Finding Effective Treatments for Pelvic Pain
 Chronic pelvic pain can be a baffling problem in men, racking up about 2 million doctor's office visits each year.
But a review of treatments to relieve pain and other symptoms of this condition found that three types of medication were most effective:
- Antibiotics
- Anti-inflammatory drugs
- Alpha-blockers
About 95 percent of chronic pelvic pain in men is brought on by chronic prostatitis, an inflammation of the prostate. This in turn is usually caused by a bacterial infection. The inflammation develops slowly and lasts for at least six months. In addition to chronic pain in the pelvis, other symptoms include pain in the urethra or penis, back pain, difficulty urinating, frequent urination, and sexual difficulties.
Men between ages 35 and 45 are at greatest risk of developing this condition.
The review looked at 23 medical studies published between 1949 and 2010 and found that the most effective treatment was a combination of antibiotics and alpha-blockers, particularly when the main symptom was pain while urinating. But anti-inflammatory medications also were effective for pelvic pain.
Less effective treatments were steroids; phytotherapy, or plant-based alternative medicines; finasteride, a medication for enlarged prostate; and gabapentinoids, which are used to treat nerve pain.
Alpha-blockers, which block the nerves going into the muscles of the prostate, are often prescribed along with antibiotics for chronic pelvic pain. If that combo doesn't work, another antibiotic is tried. But a man with chronic pelvic pain shouldn't just keep switching from one antibiotic to another, says Paul C. Cook, M.D., a Houston urologist.
"If the patient comes back and the treatment isn't working, it's time to rethink the diagnosis," he suggests.
Other conditions that can cause chronic pelvic pain include pudendal nerve entrapment, a condition in which nerves get trapped in bony canals, and compression of blood vessels in the pelvis, sometimes caused by long-distance bicycle riding, Cook says.
Always talk with your health care provider to find out more information.
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Chronic pain can leave you feeling helpless about your condition. It can cause emotional problems or physical limitations. Anxiety, depression, anger, or desperation about the pain can make it seem worse. Chronic pain can interfere with sleep, leaving you tired and less able to cope with the pain.
Here are steps you can take to feel more in control:
- Learn all you can about your condition.
- Keep a pain diary that includes where the pain is, how bad it is, how often it occurs, and what makes the pain better or worse.
- Find a health care provider who understands chronic pain, has experience treating pain similar to yours, is willing to talk and listen to you, and is willing to talk to your family. Not all doctors have been trained to treat pain.
- With your health care provider, figure out a pain management plan. This plan may include medications, as well as nonmedical treatments such as exercise and meditation.
- Take care of your mental health. If you think you may be depressed or are having difficulty with another mental or emotional problem, tell your health care provider.
Always talk with your health care provider to find out more information.
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