What Is the Most Common Cause of Prostatitis? Understanding Prostate Pain Through a Pelvic Health Lens
Prostatitis is one of the most commonly misunderstood pelvic health conditions for men and people with prostates. It can show up suddenly or build over time, and often brings symptoms like pelvic pain, urinary urgency, pressure, or discomfort with sitting.
And here’s the surprising part : Most cases of prostatitis are NOT caused by infection.
As pelvic health specialists in Scarborough, Maine, we see this every single week. Many patients have been treated with multiple rounds of antibiotics for “suspected prostatitis,” yet their symptoms continue. That’s because the most common cause isn’t bacterial…it’s muscular.
✔ So What Is the Most Common Cause of Prostatitis?
Most Common Cause: Pelvic Floor Muscle Dysfunction
The majority of prostatitis cases (nearly 90–95%) fall under a category called:
Chronic Pelvic Pain Syndrome (CPPS)
This means that symptoms are coming from:
Tight or overactive pelvic floor muscles
Trigger points in the pelvic floor or hips
Nerve irritation
Stress-related tension
Posture or sitting mechanics
Core and diaphragm imbalance
Scar tissue or myofascial restrictions
In CPPS, the prostate itself is often normal on imaging or exam. The discomfort is coming from the muscles, nerves, and connective tissues surrounding the prostate and those structures can mimic prostate pain incredibly well.
This is why someone can feel:
Pressure in the perineum
Deep groin pain
Urinary urgency
Pain with ejaculation
Testicular aching
Rectal tension
Pain with sitting
…but have no infection.
✔ Why Muscular Prostatitis Happens
Pelvic floor dysfunction can develop for many reasons. The most common include:
1. Chronic stress
Stress can lead to pelvic floor gripping. The pelvic floor muscles tighten subconsciously the same way shoulders scrunch toward the ears.
2. Prolonged sitting
Desk work, driving, or cycling can compress the pelvic nerves and irritate the muscles around the prostate.
3. Core + pelvic floor imbalance
A tight diaphragm or inefficient breathing affects pelvic tension.
4. Exercise patterns
Heavy lifting, bracing, and high-intensity workouts can create chronic tightness.
5. Previous back, hip, or abdominal injuries
Your pelvic floor compensates for pain or instability in surrounding areas.
6. Post-infection tension
Even after a real infection clears, the muscles may remain tight and reactive.
✔ What About Bacterial Prostatitis?
Acute bacterial prostatitis does exist… but it is:
Less common
Usually obvious (fever, chills, severe pain)
Treatable with antibiotics
Short-term
Chronic bacterial prostatitis is very rare and most men labeled with it actually have CPPS.
This is why antibiotics often don’t help and the root cause isn’t infection.
The Pelvic Health Perspective
Many patients come to us after months or even years of pelvic symptoms. They’ve had:
Multiple urine tests
Rectal exams
Imaging
Courses of antibiotics
Urology visits
Yet no one has assessed the pelvic floor muscles, which is the source for most nonbacterial prostatitis.
When we evaluate someone with CPPS, we often find:
Elevated pelvic floor tone
Tender trigger points
Diaphragm + core imbalances
Guarding around the perineum
Restricted hip rotation
Nerve tension along the pudendal or genitofemoral nerve
Once these areas are treated, symptoms commonly improve.
✔ How Pelvic Floor PT Helps Prostatitis
Pelvic floor physical therapy is considered first-line treatment for chronic prostatitis/CPPS.
At Root To Rise, sessions may include:
Hands-on pelvic floor release
Myofascial work around the hips, abdomen, and low back
Breathing retraining to reduce pelvic guarding
Nervous system down-training
Hip and core mobility
Tailored home exercises
Lifestyle modifications and stress-reduction strategies
When the muscles relax and the nerves calm, prostate-related symptoms often improve dramatically.
Try-It-Yourself Strategies for Prostatitis Relief
These are safe first steps, but should not replace individualized care:
✔ Diaphragmatic Breathing (1–2 minutes)
“Inhale low, exhale long.”
This reduces pelvic tone and supports the nervous system.
✔ Warm Sitz Bath
10–15 minutes to reduce muscle tension.
✔ Gentle Hip Mobility
Happy baby
Figure-4 stretch
Cat/cow
✔ Limit sitting pressure
Use a donut cushion or change positions frequently.
✔ Avoid excessive “core clenching”
Many people unknowingly brace the abdomen all day.
If symptoms persist, worsen, or affect sexual or urinary function, pelvic floor PT is strongly recommended.
📍 Prostatitis Treatment in Scarborough, Maine
If you suspect your prostatitis symptoms are muscular, or if you’re tired of being told “everything looks normal” while still experiencing pain, you’re not alone.
We help individuals every day who finally find relief once their pelvic floor is properly assessed.
✨ Book a pelvic health evaluation at Root To Rise Physical Therapy & Pelvic Health in Scarborough, Maine.
Let’s get to the true root of your symptoms so you can return to mobility, confidence, and comfort.