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Manual Therapy and Education for Physical Therapy Management of Male Chronic Pelvic Pain Syndrome

Davia, Jennifer PT, DPT1; Welty, Ann DPT2

Journal of Women’s Health Physical Therapy: January/April 2014 - Volume 38 - Issue 1 - p 3–10
doi: 10.1097/JWH.0000000000000007
Case Reports

Background: Chronic pelvic pain syndrome (CPPS) is a painful condition that is difficult to diagnose and treat. This case report presents physical therapy management of a male patient with CPPS using external myofascial trigger point release and patient education.

Study Design: Case report.

Case Description: This patient was a 47-year-old man with a diagnosis of chronic pelvic pain/epididymitis. His chief complaint was pain in sitting or standing for more than 15 minutes in his left testicle and perineal region. Treatment focused on myofascial trigger point release, stress management, lifestyle changes, and postural reeducation for managing CPPS and chronic epididymitis.

Outcomes: The patient had a baseline National Institute of Health-Chronic Prostatitis Symptom Index total score of 39, with 3- and 6-month follow-up scores of 9 and 7, respectively. He scored 7 out of 20 possible points on the Pelvic Pain Symptom Survey and later scored 2 for the 3- and 6-month follow-ups. Initially, he reported pain of 3/10 with spikes to 6/10. His pain levels fluctuated, but in general decreased from 3/10 to 2/10 and lastly to 1/10 with less intensity in spikes of pain. By the final visit, the pain did not spike any higher than 3/10.

Discussion: Myofascial trigger point release and patient education seem to have been effective in addressing the CPPS/chronic epididymitis symptoms of this patient. He was able to maintain low levels of pain and mild symptom severity by the end of therapy and 6 months later.

1Physical Medicine Department, Longmont United Hospital, Colorado.

2Rehab Essentials, College Park, Maryland.

The authors declare no funding or conflicts of interest.

Copyright © 2014 by the Section on Women's Health, American Physical Therapy Association.
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