Chronic Pelvic Pain Syndrome

A Holistic Approach to Chronic Pelvic Pain Syndrome (CPPS)

Finding Relief for CPPS with Physiotherapy

If you’re among the 6% of men with chronic pelvic pain syndrome (CPPS), you know all too well the physical and emotional toll it can take on your life. However, take heart, as there is hope for relief. Physiotherapy offers a comprehensive and effective approach to managing CPPS, addressing its underlying causes and helping you regain control over your life. In this article, we will explore how Physiotherapy can assist you in managing CPPS through assessment techniques and a range of targeted interventions.

Understanding Chronic Pelvic Pain Syndrome (CPPS):

Chronic pelvic pain syndrome (CPPS) is a complex condition characterised by persistent pain in the pelvic region, lasting for longer than 12 weeks. The causes of CPPS can vary, including musculoskeletal dysfunction, nerve sensitivity, hormonal imbalances, and psychological factors. To effectively address CPPS, a multidimensional approach is required, and that’s where pelvic health Physiotherapy can make a significant difference.

Assessment Techniques:

An accurate assessment is the foundation of effective treatment for CPPS. During your initial consultation, a skilled Pelvic Health Physiotherapist will conduct a thorough evaluation to identify the underlying factors contributing to your pain. This assessment will include a detailed medical history and may include the use of real time ultrasound, a physical examination of your global muscular function and your pelvic floor, and additional diagnostic tests if necessary. By understanding the unique factors contributing to your CPPS, your physiotherapist can tailor a personalised treatment plan that best suits your needs.

Pelvic Floor Muscle Program:

One of the primary focuses of pelvic health physiotherapy for CPPS is retraining the pelvic floor muscles. These muscles play a vital role in continence and sexual function as well as supporting the pelvic organs and maintaining pelvic stability. By teaching you specific exercises and techniques to target these muscles, your physiotherapist can improve their relaxation, coordination, strength and overall function. These exercises may involve both internal and external techniques and can be gradually progressed to optimise results.

Biofeedback and Electrotherapy:

Biofeedback and electrotherapy are valuable tools utilised by pelvic health physiotherapists to enhance the effectiveness of pelvic floor muscle training. Biofeedback may involve using specialised sensors to provide real-time feedback on muscle activity, helping you learn to control and strengthen your pelvic floor muscles. Electrotherapy, such as transcutaneous electrical nerve stimulation (TENS), can provide pain relief by stimulating nerves and reducing pain signals.


Acupuncture can be a beneficial adjunct to physiotherapy for CPPS. This therapeutic modality involves the insertion of thin needles into specific points along the body to reduce pain and promote healing and balance. Acupuncture has been shown to reduce pain, relax muscles, and improve overall well-being, offering a holistic approach to managing CPPS.

Real-Time Ultrasound and Therapeutic Ultrasound:

Real-time ultrasound allows physiotherapists to visualise the pelvic floor muscles in real-time, enabling precise assessment and guidance during exercises. This technique enhances your understanding of the muscles’ activation and coordination, ensuring correct execution of exercises. Therapeutic ultrasound, on the other hand, utilises sound waves to deliver deep heat to the affected tissues, promoting blood flow, reducing muscle tension, and relieving pain.

Rehabilitation Education and Strategies:

In addition to the specific interventions mentioned above, your pelvic health physiotherapist will provide you with invaluable education and strategies to manage CPPS. These may include lifestyle modifications, postural correction, stress management techniques, and ergonomic advice to optimise your overall pelvic health. Your physiotherapist will also collaborate with you to develop a personalised plan for long-term pain management and prevention.


Chronic pelvic pain syndrome (CPPS) can be debilitating, but with the help of a skilled pelvic health physiotherapist, relief is within reach. Through a comprehensive assessment and targeted interventions such as pelvic floor exercises, biofeedback, acupuncture, real-time ultrasound, and therapeutic ultrasound, physiotherapy offers a holistic approach to managing CPPS. By empowering you with knowledge and personalised strategies, physiotherapy aims to improve your quality of life, allowing you to regain control and live pain-free.

Don’t let CPPS dictate your life any longer. Take the first step towards relief by consulting with a pelvic health physiotherapist today. You deserve a pain-free future filled with joy and vitality.

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What are the Common symptoms of CPPS?

  • Pelvic pain: can be burning, shooting, aching, and/or itching in nature in the lower abdomen, groin, buttocks, and/or inner thighs
  • Genital pain: can include scrotal, testicular, and/or penile pain
  • Perineal and/or anal/rectal pain
  • Urinary dysfunction: can include urinary frequency, urgency, hesitancy, incomplete emptying, pain, and/or dribbling
  • Bowel dysfunction: can include pain with bowel movements, constipation, incomplete emptying, gastrointestinal distress, and/or bloating
  • Sexual dysfunction: can include erectile dysfunction and/or pain before, during, and/or after ejaculation
  • Pain with sitting, particularly in the perineum and/or “sit bones”
  • Pain with exercise, particularly with squatting or heavy lifting

Why do men develop Pelvic Pain?

  • Excessive sitting, such as with cycling, horseback riding, or long periods of required sitting
  • Surgical trauma: inguinal hernia repairs, vasectomy, benign prostatic hyperplasia (BPH)
  • Orthopedic injuries or trauma: spine, knee, ankle, and/or any other orthopedic pathologies
  • Biomechanical or structural dysfunction: hip dysfunction, leg length discrepancy, sacroiliac dysfunction
  • Excessive exercise or change of exercise routine
  • Excessive and aggressive sexual activity and/or aggressive lengthening of the penis, also known as jelqing
  • Chronic constipation or straining with bowel movements
  • Chronic infections, such as bacterial prostatitis or sexually transmitted infections

What other diagnoses cause Pelvic Pain?

  • Male Pelvic Pain
  • Chronic Nonbacterial Prostatitis
  • Pudendal Neuralgia
  • Hard Flaccid Syndrome
  • Interstitial Cystitis/Painful Bladder Syndrome

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