For men, chronic pelvic pain syndrome (CPPS) is defined as ongoing or repetitive pain episodes in the pelvic region in the absence of urinary tract infection or other relevant pathology, such as prostatitis. Because the condition is complex and satisfactory results seldom occur from just one form of treatment, researchers have proposed tackling CPPS with a multimodal approach that may include manual therapies, a form of treatment provided by doctors of chiropractic.

An April 2022 prospective study included 23 middle aged men with CPPS that presented with prostatic tenderness with no other positive clinical findings (negative clinical and/or lab tests). Each participant received three manual therapy treatments in the first week and six additional treatments spread over the next four weeks. The techniques employed were all externally applied and intended to achieve normal joint alignment, reduce muscle tightness/stress, create flexible fascial structures, and improve blood flow and nerve function to the affected area.

Questionnaires completed by the participants revealed that this approach led to clinically significant results improving pain intensity, prostate-specific symptoms, and quality of life. This study suggests that manual therapy might be a practical therapeutic approach given the exact same protocols were applied to all patients to eliminate confounding factors and confusion.

There is also research that shows the following treatment options, many of which may be provided by chiropractors, may benefit the CPPS patient: acupuncture, lifestyle modifications, specific-targeted exercises, shockwave therapy, phytotherapy (the use of medicines derived from plants or herbs to treat or prevent health conditions), and some forms of electrical, magnetic, and ultrasound physical therapy modalities.

It’s important to note that the current clinical practice guidelines for treating CPPS support pharmacologic treatment as the standard of care, and more research is needed before guidelines can be updated to include manual therapies and other non-pharmaceutical approaches in the management of CPPS. However, a patient whose condition does not respond to pharmacologic treatment may inquire with their medical physician if these alternative therapies should be considered, of which a doctor of chiropractic is well-equipped to provide.