Chronic Prostatitis and Chronic Pelvic Pain Syndrome

CP/CPPS Symptoms and Causes

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.

The exact cause of Chronic Pelvic Pain Syndrome is not entirely understood and probably stems from a combination of factors.  

Prostatitis was originally thought to be caused by inflammation caused by a bacterial infection. But most men have symptoms without an infection. Some men have recovered from a prostate infection while others who have CPPS symptoms have never an infection at all.  Additionally, some men have persistent inflammation that is detectable while others do not have any inflammation.

The condition is not only uncomfortable physically, but it also causes a significant amount of stress in one’s work, relationships, and personal life. 

Many scientists and clinicians, including myself, believe that the most common and significant cause of CP/CPPS is referred pain from muscle tightness and trigger points in the pelvis and back.

This is because most patients with CP/CPPS have muscle tightness in the pelvis, pelvic floor, back, abdomen, and legs. The gluteus maximus and medius, adductor magnus, illopsoas, and rectus abdomis (among others) very commonly refer pain to the pelvic floor and genitals.

Acupuncture: An Ancient Treatment for CP/CPPS

Acupuncture provides a holistic approach to healing and is an effective treatment to relieve pain, improve sexual function, and decrease urinary problems associated with Chronic Pelvic Pain Syndrome.

In fact, Chinese medicine’s 3000 years of history could possibly make it the oldest and most used treatment for Chronic Pelvic Pain Syndrome of all time. In one of Chinese medicine’s earliest texts called Elementary Questions, TCM has described the diagnosis and treatment of many syndromes characterized by painful, frequent, and urgent urination with pain and distention of the lower abdomen and pelvis.

Acupuncture works by correcting the underlying imbalance that is causing your condition. This is often an imbalance in the body’s Qi. Qi is the body’s energy that is required for daily living. We use it to digest food, grow, reproduce, fight off disease, and do everything else the body does. It also circulates in the channels which cover the body.  Stress and inflammation can cause the qi to slow down and get stuck. This is called Qi stagnation and is one of the main causes of pain. Acupuncture relieves pain by regulating the flow of qi. It also helps to clear the congestion and stagnation in the pelvic channels and increase qi flow.

Signs of inflammation and infection such as redness, burning, and pain as caused by the imbalances of heat or damp heat in the body. CP/CPPS with burning urination and fullness in the prostate areas may be caused by damp heat. Acupuncture targets these imbalances to address underlying the cause of your pelvic pain.

How does Acupuncture Work?

Acupuncture works to reduce pain and inflammation by 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. 

This produces analgesic effects as well as relaxation and positive feelings in the patient.  Many studies have also shown acupuncture to have an anti-inflammatory effect, reducing the circulating inflammatory hormones in the blood. It is also believed to decrease proinflammatory cytokines in the body and promote anti-inflammatory responses. It has been shown to affect multiple cytokines, including IL-10, and decrease inflammation. These changes are linked to a reduction in pain and swelling.

Additionally, acupuncture promotes microcirculation, reduces oxidative stress, relieves muscle spasms, and regulates bladder function. 

Many clinical trials have shown that acupuncture provides significant relief for men with CP/CPPS.  One recent study had 400 patients who received acupuncture or a placebo for 8 weeks. The acupuncture points included

• Zhongliao (BL33), Huiyang (BL35), Shenshu (BL23), and Sanyinjiao (SP6). 

These acupuncture points are found in the lower back and around the sacrum.

By week 4, those who had been treated with real acupuncture saw a significant decrease in their symptoms than those who were given placebo acupuncture. 

Real acupuncture produced lasting results.  In a follow-up at week 32, which is 24 weeks after the study concluded, there was still improvement in quality of living and pain relief. 

What is treatment like?

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 in the muscles. This information creates a picture of the specific imbalance causing the problem.

We will consider symptoms of pain, urinary changes, sexual dysfunction, as well as digestion, energy, and sleep are all factored into identifying the cause of the issues.  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.

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 focus on identifying the specific root imbalance causing the condition and tailoring the treatment for you.

Acupuncture is most effective through a treatment course.  The treatment should decrease pain and urinary complaints, and improvement in sexual function. Many people find rapid relief after beginning treatment to reduce the pain and symptoms within about a month of beginning the treatment. Generally, patients come in for acupuncture once to twice a week depending on the severity for approximately 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 patients have few symptoms.

Is Acupuncture Treatment Safe?

Yes, acupuncture is very safe treatment for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. All side effects are rare.  The most common side effects as minor bruising, soreness on the affected muscles, and occasional lightheadedness when getting up from the table. Acupuncture is very relaxing.  Patients will often take a nap or go into a very relaxed meditative state during the treatment.