Acupuncture for Chronic Prostatitis Category III: Chronic Pelvic Pain Syndrome
Men with Chronic Pelvic Pain Syndrome (CPPS), or Chronic Prostatitis Category III, suffer from pelvic pain, painful, frequent, urgent, or difficult urination, as well as sexual dysfunction. The pain can be intense or dull and is generally located on the pelvic floor, in the genitals, lower back, or the lower abdomen. These symptoms can be severe and affect all aspects of your life, resulting in depression, lost work and educational opportunities, and trouble in relationships. CPPS is the most common form of chronic prostatitis.
What Causes Chronic Pelvic Pain Syndrome?
The exact cause of Chronic Pelvic Pain Syndrome is not entirely understood. Prostatitis was originally thought to be caused by inflammation caused by a bacterial infection. But many men have symptoms without an infection (1) Some men who have CPPS symptoms do not even have any inflammation. Some physicians believe that CPPS may be caused by referred pain from muscle tightness in the pelvis and back, contracture of smooth muscle such as the bladder, emotional stress, and inflammation after an infection. Intrapelvic congestion of fluids may also be a factor (2).
How does acupuncture help treat Chronic Pelvic Pain Syndrome?
Treating CPPS requires a holistic approach addressing that naturally corrects the underlying cause of the pain and distress. Acupuncture and Chinese medicine provide a holistic approach to healing and are effective treatments to relieve the pain, improve sexual function, and decrease urinary problems, as well as relief depression associated with Chronic Pelvic Pain Syndrome. Acupuncture is also a natural treatment, so as opposed to many of the medications for CPPS, there are very few side effects.
In fact, Chinese medicine’s 2000 years of history could possibly make it the most used treatment for Chronic Pelvic Pain Syndrome of all time. In one of Chinese medicine’s earliest text called Elementary Questions, TCM has described the diagnosis and treatment many syndromes characterized by painful, frequent, and urgent urination with pain and distention of the lower abdomen and pelvis (3). Of course, this syndrome was not called Chronic Pelvic Pain Syndrome or Chronic Prostatitis at the time. But the practice of Chinese medicine has shown that those same principles of diagnosis and treatment are effective when applied to the symptoms caused by Chronic Pelvic Pain Syndrome.
Traditional Chinese Medicine has a holistic approach to diagnosis and treatment, identifying specific imbalances in the body and using acupuncture, Chinese herbs, and acupressure to correct them. Correcting the imbalance does not just treat the symptoms or mask the condition, but rather corrects the root of the problem by encouraging self-healing of the body. Generally, the root cause of painful urination, voiding difficulties, and depression is an imbalance of the body’s vital energy, or qi. The two most common imbalances in qi that cause CPPS are when there is too little qi or when the qi circulation becomes impaired. One way acupuncture and Chinese herbs work is by helping to improve the circulation and the amount of qi.
Those with too little qi may experience the symptoms of poor digestion, bloating, loose and sticky stools, fatigue, shortness of breath, sinus headaches, soft voice, cold limbs, a weak pulse, and pale tongue. Qi stagnation, when the qi is not circulating well, can also cause pain. Those with qi stagnation will often get a cold after a stressful or emotional situation. They also may be prone to headaches, irregular bowel movements, ribside pain, irritability, anger, and depression.
Physiological, acupuncture works to reduce pain and inflammation through regulating neural pain pathways, stimulating the release of natural pain relievers in the body, such as opioids, as well as regulating pain relieving opioid receptors. Many studies have also shown acupuncture to have a anti-inflammatory effect, reducing the circulating inflammatory hormones in the blood (4).
What is the Acupuncture and Chinese Medicine treatment like for Chronic Pelvic Pain Syndrome?
Chinese medicine works best as a combination therapy that includes acupuncture, tui na (acupressure), and other therapies such as cupping. Chinese herbs are also effective and may be required for certain people. Acupuncture diagnosis and treatment focuses on identifying the specific root imbalance causing the condition and tailoring the treatment for you.
During the first visit, I will complete a medical history and an in depth physical examination, which focuses on an examination of acupuncture points and trigger points of the hips and pelvis. This information creates the picture of the specific imbalance causing the problem.
Acupuncture is most effective through a treatment course. The treatment should decrease pain and urinary complaints, and improvement in sexual function. Many men find rapid relief, within a week or two of beginning the treatment. For others, it may take longer to have an effect. Generally, patients come in for acupuncture once to twice a week depending on the severity, and gradually get acupuncture less frequently. The treatment generally lasts 3-4 months.
The pain and other symptoms are gradually lessened. It is like peeling off the layers of an onion until you correct the root cause of the problem. The results are usually long lasting and patents have few symptoms.
1. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (Current Clinical Urology). Daniel A. Shoskes (ed.) Humama, Totowa, NJ. 2008.
2. Honjo H, Kamoi K., Naya Y, et al. The Effects if Acupuncture for Chronic Pelvic Pain Syndrome with Intravenous Congestion: Preliminary Results. International Journal of Urology. 2004 Aug; 11(8): 607-612.
3. Wiseman N, Feng Y. A Practical Dictionary of Chinese Medicine. Brookline, MA: Paradigm; 1998:583.
4. Napadow V, Ahn A, Longhurst J, et.al. The Status and Future of Acupuncture Mechanism Research. J Altern Complement Med. 2008 September; 14(7): 861–869.