The Two Types Of Internal Massage For Male Pelvic Pain - And They Don't Agree With Each Other

Prostatitis is very common. It is so common the condition accounts for a quarter of all urology consultations in the UK, according to The Urology Foundation. 

Classic prostatitis symptoms range from a split urine stream, nerve spasms throughout the pelvic region, a sudden urge to urinate, and pain with or after ejaculation. 


Nobody really knows the true cause. Given the location of the walnut-sized gland, prostatitis is notoriously tough to treat. 


Blood tests, urine flow tests, cystoscopies, ultrasounds and digital rectal examinations often show nothing wrong. By process of elimination, most men are diagnosed with chronic pelvic pain syndrome (CPPS) - the type of prostatitis that accounts for 90 per cent of all cases.


When antibiotics don’t work, or anti-inflammatories or alpha-blockers, sufferers are left to work through a list of options on their own. Patients seek relief rather than a cure. 


My own prostatitis led me to discovering the two main massage therapies: both internal. I spoke to two of the leading exponents of prostate massage in the UK. 


Dr Ruth Jones is a physiotherapist and expert on pelvic dysfunction. She specialises in massaging painful internal ‘trigger points’ that recreate symptoms throughout the pelvic region.


This therapy is combined with relaxation breathing exercises and work on the lower spine to release any squeezed nerves.


Physiotherapist Dr Ruth Jones explains the technique of using the pelvic wand 


The approach is based on the Wise-Anderson Protocol, devised by American psychologist Dr David Wise and urologist Dr Rodney Anderson. 


Dr Jones believes the word prostatitis is 'misleading'. 


‘The condition is a dysfunction and tension of the muscles associated with the prostate.’


Dr Jones treats Premier League footballers for the condition where it is common for players to hold in their stomach, thus tensing the pelvic muscles.


When the muscles are very tense, a tool is used called the EZMagicwand - a ten-inch see-through acrylic implement in the shape of an elongated S. 


‘The internal massage is nowhere near the prostate, but done in a clock motion around the pelvic floor. You’re relaxing, not knots, but overactive muscles by pressing on them for 60 seconds maximum [American physiotherapists go for 90]. 


‘As the pain eases then you push harder to keep loosening the muscle.


‘But, it’s only relevant and useful if the pain spreads and refers, not if it’s just painful where you’re pressing.  


‘It’s irrelevant which side you’re working on too as both sides will be being relaxed. Sometimes it’s two of three sessions, with others it can be years.’ 


Treatment depends on how long a sufferer has had chronic pelvic pain syndrome but the sooner it is dealt with the easier it is to resolve.  


In 2011 a study by Stanford University into trigger point myofascial release combined with relaxation techniques, was found to help reduce pain and dysfunction in men with chronic prostatitis.


'Misleading': Premier League footballers suffer from chronic pelvic pain syndrome 

Published in The Journal of Urology, it looked at 116 men who had suffered with unmanageable CPPS for an average of 4.8 years. 


Each were given three to five-hour sessions of trigger point myofascial release, relaxation and self-care over a period of six days. 


An evaluation six months later showed 60 per cent (70) had significantly improved symptom scores for pain, urinary and sexual function. 


Dr Julian Shah, a consultant urologist at University College Hospital and the Royal National Orthopaedic Hospital, said: 'Most sufferers I come across are middle-classed, twitchy and over-anxious who are under great pressure, not ejaculating enough and sitting down for long periods of time...cyclists, lawyers, pilots etcetera.’


Dr Shah uses a technique popularised by Filipino doctor Dr Feliciano called the Manilla Protocol. It is one of prostatic drainage or massage, directly on the prostate. 


‘If a patient comes to see me. I will take the history and then I will examine the prostate. Then I will massage it and the fluid that comes out of the penis from the prostate gets cultured - called Expressed Prostatic Secretions [EPS].


'Blocked ducts': Consultant urologist Dr Julian Shah


‘The technique is massaging, with the index finger, each lobe of the prostate sweeping from the outside to the inside fairly firmly.


‘The prostate is a gland with doors and rooms. The massage is alleviating some of the tension caused by blocked ducts and getting some of the rubbish out. I don't think massaging your pelvic floor is a good thing. It's a rigid structure and you might damage it.


‘Ninety per cent of people don’t have an infection in the prostate. If I massage a prostate for the first time, it’s usually exquisitely painful. The patient is jumping off the bed. If I massage a person’s prostate three or four times, I will make significant inroads into a person’s symptoms.


‘Of my first 208 patients I treated over a four-week period, 90 per cent were better with a once-a-week 30-second prostate massage. 


‘They weren’t all cured but their symptoms were much better. Maybe after six months a patient will come back for a top-up. Some people take only eight massages...I have one that has had 46 over many years.


‘There is no doubt that it works.’


Published on September 19, 2020


CLARIFICATION 22/08/2020: Eastleigh Osteopathic Clinic, where Dr Ruth Jones practised from for seven years, has confirmed Dr Jones has retired, on ill health, and is no longer practising.

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