Male pelvic pain & CPPS
Ongoing pain in the pelvis, groin, testicles or perineum — often when sitting. It’s common, it’s real, and in most men it gets meaningfully better with the right physiotherapy.
What it is
Living with male pelvic pain can be frustrating, exhausting and often isolating. Many men tell us they’ve seen several healthcare professionals, had normal scans and tests, yet are still living with pain that affects their work, exercise, relationships and quality of life.
At Birmingham Men’s Health Physiotherapy, male pelvic pain is one of our specialist areas. Gerard Greene and his specialist team regularly assess and treat men from across Birmingham, the West Midlands and throughout the UK with complex pelvic pain conditions.
Every patient is different. Our role is to identify the factors driving your symptoms, explain them clearly and develop a personalised treatment programme to help reduce pain, restore confidence and get you back to living life again.
You're in the right place if…
Most men we see recognise several of these. You don’t need all of them — if a few sound like you, it’s worth a conversation.
- Aching or pain in the perineum, testicles or penis
- Pain or pressure that’s worse after sitting
- Discomfort during or after ejaculation
- Needing to pee often, or urgency and hesitancy
- A feeling of fullness or a “golf ball” sensation
- Pain in the lower abdomen, groin or lower back
- Symptoms that flare with stress or after exercise
- Tests came back “normal” but the pain is very real
Why does it happen?
We’ll be honest: pelvic pain rarely has a single, tidy cause — and that’s exactly why it’s so often missed. In most men it’s a combination of an overactive, tense pelvic floor (muscles that have learned to guard and won’t fully let go), irritated or sensitised nerves in the area, and a nervous system that has turned the volume up on pain signals over time.
It can be set off by a one-off event — an infection, an injury, a period of stress, a lot of cycling or heavy training — and then persist long after the original trigger has gone, because the muscles and nerves stay switched on. Understanding your particular mix is the whole point of a proper assessment.
How we help
Your first appointment is a proper, unhurried conversation followed by a physical assessment. We look at how your pelvic floor, hips, breathing and posture are working together, so we can find the real driver of your pain rather than guessing.
From there, treatment is hands-on and practical: releasing and down-training the overactive muscles, calming the sensitised nerves, retraining your breathing and bladder habits, and a graded plan to get you back to sitting, training and intimacy without flaring up. Most men need a course of sessions, not endless ones — and you’ll understand what we’re doing and why at every step.
What your journey looks like
Most men need a course of sessions over a few months rather than open-ended treatment. Here’s how it usually looks:
- A proper conversation. Time to hear your story and examine what’s really going on — in complete privacy.
- A clear explanation. We tell you, in plain English, what’s driving your pain and what the plan is. Finally, answers.
- A plan that works. Hands-on treatment plus a few things to do at home. We track progress and adjust as you improve.
Two years of being told it was “just prostatitis” and handed antibiotics. Gerard was the first person to actually examine me and explain what was happening. I’m about 80% better and, honestly, I feel like myself again.— Patient with chronic pelvic pain, Birmingham
The questions men actually ask
How do you examine the Pelvic floor and Is this going to involve an internal examination?
Ultrasound Imaging of the Male Pelvic Floor
Initially we examine your pelvic floor externally with ultrasound imaging. This is done on the lower abdomen and also the perineum . It allows us to look inside but stay outside. It also in the words of my brilliant Ultrasound Colleague Dr Alime Buyuk, "Makes the invisible visible". We always start with ultrasound imaging to explore the pelvic floor and this is included in the appointment cost.
Perineal Assessment
We also examine the pelvic floor through outer perineal palpation or gentle pressure .
Internal Pelvic Floor Assessment
With many patients it may also be necessary to examine the pelvic floor because it’s the most direct way to assess the pelvic floor . Gerard and his team are very skilled at this and we can do it gently and sensitively in a way that involves you and is well explained to you. It is only ever done with your explicit consent, fully explained first, and never forced.
Can it actually be cured, or just managed?
Many men become pain-free; others get to a point where symptoms are mild and easily controlled. We’ll give you an honest picture of what’s realistic for your situation after your assessment.
How many sessions will I need?
It varies, but most men are looking at a course of sessions over a few months rather than open-ended treatment. We review progress regularly so you’re never left wondering.
You don’t have to live with this
If any of the above sounds like you, the next step is simple. Ask us anything in confidence — no pressure, and no obligation to book.
Ask Gerard a question in confidence