in the past. I’m not sure if that may have contributed to it. I have the feeling of sitting on a golf ball, pain to the groin and perineum which I can replicate when touching the muscles, and a cramping discomfort immediately after and sometimes with ejaculation in those painful areas. I think I could greatly benefit from Pelvic Floor Therapy. Are there any providers you could recommend in San Antonio, Tx? Thanks.

    • Hello Chris,

      It is difficult to be sure without first evaluating you, but from the description of your symptoms pelvic physical therapy may be a good resource for you. Below are local therapist recommendations near you:

      Colleen Basler, PT Austin TX (512) 219-5377 PT Specialty Clinic

      Carolyn Walker, PT Waco TX 2544055203 Premiere Physical Therapy

      Regards,

      Liz

  73. Hi, I live in Vancouver Canada and from what Ive seen, no one really knows about internal trigger point therapy. Do you know anyone near Vancouver who may be able to help? Also any tips on doing these massages myself? I read that using a wand to massage can be good.

  74. Hi. First of all thank you so much for posting this blog and replying to everyone, it means so much to those that are suffering.

    I’m just looking for some advice. About a year ago, I had a uti/prostate infection that was quickly eradicated with antibiotics. My symptoms were horrible penis burning/stinging, discharge, burning with urination. These all went away when I took the antibiotics. Four days later, the pain came back totally in my penis, and has been there constantly, without a single moment of disappearance for about a year, and no other symptoms really.Just some right leg burning pain and some urinary hesitancy. The pain in my penis is a burning/stinging with the skin being hypersensitive to touch– it rubbing against my underwear causes me considerable pain. I’ve been tested over and over– no infections, every test is negative. My prostate appears normal, so my urologist doesn’t think this is the problem.

    One dr thought that this might be pudendal neuralgia due to spasm of the perineal wall muscles following the initial trauma of the infection. My question is can these muscles spasm and remain there for such a long period of time constricting the pudendal nerve causing the constant (hopefully not permanent pain)? I masturbate just about every day, because this is the only relief I get from this tortuous pain. Should I stop doing that to give the muscles a chance to relax??

    I have been receiving physical therapy for the last 2 months and felt maybe 20% improved after a month, but I think this might have been more placebo effect than anything. Lately it hasn’t helped me at all Id say.

    The treatment consists of a daily regime of stretches (3x daily), and sessions of PT are her doing inner trigger point release, followed by exterior muscle release. She said that my hip flexors are weak and this is probably creating undue stress on my pelvic floor, so I’m doing some minor strengthening for them with an IT band. Is this what you what consider proper PT? I have no idea really so any advice would be sooo much appreciated.

    Sorry for the super long post–Thank you so much for your time.

  75. I have been to a Pain Clinic where there diagnosed me with a Pelvic floor
    problem. They did not feel a severe assault by a bully to my perineum area by kicking could become a problem many years later. They did do an exam.
    I am wondering if the scar tissue from the assault could have caused a
    PNE. I experience the pain as an aching internally in the perineum area.
    Have had this pain since 1990. Tried nerve blocks twice at another Pain
    Clinic that did not provide any lasting relief. Even had the investigation done through the uretha, twice. No blockage or problems. Would Botox
    injections help possibly? I am a 64 year old male in Vancouvet, BC, Canada. Can you recommend any specialists here in Vancouvet who could help? Is the scar tissue causing PNE possibly?

    My pelvic pain started out as sharp pains of short duration( a few seconds)
    but has grown into a constant ache for many years. Has affected my life severely, ie career, relationship, mental health and so on. So far, no one
    seems to be giving me any help. Read A headache in the Pelvis but I really
    think my problem originates due to the violent assault at ten years of age.
    I was in extreme pain for three weeks at that time. Finally, I asked my folks
    to send me to a GP who said he could not do anything. He did say I would
    likely have difficulty with it later in life. The pain started while driving home
    after stressful day. Please help as per my last message.

    • Hello Richard,

      I am sorry to hear about your situation and past experiences. We have several pelvic floor therapist recommendations in your area. We encourage you to contact them for a second opinion:

      Sabourin Johanne PT Coquitlam, British Columbia Canada 604-475-0522
      Nerreter Tamarah PT South Surrey, British Columbia Canada 604-475-0522

      Regards,

      Liz

      • Do you have a recommendation for a PT for male pelvic pain in Washington, DC or in Baltimore/Annapolis, MD, I’m a long time sufferer.

        Ed

        • Hello Ed,

          Below are the therapists we recommend in your area:

          Devine Stacey PT Eldersburg MD (410) 404-4772 Devine Intervention Physical Therapy

          Marshall Marci PT Frederick MD (301)698-9214 Women’s Wellness Works
          Stack-Sides Christie PT Annapolis MD 3018073931
          Graham Miriam PT Rockville MD (301) 881-9313 Restore Motion
          Ortiz Jennifer PT Columbia MD (443)283-2018 Her Health Physical Therapy
          Reinhardt Melissa PT Columbia MD (443)283-2018 Her Health Physical Therapy

          Best,

          Elizabeth

  76. Hey. So I’m a little worried. I’m 21 male.
    So for the last three days I’ve had pretty bad pelvic pain, i woke up to it the day after having sex. I’m pretty sure it was the sex that triggered it, but it doesn’t really make sense because I’ve had sex way more often and way harder before without anything like this resulting.
    A few years ago I got a partial Hernia from lifting to much at work. This honestly feels similar,,, not nearly as painful, but a bigger area. And the pain is lower. Like directly around the penis.
    Could I have pulled something? How long should I wait for the pain to just go away before I talk to someone. And if I do need to talk to a doctor or specialist, is there any one recommended in Alaska?
    I’m just worried because I do NOT want to live with this for years.

  77. My pain started 6 months ago after getting an STD (NGU) from oral sex. I took all of the antibiotics prescribed from doctor and most pain during urination and itching went away. Now, I have constant pain/burning at tip of penis and pain in right side of groin where the lymph nodes are (they were throbbing for the first 6 weeks after getting STD). Pain is not as bad in the morning and gets worse through the day… pain gets worse when sitting on plane or in car for long periods of time. Also, my urethra is inflamed randomly throughout the day but other times looks normal. I’ve been to two urologists and both were clueless, tried alpha blockers but no luck. I’m taking daily ibuprofen for the pain and vicodin when it’s really bad. 30 year old male.

    Would I be a good candidate for this? If so, can you please recommend a PT to visit in Charleston, SC (also willing to travel to Columbia, SC or Jacksonville, FL if needed). Thanks.

    • Hello Chad,

      It is difficult to know for certain as I have not evaluated you, but given the description of your symptoms, I do believe that internal manual therapy would be a valuable resource for you. We do not have a therapist recommendation for Charleston, Columbia, or Jacksonville, but I can recommend two wonderful therapists in Greenville, SC. Here is their information:

      Powley Jessica Greenville SC (864) 454-0952 Proaxis Therapy
      Sires Jenna Greenville SC (803) 979-5646 Proaxis Therapy

      All my best,

      Elizabeth

  78. I have been dealing with constant urethral (tip of penis) pain for 15 months. Do you have any recommendations for PTs located in downtown Toronto who might be able to assist?

    • Hello Will,

      Below is a therapist we recommend:

      Vandyken Carolyn PT
      Cambridge, (Toronto) Ontario
      Canada (519)624-8798
      Physiotherapy Association of Cambridge

      Best,

      Elizabeth

  79. I’ve been dealing with scrotum pain and pelvic pain for 5 yrs. I gone and had two surgeries which were neurolysis of the spermatic cord and also had the nerves on the left side frozen; which I’m currently recovering from.

    I don’t have insurance as it has ran out and unfortunately I’m currently not working due to the amount of pain I’m in while sitting or standing.

    I live in the Orlando, FL area and I’ve researched do much only to find dead ends. This has mentally, physically and emotionally worn me out yo the point where I’m extremely depressed and been down a hard, narrow and dark path I don’t want to be in.

    Any help..anything would be greatfully appreciated. I’m trying to find some one who is willing to take me under their wing (pro bono) and truly help give back the life I once had or a better one.

    Thank you!

  80. Liz/Stephanie,

    After reading the article I think I might have this PNE. I’ve been to several doctors over the past 11 months (Primary care provider, neurologist, urologist, etc) and have yet to be given an answer. My only symptom is that the head of my penis is numb and now recently the shaft. I have no other pain. Does this sound like my pelvic floor could be a problem?

    If so, I have the contact info of Kotarinos Physical Therapy in Chicago and will set up an appointment. Hope this is it since I am extremely frustrated and upset.

    • Hello Ricardo,

      We encourage you to contact Kotarinos PT in order to fully understand the causes of your numbness. Not only are they wonderfully skilled, but an evaluation is also imperative before any medical advice can, or should be recommended. We apologize for the delay in our response!

      Wishing you the very best,

      Elizabeth

  81. hello
    I had a single episode of hematuria recently and was diagonised with nothing but with a chance of stone passed out..however i was experiencing discomfort in pelvic region and specially in perinium region..feeling of something flowing,vibration and heavyness. After hematuria the pain has reduced noticebly but still its bothering me and sometimes its as same as before. My level of comfort and confidence has reduced and its directly hampering my life. Do you have any recommendation for me? thankyou

  82. Thanks for the article. I am finding it difficult to get appropriate diagnosis here in the UK – do you have any suggestions? I’ll try to be brief.
    Male, 45. Always been reasonably fit, played lots of golf especially.
    In my mid-30s, I had lower back issues, inc. sciatica and scoliosis. An MRI diagnosed a dehydrated disk in my lower back (L3), and I was informed my back/spine was quite long, putting a lot of strain on my lower back. I gave up golf, took up hiking, did some Pilates, and took a lot more care in terms of posture. The problems went away apart from occasional stiff back, all fine, and I have remained very active.
    More recently, three years ago I had a fall off a sledge, nothing major, but the next morning I urinated blood. I had all the checks from a Urologist, all fine.
    February 2015, I was on a mountaineering trip, and returned with sharp pains in both hips and across the pubic bone area – I did have a small fall of a metre or so, and ‘jolted’ my whole body on a rope.
    And that was where things started – the pains in my hips went after a couple of days, to be replaced by a really uncomfortable feeling when sitting – in the perineum area, sort of behind the scrotum. Never excruciating, just very uncomfortable, especially when driving. But no pain when standing, no erectile or urinary issues.
    My doctor sent me to a Urologist, who did all the checks and gave me the all-clear. Tried antibiotics, no luck. He found a very small ‘calcified lesion) tucked away behind the scrotum, said it was probably not the cause of the pain, but a simple operation would remove it. I agreed, as no other option was on offer.
    The ‘simple 10mins operation’ took 40mins+ (under general anaesthetic), and it was 7 weeks before the wound healed /stopped weeping.
    That was in August.
    So, since the operation, the original symptoms (mild to medium pain when sitting) are still there, plus a whole extra layer of discomfort – the perineum area is very sensitive, walking feels like the whole area is chafing, I have to sleep with a pillow between my knees. Paracetomol/Ibuprofen have no effect.
    I have, of course, been back to see the Urologist, and my doctor, and have tried Tramadol (works, but the side effects are too much), and now Amitriptyline.
    I am in a ‘Pain Management’ scheme with the NHS, but despite several direct requests to get ‘root cause’ diagnosis, both the Urologist and doctor have stated I have Chronic Pelvic Pain Syndrome, and they can only refer me to pain management!!!
    I am sure I need to be seeing a back specialist, or a pelvic physio – based on what I have described, what ‘treatment’ should I be asking for/demanding?
    Regards
    Andy

    • Hello Andy,

      I apologize for the delayed response. We have received a high volume of inquiries, and have been unable to attend to them in a timely manner. You are correct, physical therapy may be the most appropriate treatment for you. This will address any muscular impairments that may be present. We recommend that you consult with Maria Elliot, PT. Below is her inforamtion:

      http://www.simplywomenshealth.co.uk/

      All my best,

      Stephanie

  83. Dear Liz,
    I’ve been suffering with pelvic pain for 9 years. I was a weekend warrior working out 3-4 days a week at three hours a stretch. Workouts comprised of spinning for an hour, heavy weight lifting for an hour and laps in the pool for an hour. When not in the gym I’d be found on roller blades for at least an hour to two hours a few days a week.

    That all came to a screeching halt in November of 2005.
    Came home, picked up my wife off the floor in a twisting motion and felt as though I got stabbed in my lower left abdomen. The pain lingered there for a few days. It was a nagging constant pain that was worse while sitting. After three days I came up with the notion that maybe if I go for a run this kink will resolve itself.

    Worst mistake I ever made. After a six block sprint the pain traveled from the original location to my left testicle. It was a searing, burning pain. After three days it traveled to the right testicle and for years and years it took its toll and destroyed everything about who I am. I saw a PT that specialized in pelvic floor therapy in 2008. She did internal massage but no referred pain or easing of symptoms occured. After the full course of PT nothing changed.

    However, I did see a chiropracter that was masssaging my lower oblique muscles along my belt line. I believe this to be where the illiohypgastric nerve passes and found relief for about 10 days. At day 10 I cleaned my apartment and went back to baseline the following day.

    Any physcial activity involving my lower abdomen increases the pain whether it’s cleaning my house, going to the beach which involves use of my core including twisting, turning movements and swimming. Intercourse is also a problem. I believe the lower abdomina muscles after orgasm are contracted illiciting pain 8-16 hours later. It woud seem any activity involving my core is exacerbated 8-16 hours later (next day) and is always worse in the morning.

    After getting a neurography done it showed that all of my pelvic nerves are hyper intense; inguinal, genital-femoral, illohypogastric.

    I’m either a trigger point infested mess or I’m thinking I may have external oblique apeneurosis nerve entrapement or some other lowerabdominal wall related issue referring pain to my groin. It waxes and wanes when not physically active and even swtiches sides based on posture either sitting or standing.

    Over time the level of pain has dropped in intensity but will always spike during any physical activity which has rendered me to taking walks so apart from walking I went from being very physically active to being sedentary.

    I’ve been to scores of doctors.
    The majority of urologists can’t find anything wrong with me.
    I had a bilateral inguinal hernia surgery in 2009. Didn’t make things better or worse. I even went as far as having a cocktail of antibiotics and steroids injected into my prostate with no effect.

    I’m basically at my wits end and don’t know what to do anymore. If you think you might have an idea what is going on with me please, please reply. I can’t take this anymore.

    • Hi Guy,

      I am sorry to hear of your trouble. With proper management these issues can improve, it sounds like you have not found the right combination of therapies yet for you. We recommend finding a pelvic floor physical therapist with a particular interest in pelvic pain in your area.

  84. I live in Cleveland, Ohio.
    For about 4 months I have been having pain in lower right side. Saw a surgeon who said I had hernia and would require surgery. My Gp was not convinced and asked me to take a ct of pelvis and abdomen. The ct was clear and no sign of hernia. At about the same time I started having a slight burning pain in the penis.. At this time I took my annual psa test and was shocked to see it jump from 1.2 to 7.3. A second psa was even higher at 24. I was told this sudden elevation was not caused by prostrate cancer but by inflammation or prostatis. I am now taking cipro for 21 days after which I have to re take the psa. I am hoping that comes down to normal levels. In the meanwhile the pain in the pelvis and groin continues. This has been extremely stressful. What would you recommend ? Thank you.

  85. Hi,

    I’m a 25 year old male who has been dealing with symptoms of pudendal neuralgia/pelvic floor dysfunction (can’t sit, increased pain with a certain exercises, incomplete voiding and burning/tingling) for about 18 months now. It took 7 physicians and 4 physical therapists before I found a physical therapist who specializes in pelvic floor therapy. Prior to seeing her my symptoms were irritating but manageable through lifestyle changes/pharmacotherapy. However since November when I tried to completely eliminate sitting other than driving and my symptoms became work/school ending. I started to notice an increase in the itching/burning/tightness throughout the perineum (was localized to the ischial tuberosity before) and eventually it started shooting sharp burning pains into my hamstrings/adductors as I tried to grind it out. Since starting physical therapy 4 weeks ago I have noticed slight improvement but still wake up with the “tightness” that progresses to severe burning in the areas I mentioned above unless I lay down. Now after stretching/yoga I’m stuck at home. Initially tendonitis was the diagnosis but two MRI’s and failing physical therapy made it less likely. Is the obturator nerve sometimes involved in pelvic floor injuries leading to the tightness in the hamstrings/adductors? This symptom has everyone stumped and no one in the area knows where to go from here. I’m currently a pharmacy student trying to finish up my last year of school between Wausau and Madison, Wisconsin. Is there anyone at the University of Wisconsin Hospital and Clinics (physicians/physical therapists) who are well versed in this area?

    Thank you so much for your help and posting success stories!

    Nick

  86. For me all started with a presumed Herpes Genitalis infection that was probably superposed by other bacterial infections. There was this throbbing pain in my penis glans that I couldn’t handle, that just persisted. I took antibiotics against it to no avail. Then my girlfriend had the idea to put a hot warming flask on my perineum. That stopped the pain temporarily so I fell asleep a few nights with the warming flask between my leg. Unfortunately, since then I have numbness in my penis area and constant pain and numbness in my testicles. Which regimen would you recommend to get healthy again? I am living in germany.

  87. Hi,
    I have had multiple years of pain and some dysfunction. Stretching has reduced some pain. I went back to my urologist after 3 years and he suggested trigger point injections consisting of sodium bicarbonate, lidocaine and bupivicaine in the trigger points on the pelvic floor. After a few days, my pain is actually much worse and I am concerned because I am reading that sodium bicarbonate may cause cellular necrosis or damage if injected outside the vein. I have less feeling in my penis. I am concerned that since the pudendal nerve is blocked during the injections, something may have happened. However, the procedure was done at a very well recognized medical center by a specialist.
    What is your experience with trigger point injections? Does it hurt but help? Or is it not supposed to hurt? I could not sit today due to the pain. I intend to call the doctor on Monday but would be appreciative if you could share your experience with trigger point injections — I have no frame of reference and am up late worried about whether this is how this is supposed to feel.
    Thanks for any response.

    • Author, Stephanie Prendergast says:

      I am sorry to hear of your trouble. It is not uncommon to have a transient increase in your symptoms after trigger point injections because a needle is being introduced into a painful muscle. The goal is to eliminate the trigger point with the injection but that does not always happen on the first try. The pain from the injection should settle down in roughly one week. It is unlikely the sodium bicarbonate is causing the symptoms. It is a good idea to discuss your concerns with your physician as you suggested, he or she will be best able to answer your questions.

  88. Hi, I am a 42-year old male in Ottawa Canada who has been suffering from chronic pelvic pain for almost half a year now. I got an early warning sign in late July 2015 when I travelled to Brazil, I got a bout of IBS just before travelling – the loose kind – but upon arrival on July 26, I was constipated for 2 days straight with awful cramping pain (but no groin pain, yet). And no, I never suffered a traumatic injury or had surgery. I did bike a lot though.

    The IBS ended in late Aug, but the groin numbness persisted until Oct. 10, when it turned to horrible pain. At first it was pure hell, like somebody was grinding glass around my urethra and in my rectum, and as if my pelvis was being immersed in hot water. I’d sometimes get these electric shock sensations in the worst places. The worst was that it affected my mobility, as I couldn’t tolerate any clothing rubbing on the end of my penis, so walking and going up/down stairs and other such basic manoeuvres that I took for granted had been adversely affected. It’s improved greatly from taking Lyrica in the past week, albeit symptomatically. In Nov. 2015 I saw one of the foremost authorities on prostatitis and urological disorders (based in Kingston, Ontario – Dr. J. Curtis Nickel) who diagnosed me with bordering bacterial prostatitis and type IIIa inflammatory prostatitis, putting me on a course of Terazosin and Levofloxacin – the latter appeared to do nothing – but I gained back about 75% sexual function which was absent for the past few months. Then that vanished in Feb. 2016. No discernible pain relief from that course, other than the Elavil my GP put me on.

    My urinary issues were mild upon the full-blown pain, and have disappeared. Today, in March 2016, the electric shock and stabbing sensations have all but gone, but there’s still mild burning, and pins and needles at the end of my groin, with sexual feeling gone. I have been seeing Andrea Plitz, PT, who is really good at pelvic floor therapy; I would recommend her to anyone in the Ottawa area. Due to her techniques I no longer have the stabbing / shock pain, but have just relied on external technique; the internal technique made me squeamish and uneasy making me tense up (defeating the purpose of calming pelvic nerves!) but I’m willing to give it another go.

    I apologize for the long-winded story, but maybe you’ve got further insights on this, or someone can relate to it. I can only hope that I can get back to the man I was last year, but that may be wishful thinking.

    Jason

  89. Hi,

    38 year old, in the UK here. Been experiencing symptoms of pelvic pain and dysfunction for three years. Pain isn’t a main symptom (thankfully) other than discomfort in the perineum but urinary symptoms are really disconcerting. Frequency, hesitancy, urgency – the lot!
    Is there a good therapist based in the south of England??

    Seb.

  90. I am 45 yo male with relapsing remitting multiple sclerosis since 2002, issues with limb spasticty/stiffness, and neurogenic bladder with detrusor-sphincter dysnergia (DSD).

    A few months back I experienced some minor perineal pain after orgasm, a few times but did not pay much attention as dull pain that was minor and resolved in a few hours. Did nt experience symptoms again until this most recent weekend:

    I have had post micturition dribble for at least a couple years. Recently read that kegels can help this and was overzealous in doing these – for a few days I did pulsed and sustained kegels every time I voided. Had an orgasm after a few days of this training and had perineal pain that was acute all night and still hurts a few days later (now). I have obviously stopped the kegels after reading your article
    http://www.pelvicpainrehab.com/pelvic-pain/507/why-kegels-are-bad-for-your-pelvic-floor/

    I hope this puts me in better shape. I am seeing my PCP for prostate exam, etc, and discuss this issue.

    Do you think kegels caused my pain?
    I have read some research that DSD, autoimmune issues,spasticity can all contribute to pelvic floor issues.
    Have you seen this in your practice?Have you treated many patients with MS with these issues?
    Should I set up appt to see pelvic floor PT at this point?
    Do you recommend book/system A Headache in the Pelvis by Wise? Frankly I am bit concerned re insurance coverage and paying to see pelvic floor PT if I can start doing some of techniques in home, myself.

    Thank you,
    Jon

  91. My name is Phil. As I write this, I’m in extreme pain. Four years ago the symptoms started and have continued to get worse. My pain is always at the base of the penis and on each side of my testicles. I’m losing hope that anyone can find and treat my problem. I have seen over 15 doctors without any improvement. Can anyone recommend a doctor and therapist near St Louis, MO? I checked the listings provided on numerous post and don’t see anyone in St Louis. I would be so thankful for any recommendations. Thank you.

    • Hi John,

      Please call our Berkeley office at (510) 922-9836 or our San Francisco office at (415) 440-7600 and we would be happy to schedule you.

      Regards,

      Kristin

  92. Hi there thanks for this post, I’m a competitive sportsman. I was playing a tennis tournament in Jan 2016 and tore what felt like my right groin…high up across pubic area…I rested etc.. then when pain cleared tried to run again and after the run i could not get out of bed the next day. The pain shoots across abdomen and sometimes cramps deep in pelvis area, doctor then said it could be torn hip flexor…i went for ultra sound and all is perfect with muscles etc.. its now June and i still cant run and tennis is becoming more difficult to even walk and play. Now my right side is starting to hurt. I’m in South Africa. Regards

  93. My pain feels like it is just inside my anus and nowhere else. A colon and rectal specialist diagnosed me with Pelvic (Levator) Muscle Spasm and told me there was no cure. I wake up in the morning feeling pretty good, but when I start sitting the pain begins and gets worse as I continue to sit. When I stand up I get immediate relief. I have this pain everyday. Can you recommend someone that can help me in the Houston, Texas area?

    Thank you

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