Medical Questions > Mens Health > Prostate Forum

Could chronic Epididymitis and Prostatitis be down to tension?

I’ve suffered with ‘chronic epididymitis’ and ‘prostatitis’ for years. Like many people here, I’ve sometimes been given antibiotics, but sometimes there’s no sign of infection. Even been offered antidepressants at a low dose for the pain. Both conditions still come and go, episodes can last 1-6 weeks and it can be damn uncomfortable.

After extensive reading, I‘m starting to come around to the idea that constant muscle tension is the culprit. People with mild stress get tension headaches, back aches etc. don’t they? Tensed muscles eventually stress nerves and cause pain. In the abdomen, genital area must be common, but probably largely unnoticed until the pain shows up (tugging in scrotum, pain in perineum etc.) I guess it’s even more likely with the genital areas, an evolved stress response to threats, like a sad dog activating a muscle which tucks its tail between it’s legs ? You’ve got to be pretty comfortable and relaxed with your circumstances to let it all fully hang loose down there!

Could explain why antidepressants and nerve blocks may work, but antibiotic & anti-inflammatories have mixed results ? When they do work it may simply be that you’re more relaxed because you think you’re getting help. Tension may also explain why stimulants like caffeine and booze commonly seem to make it worse, as they relax you initially , but in the end they are stimulants and make tension and ability to relax worse (ask people with anxiety disorders if they feel better after booze…they don’t!) Could also explain why it comes and goes, as we go through more, or less stressful periods. If I’m on the money here (and OK there will be people with serious swelling, heat - real infection) no wonder it’s hard for Dr’s to treat. If they told us to go home and relax, would we accept this? Would we even know ‘how’ to relax when we’re in such pain?

I’m trying relaxation, pushing my breath slowly out with my mouth in an ‘O’. It’s taking some dedication, but’s it’s working slowly. The pain is reducing (you can actually feel your whole groin and perennial area ‘letting go’ as you breath) I doubt the results will be instant, those muscles are probably nicely tight, the nerves jangled, but I’m trying and I’m spurred on by new Stanford research suggesting a strong link between tension, chronic pelvic pain and prostatitis, which supports this idea.

Any similar experiences out there?
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First Helper ek74

replied October 10th, 2013
I have what you have. Although my pain is not absolutely unbearable, it’s bad enough none the less. The attack is cyclical, coming in waves that last for a week or two. It will peak at high point and this then slowly edd off--until the next round.

My story: I started having problems with epididymitis (without an infection) about five years ago. I’ve gone to the doctor about this condition a few times and I received ciprofloxacin and doxycycline on separate occasions. Neither of them made a difference—and frankly, I don’t feel that is the right solution since I show no signs of acute epididymitis. Generally the pain comes slowly into my right testicle for a week and then peaks to being very uncomfortable; then the discomfort will ebb, but never go away completely. I had a bad bout in 2008 for 6 months, and then I was reasonably okay in 2009 and 2010. In November 2011 it came back again (badly) and then it went away. Now, since December 2012 to the present, the discomfort has been coming back every few weeks. The last doctor I went to in December 2012 gave me a urinalysis (which showed up negative for any bacteria) and he told me the condition is chronic. Sometimes when the pain gets bad enough it radiates to above my left knee and down my legs. Also I feel it into my bladder in its worst period. Having to go to the bathroom makes the discomfort worse. Being in certain positions eases the discomfort slightly; and for some reason being in a car seat makes it worse.

At the moment, I am in the middle of another attack. I was good for two months, but then I could feel the pain coming on for a week. Most likely, giving past experience, it will peak in a few days then ebb off—and then it will come back.

So yeah, I know what you are going through. I can tell you that any herbal remedy you might come across is a joke, or just a scam. I tried one from Australia years ago; I thought it was making a difference, but I think the condition just burned out after a while. I tried the same remedy recently and I saw no difference. I don’t think doctors have an idea of what really causes it—the best cause I could find is ‘over-active’ nerves, which I tend to believe When it’s in attack mode the pain is bad and the only thing can do is wait it out. On bad days you just want to come home, take a bath and go to bed with a pillow between your legs.

I think muscle tension has something to do with it.
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replied October 11th, 2013
Sacral nerves?
I've since been to an Osteopath for back pain, she noticed my pelvis was quite tilted to the left, which she said might be compressing sacral nerves. I asked if this could cause my testicular/abdominal/leg pain, she said quite possible, as the nerves to these areas go through the sacral cleft between pelvis and spine. I've been doing exercises to level my pelvis, stretch the muscles in this area and generally open the sacral cleft. Not had my symptoms for ages. Stopped the exercises a month or so ago, and the pain is slowly returning. You do the math.
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replied October 11th, 2013
What are these pelvic exercises? Can you give me any information in it?

When I get an attack I can feel the trunk of my body getting stiff and sore, as though the nerves are contracting. Plus, I often get a pain over my left knee. I think it’s all related.
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replied October 18th, 2013
Yep...I think it is all related. Might be coincidence that my exercises sorted it, only time will tell. If it's not the sacral nerve entrapment, then my only other theory is related to urine backwash into the tubes. I think this could happen if you take a leak whilst semi-erect.Some people can't so this, but I can ...and so wonder if the 'valves are still open' to speak. This could irritate the vas deferens and other 'pipework' no end I guess.

If it is sacral nerve , try my exercises for 5 min each a day. 1 - this involves sitting on the floor with the soles of your feet together and your hands clasped around your toes. The further you let your knees drop, the more it opens up the pelvis...gently does it to begin with!. 2 - The other is harder to explain. go down with your lower arms and knees in contact with the floor (like your going to give the kids a horsey ride!)Then cross the right foot over, so the back of your right heel is positioned just above of your left knee. Push those left toes away from you as far as you can (you know you've got this as it will pull the muscles in the side of your butt) 5 min each size.

If it's not the nerves getting squashed , then I think try to avoid peeing until you are full flacid...that's my strategy.

Hang in there, it's no fun, I get exactly the same , don't let it get you down!

Good luck!
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replied December 1st, 2013
You guys highly likely have tension myositis syndrome. I've been suffering with it for 4 years- Dr John Sarnos books may help.
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replied September 28th, 2015
Can you update us? How are you felling now? You successfully cured? Please help us out.
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replied May 16th, 2016
Prostate and Pelvic Tension
I am a Medical Doctor and have also had pelvic pain and an elevated PSA. I am not a surgeon, but I am carefully studying prostate anatomy. The muscles directly surrounding the prostate are smooth muscles and would not respond to stress. However, the endopelvic fascia surrounding the prostate is connected to the connective tissue surrounding the levator ani muscles. Contraction of those muscles, which is under voluntary control, might affect prostate tension. Also contraction of the levator ani muscles and the pubo rectalis muscles, probably decrease the size of the space the prostate is found in and can potentially exert pressure on the prostate.
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replied May 19th, 2016
Prostatitis epididymitis tension pain
I have to say that yes, tension and stress play a huge role in prostatitis and epididymitis. I have been facing this foe for about 2.5 years now. I have been on several rounds of the strongest antibiotics and nothing in the medical community has brought relief. My ultrasounds come back normal with the exception of minor calcifications in the right testicle and mild varicocele in the left testicle. Prostate size is normal.

My symptoms are definitely brought about by stress and anxiety. Think debilitating pain, frequent urination, burning, tensed right testicle hang (have to concentrate to relax and let it hang), pain in left testicle, and low libido, plus depression. I originally thought that I had non specific gonococcal urethritis, or something similar. All STI tests were negative and urinalysis was fine except for a little blood (I've had this even before any symptoms).

My current thinking is that at one time I could have had an infection; however, it has to have long since pasted. I've passed several kidney stones in my life, not sure if this could have an impact? A CAT scan shows that there are very small calculi in the prostate and kidneys. I'm unsure if this is really an issue as most men have these and are asymptomatic.

The things that have helped me the most are:

*accepting the pain
*ignoring it and getting out and doing things
*deep breathing
*prescription strength muscle relaxers such as Flexeril (10mg)
*walking in the Sun
*being engaging with positive people
*Ativan (2mg)

As a side note; heavy lifting at the gym can seem to intensify symptoms, but I refuse to give up weight training. I think weight-lifting causes more muscle tension which in turn can lead to more pelvic pain.

Some may find these links useful: en/pelvic-floor-muscle-relaxation-men/ en/yoga-poses-relax-pelvis/

The better senses of me tell me this is indeed caused by tension, stress, and negative emotions. During periods that I am relaxed I feel no, let me repeat, no pain. My varicocele disappears and my testicles hang evenly. These periods of feeling well suggests there is nothing wrong physically with the body; no virus, no fungus, and no infection. For me personally I think the pain is a manifestation of mental issues that I can only fix.

I hope my experience will help others and they may find management and relief of these symptoms.
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replied November 5th, 2016
Hi guys, I am now cured from this gremlin for about 1.5 years so far. It sucked my life away quite a lot in the time I had it (5 years i'd estimate). It all began from some kind of sporting injury, or so i thought.

However, it was almost certainly tension myositis syndrome (TMS). I read for months and months on the internet, as Dr's were hopeless for this sort of thing. I even had scans fearing i had something wrong in the you know whats.

In desperation to find a cure, i would read the comments on everything just in the hope i would find a little gem somewhere, and sure enough up it popped eventually.

I found this blog, which turned me onto Dr Sarnos books (i got the audiobooks as i find reading a chore).

After going through the books it all began to make sense.

Hilariously now, i have found that because I don't hold tension in my pelvis (god knows what caused me to do this in the first place!) the tension creeps into my neck and shoulders. This is what is described as the tension in your body "moving around" as it needs a place to harbour.

This is very likely to happen if you are an introvert person with people pleasing characteristics. If you cant let out your anger anywhere then you start developing odd muscular idiosyncrasies.

Its all about discovering what triggers the tension holding practices, and then stopping these in their tracks. Once you effectively learn to do this your body will return to its normal self, and for some this will be fast, others it could take a few months to a year to work it out.

Good luck & relax!
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User Profile
replied April 25th, 2019
Thank you for asking at Ehealth forum!

I read your question and I understand your concern.
There is a strong association between mood disorders and chronic prostatitis. We receive bulk of patients. Tricyclic antidepressants are best if there is no contraindication.
I hope it helps. Stay in touch with your healthcare provider for further guidance as our answers are just for education and counselling purposes and cannot be an alternative to actual visit to a doctor.
Take care
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