Chronic Pelvic Pain Syndrome (CPPS)

Chronic pelvic pain syndrome is a condition in which unexplained pain is experienced in the pelvic region for six months or more, often affecting daily activities.

The basics

Chronic Pelvic Pain Syndrome (CPPS) is a condition that can cause persistent pain in the pelvic region lasting for several months or more. This type of chronic pain can affect both men and women, and can be caused by a variety of factors such as muscle tension, nerve damage, inflammation, and psychological factors like stress or anxiety.

In women, CPPS may be associated with conditions like endometriosis or pelvic inflammatory disease, while in men it may be linked to prostate problems. The symptoms of CPPS can be challenging to manage and can impact a person's daily life, but with the right treatment plan, including pain management, physical therapy, and psychological support, many people with CPPS are able to lead fulfilling lives.

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CPPS is characterized by pain in the pelvic area, which may be accompanied by a range of other symptoms. Some of the most common symptoms of CPPS include:

  • Chronic pelvic pain that lasts for several months or longer
  • Pain in the lower back, abdomen, or rectum
  • Pain during urination or bowel movements
  • Pain or discomfort during sexual activity
  • Erectile dysfunction in men
  • Urinary urgency or frequency
  • Muscle spasms or tightness in the pelvic floor
  • Fatigue and sleep disturbances
  • Anxiety and depression

The symptoms of CPPS can vary widely between individuals, and some people may experience only a few symptoms while others experience many. It's essential to seek medical attention if you're experiencing chronic pelvic pain or other symptoms, as early diagnosis and treatment can help manage symptoms and improve long-term outcomes.

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Therapies & treatments

Pelvic Floor Physiotherapy

Pelvic floor physical therapy involves targeted exercises to strengthen the muscles of the pelvic floor, as well as manual techniques such as trigger point release and myofascial release. These techniques can help alleviate muscle tension and pain associated with CPPS.

Muscle Retraining

Pelvic floor muscle retraining is a common intervention for CPPS. This technique involves exercises to improve the strength, endurance, and coordination of the muscles that support the pelvic organs. Pelvic floor muscle retraining can help alleviate pain and discomfort associated with CPPS by improving pelvic muscle function and reducing tension in the pelvic region.

Trigger Point Release

This therapy involves manual manipulation of trigger points or knots in the pelvic floor muscles to relieve tension and pain. A healthcare provider may use a combination of massage, pressure, and stretching techniques to release trigger points in the pelvic region.

Myofascial Release

This therapy involves applying sustained pressure to the connective tissue or fascia surrounding the muscles to release tension and improve blood flow. A healthcare provider may use hands-on techniques or specialized tools to perform myofascial release.

Muscle Relaxation Training

This type of therapy involves teaching patients techniques to relax their pelvic floor muscles, such as deep breathing and progressive muscle relaxation. This can help reduce tension and pain in the pelvic region.


Certain medications may be prescribed to manage the pain and inflammation associated with CPPS. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or nerve pain medications.

Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy that focuses on changing negative thought patterns and behaviors that can contribute to chronic pain. It can help individuals with CPPS to develop coping strategies and improve overall quality of life.


Biofeedback involves using sensors to monitor and visualize physiological responses, such as muscle tension, and learning to control these responses through relaxation techniques. Biofeedback can help individuals with CPPS to reduce muscle tension and manage pain.

Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) Treatment

Because IC/PBS and CPPS often occur together, treating IC/PBS symptoms can also help alleviate CPPS symptoms. Treatment options for IC/PBS may include medication, bladder instillations, or nerve stimulation.

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Self-care strategies

Pelvic floor muscle exercises

Pelvic floor muscle exercises, also known as Kegel exercises, can help to strengthen the muscles in the pelvic floor and improve blood flow to the area, reducing pain and discomfort.

Heat therapy

Applying heat to the pelvic area, such as with a hot water bottle or warm compress, can help to relax the muscles and reduce pain.

Stress reduction techniques

Stress can exacerbate CPPS symptoms, so practicing stress-reduction techniques such as meditation, deep breathing, or mindfulness can help to reduce stress levels and manage pain.

Gentle exercise

Engaging in low-impact exercises such as walking, swimming, or yoga can help to improve blood flow and reduce pain and discomfort.

Dietary changes

Eating a balanced diet that is rich in fiber, fruits, and vegetables and avoiding spicy or acidic foods may help to reduce inflammation and manage symptoms.

Pain management medications

Over-the-counter pain medications such as ibuprofen or acetaminophen can help to alleviate pain and discomfort associated with CPPS. Always talk to your doctor before starting a new medication.

Relaxation techniques

Practicing relaxation techniques such as guided imagery, progressive muscle relaxation, or biofeedback can help to reduce muscle tension and alleviate pain.

Sleep hygiene

Getting adequate sleep is crucial for managing pain and overall health and well-being. Establish a regular sleep schedule, avoid screens before bedtime, and create a comfortable sleep environment to improve sleep quality.


Learning about CPPS and its management strategies can help to empower individuals to take an active role in their care and advocate for their needs. Educating oneself can also help to reduce anxiety and stress associated with the condition.

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