Pelvic pain is a common condition that affects both men and women. However, it is often more difficult to diagnose in men, as they may be reluctant to discuss such issues due to stigma or embarrassment. In this blog, we will take a closer look at pelvic pain in men and provide information on its symptoms, causes, and available treatment options.

Symptoms of Pelvic Pain in Men

Pelvic pain in men can present itself in a variety of ways, including sharp, stabbing pain, dull aches, and burning sensations. The pain may be constant or intermittent, and it can be located in the lower abdomen, lower back, or genitals. In some cases, the pain may also radiate to the legs or lower back.

In addition to pain, other symptoms of pelvic pain in men may include:

  • Urinary problems, such as difficulty starting or stopping the flow of urine or frequent urge to urinate
  • Sexual difficulties, such as impotence or reduced libido
  • Bowel problems, such as constipation or diarrhea
  • Testicular pain
  • Swelling or tenderness in the pelvic area

Causes of Pelvic Pain in Men

There are many different factors that can contribute to pelvic pain in men. Some of the most common causes include:

  • Prostatitis: Inflammation of the prostate gland can cause pelvic pain, especially in younger men.
  • Urinary tract infections: UTIs can cause pain in the pelvic area, as well as urinary symptoms.
  • Testicular conditions: Issues such as testicular torsion, a condition where the testicle twists on its own blood supply, can cause severe pain in the pelvic area.
  • Abdominal conditions: Conditions such as diverticulitis, appendicitis, and inflammatory bowel disease can all cause pelvic pain.
  • Sexually transmitted infections: STIs such as chlamydia and gonorrhea can cause pelvic pain, as well as other symptoms such as discharge and itching.

Here is the list of the ones that are missed (from Pelvic Floor Dysfunction Symptoms blog) but are certainly leading to pelvic pain and are ignored by most physicians:

  • “Lower back pain
  • Pain in the back joints of the pelvis (SI Joints)
  • Pain in the front pubic area
  • Arched lower back
  • Slouched lower back
  • Slouched mid-back or hunchback
  • Military posture with the chest pushed out
  • A V-stance where the torso is positioned behind the hip joints on the side view
  • Chronic forward neck
  • Inability to bend down below the knees
  • Habitually standing on one leg with the other leg bent
  • Chronic one-sided pain in the lower extremity
  • Hip pain on one or both sides”

Standard Treatment Options for Pelvic Pain in Men

The treatment for pelvic pain in men will depend on the underlying cause of the pain. Often physicians have looked into the following which may or may not be the cause or necessarily the proper treatment for pelvic pain in men:

  • Antibiotics: For UTIs and STIs, antibiotics are often prescribed to help clear up any infection.
  • Pain medication: Over-the-counter pain medication such as ibuprofen or acetaminophen can help to reduce pain and swelling in the pelvic area.
  • Pelvic floor rehab.: Rehabilitation of the muscles and movement is essential for sustaining relief from pelvic pain. This treatment can be done by pelvic floor-trained physical therapists, chiropractors, occupational therapists, nurses, or physicians. The treatment rendered can vary.
  • Surgery: In some cases, surgery may be necessary to address the underlying cause of the pain, such as a hernia or testicular torsion.

Holistic Treatment of Pelvic Pain in Men

As mentioned in the blog: “Are Yoga Exercises Good for Pelvic Floor Dysfunction”, the following is the list of treatments for pelvic floor dysfunction in men:

  • “Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
  • Postural Neurology: Movement is like a concert and the body parts are like the musicians! In that, the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
  • Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
  • Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
  • Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
  • Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.
  • Nutrition:  Avoid Citrus, caffeine, soda, artificial sweeteners, and spicy foods. Take collagen, Vit. C, Vit. D, Omega 3, and protein if no conflict with any other conditions that suggest their avoidance.
  • Ergonomics: Sit on an exercise ball vs a chair. Get a keyboard that is as wide as your shoulders. Limit your sitting to no more than one hour and alternate with standing. Make sure the middle of your monitor is at the eye level to name a few.
  • Postural Awareness: It is important to pay attention to the posture and catch yourself when not standing on both feet, slouching, or shifting the pelvis forward and in front of the ankles. Best to associate the increase in attention with activities done each day. For instance, when talking to someone pay attention to the feet and pelvis positioning.
  • Sleeping habits: do not sleep on the stomach and if you are a stomach sleeper, get a body pillow to minimize that.”

Pelvic pain in men can be complex and when treated correctly and functional movement is restored, most cases will not return again. If you are experiencing pelvic pain, or have had treatment but still with issues, contact me.

Remember, there is no shame in seeking help for pelvic pain. With the right diagnosis and treatment, it is possible to manage and reduce the discomfort associated with this condition. Don’t wait to get help, your health and well-being are important.

Dr. Shakib

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