Management techniques for Chronic Prostatitis and Chronic Pelvic Pain

Every single patient I see who suffers with Non-bacterial chronic prostatitis (CP) chronic pelvic pain syndrome (CPPS) has their own individual, unique presenting symptoms. Many of these symptoms overlap and many patients present with a number of additional symptoms too. Non-bacterial  CP and CPPS is a poorly understood condition that has baffled many a patient, urologist and therapist alike. What works well for one patient, does not always have the same positive outcome for another. There are however general, non-specific recommendations that I suggest to my patients to provide relief and help manage their symptoms. Below I have provided a number of tools to help you manage your Non-bacterial CP and CPPS. Having suffered from pelvic pain in the past (one of the reasons I studied and trained to be the therapist I am today) these are tools and techniques I have used myself to;

  1. Improve the quality of my life,
  2. Give myself a sense of control and
  3. Manage and reduce my own pain and discomfort

Fluids –

Urinary frequency and urgency is a symptom most of my patients present with. It can ruin the quality of a man’s life. Always searching out the next bathroom, always making sure you are sat in an aisle seat of the cinema/theatre/aeroplane etc. Here are some simple ways of managing your urine frequency.

Avoid diuretics. Take the drinks out of your diet that make us most want to visit the bathroom. Caffeinated drinks, both hot and cold (coffee, tea, Coke), alcohol and carbonated drinks with high sugar levels are amongst the worst culprits. Red bush or Rooibos tea is a great alternative to regular tea. Dandelion coffee will give you the bitterness of normal coffee (although there is lactose in the product so be aware if you are lactose sensitive). Nettle tea may help soothe the urinary tract and chamomile tea can be used for relaxation.

Manage your fluid intake. Switch to drinking water, water with a no sugar cordial/squash or herbal tea. Sip these fluids throughout the day, do not gulp them down in large quantities. Your body will utilise the fluid more effectively. Avoid taking on any fluids at least 90 minutes before bedtime, this will help to reduce those night time visits to the bathroom also known as nocturia. If you do wake in the night feeling thirsty simply take a mouthful of water and swill it around in your mouth to whet your palate.

Exercise –

Pain can change our daily routines, it can limit what we want to do and what we are confident in doing. Many of my patients drastically change their lives to accommodate their pain. A number of them completely give up their social lives, exercise and in some cases work. It is often believed that limiting movement will limit the amount of pain experienced. Adapting seating positions through crossing the legs and bending forward may make you feel more protected in the abdomen and groin area. But hunching over in poor posture and moving less can set up its own cycle of altered biomechanics. The body prefers movement, in fact it thrives on movement. Movement lubricates our joints, it lengthens tightened muscles, it improves blood flow, our digestion and our ability to breathe properly. It increases lymphatic drainage and aids in the removal of waste products from the body. I cannot emphasis how important movement is for our general health and well being and the management of Non-bacterial CP and CPPS. You don’t have to join a gym, or go running. In fact I would advise against heavy, strenuous exercise whilst in recovery. However, I would advise walking, even if it was for 20 minutes per day. I would also strongly advise yoga and in particular Hatha Yoga. This gentle, breath focused stretching modality has seen many of my patients symptoms drastically reduce. Use a DVD or You Tube channel at home to begin and visit a yoga practice locally for group classes once you feel more confident. Yoga is NOT a female only environment, many males attend classes. You will not have to explain your current symptoms or go into detail about your reasons for attending.

Relaxation –

Non-bacterial CP and CPPS symptoms are often exacerbated with an increase in stress, anxiety and tension. The condition itself can often be the cause of many of these responses, creating what can feel like a vicious cycle. Learning to switch off is key to our general wellbeing and it is vital in managing your symptoms. Relaxation means different things to different people so it is key that you learn to switch off in a manner that is beneficial for you. Switching off our stress response, switching from our sympathetic nervous system to our parasympathetic is vital for repair and recuperation. Magnesium is an essential mineral, required for 100’s of processes in the body including the relaxation of tissues on a cellular level, particularly within muscles. Epsom Salts are a great source of Magnesium and are easily absorbed through the skin when dissolved in hot water. Many patients already find the heat of a hot bath beneficial for relaxation and management of their symptoms. Simply adding 250grams of Epsom Salts enhances the benefits of the bath, plus they are very affordable. We buy ours through The Natural Dispensary website which can be found here. If you use the code NFOO5 at checkout you will also get a discount. I suggest taking 3-5 baths a week and soaking for 20-30 minutes.

Day to day –

Do more than you did yesterday. Set realistic goals for yourself but make sure you will achieve them, do not set yourself up for failure. Make sure your goals are going to be useful, helpful and supportive to you and your current condition. Sitting down for an extra minute or two, walking the dog for an extra minute or two, taking the stairs instead of the lift, cutting out that cup of coffee etc. May of my patients reduce their daily activities because they feel they simply cannot cope any more. The more you cut out of your life, the more you will cut out of your life. Remember, our bodies thrive on movement and application. By doing less than what you did yesterday you are feeding into a very viscous cycle.

Treatments –

Find someone local to you that offers Acupuncture, Reflexology or Deep Tissue Massage. I suggest these type of treatments because you are taking time out of your schedule to relax and switch off. You are giving your body a chance to enter into that parasympathetic mode of rest and recuperation. You do not need to tell the therapist what your symptoms are, simply that you “wish to unwind, relax and switch off.” I would advise the following types of accredited therapist:

ATCM Acupuncturist
AOR Reflexologist
ITEC, FHT or CNHC Deep Tissue Massage therapist (ask for a leg, back and glute muscle treatment)

These treatments are non-specific and are not designed to ‘treat’ your symptoms they are meant as a management tool for yourself and your general wellbeing. I would advise a weekly or fortnightly treatment.

It is important for you to feel in control of your condition. Many of my patients arrive feeling helpless and even hopeless. They are often told that there is “nothing we can do for your condition,” that it is “something you will have to live with.” Heady cocktails of antibiotics and pain relief often leave patients feeling confused about their options. I hope this list of suggestions gives you a sense of control, I hope they give you some positives to focus on. I hope it allows you to move forward with the management of your condition.

Karl Monahan

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