What is the Most Common Cause of Prostatitis?
- Nicole Cozean
- 2 days ago
- 5 min read
Updated: 10 hours ago
Despite the name, more than 90% of prostatitis cases have nothing to do with the prostate. Prostatitis symptoms—like urinary urgency or frequency, pain or burning with urination, pelvic pain, or discomfort with or after sexual activity—are most often caused by pelvic floor dysfunction.
The most proven and effective treatment for pelvic floor dysfunction - and thus chronic prostatitis - is men’s pelvic floor therapy, which addresses the root cause, relieves symptoms, and helps ensure they don’t return.
Why Prostatitis is Not About the Prostate
For more than 90% of men with prostatitis symptoms, there’s no infection and nothing actually wrong with the prostate. True bacterial prostatitis is extremely rare. However, because of the name—and because most people associate male pelvic health with the prostate—men are often sent down a frustrating path of antibiotics, prostate exams, and even cancer scares.
In reality, most prostatitis symptoms stem from pelvic floor dysfunction. The pelvic floor is a group of muscles at the base of the pelvis that support the bladder, rectum, and prostate, and help control urination and sexual function. When these muscles become overly tight or irritated, they can compress or irritate the nerves running through the area. That irritation can cause pain radiating to the tip of the penis, scrotum, rectum, or perineum, as well as
pain with or after ejaculation. Tight pelvic muscles can also affect the bladder, causing the urgency, frequency, and burning sensations that are so commonly blamed on the prostate.
How Do I Know if Pelvic Floor Dysfunction is Causing My Prostatitis Symptoms?
One of the best ways to identify whether pelvic floor dysfunction is contributing to your prostatitis symptoms is by paying attention to how and when those symptoms appear. If prostatitis were caused by an infection or an enlarged prostate, symptoms would typically be consistent, unchanging from morning to night or day to day. But that’s not what most men experience.
Instead, symptoms often ebb and flow depending on activity, stress, and posture. Flare-ups may occur after sexual activity, a long bike ride, sitting through a workday, or even during times of stress or anxiety. These fluctuations are strong clues that the pelvic floor muscles—not the prostate—are driving the symptoms. Other common links to pelvic floor dysfunction include:
Low back pain
Hip pain or tightness
A history of a fall on the tailbone (even in childhood)
Prolonged sitting
Old sports injuries or surgeries to the hips, knees or ankles
The pelvis is the body’s crossroads—it connects the spine above and the legs below—so dysfunction anywhere along that chain can contribute to pelvic floor issues.
What Does Men’s Pelvic Floor Therapy Look Like?
Men’s pelvic floor therapy focuses on identifying and resolving tight, overactive, or dysfunctional pelvic muscles that irritate surrounding nerves. Treatment starts with a head-to-toe assessment, looking not only at the pelvic floor but also at contributing areas such as the spine, hips, legs, and core. This orthopedic approach ensures that the entire system that supports your pelvis is functioning properly.
An essential part of treatment involves a gentle internal pelvic floor assessment. This allows the therapist to directly access and treat the muscles most responsible for the prostatitis-like symptoms.
A skilled pelvic therapist can often recreate your exact symptoms simply by pressing on a tight muscle inside the pelvic floor—a powerful sign that the issue isn’t the prostate at all.
Beyond relieving tightness, a comprehensive program addresses why those muscles became tense or dysfunctional in the first place—such as poor posture, muscle imbalances, breathing mechanics, or compensation from an old injury—to help ensure relief that lasts.
How Do I Find a Pelvic Floor PT Who Specializes in Men’s Pelvic Therapy?
Unfortunately, finding a provider who truly specializes in male pelvic health can be difficult. Many pelvic floor physical therapy clinics focus exclusively on women’s health, particularly pregnancy and postpartum care. Even among those who say they treat men, the male patient population is often very small—sometimes less than 5%—and many physical therapists have never received formal training in male pelvic floor treatment or rectal evaluation.
When searching for a pelvic therapist for prostatitis or male pelvic pain, ask: Do you regularly treat men with pelvic pain or prostatitis? What percentage of your patients are male? Have you taken courses specific to male pelvic health? Do you provide internal pelvic floor assessment and treatment?
The right provider will confidently answer “yes” to these questions and have a clear protocol for treating male pelvic dysfunction. Realizing that the root cause is pelvic floor dysfunction is empowering—it means effective, long-term relief is absolutely possible.
Where to Find Pelvic Floor Therapy for Men in Laguna Hills and Orange County?
If you’re searching for prostatitis treatment in Orange County (or considering travelling for treatment), PelvicSanity offers one of the most experienced and respected Men’s Pelvic Health Programs in the country. Located in Laguna Hills, California, our world-renowned clinic has helped men from across the U.S.—and more than 25 different countries—find relief from chronic pelvic pain and prostatitis-like symptoms.
Our team specializes exclusively in pelvic health and has advanced training in male pelvic floor dysfunction, including pain, urinary, and sexual health concerns. Whether you’re local to Southern California or traveling for care, we can help you identify the true cause of your symptoms and create a personalized plan for lasting results.
👉 Request an Appointment today to get started with our men’s pelvic health specialists at PelvicSanity.
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Who are We at PelvicSanity?
At PelvicSanity, it's our mission to support patients with pelvic pain and pelvic floor symptoms, regardless of where you live. We can help with:
In-person treatment for those in Southern California at the PelvicSanity clinic
Immersive Out-of-Town program for those able to travel
Remote Consultations to get you expert 1:1 help, advice and an action plan
Online patient courses on Interstitial Cystitis and Movement for Pelvic Health
A Facebook support group for patients called Finding Pelvic Sanity.
Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.
Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.
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