How TCM Relieves Severe and Persistent Pelvic Pain Caused by Chronic Prostatitis

One of the most distressing symptoms of chronic prostatitis is persistent pain in the pelvic region. This pain may occur in the perineum, lower abdomen, lumbosacral area, or inner thighs, and may even radiate to the testicles or penis. Its nature varies—it can feel like stabbing, distending, or dull pain—and often lasts for long periods, severely affecting work and quality of life.

Western medicine primarily relies on painkillers and α-receptor blockers for management. However, long-term use of pain medication has clear side effects and fails to address the root cause. Traditional Chinese Medicine (TCM), on the other hand, treats this problem by improving Qi and blood circulation and unblocking meridians. This approach not only alleviates pain but also helps correct the underlying pathology of the prostate, reducing recurrence.

How TCM Identifies Different Pain Patterns

In TCM, diagnosis and treatment follow the principle of syndrome differentiation. Different types of pain require different therapeutic methods.

1. Qi Stagnation and Blood Stasis Type

This is the most common type. Pain tends to be stabbing or distending, localized and fixed, with a noticeable heaviness in the perineum. It worsens after sitting or standing for long periods and improves slightly with movement. Patients are often irritable, constipated, and easily frustrated.

The tongue is dark or has purple spots, with distended sublingual veins; the pulse is wiry or choppy.

This pattern often appears in patients with a long disease course, where repeated inflammation causes local blood and Qi stagnation, making the gland hardened—just like a blocked river.

2. Damp-Heat Accumulation Type

Pain is accompanied by a burning sensation and distension in the perineum or lower abdomen, with pain worsening during urination and a burning feeling in the urethra. Patients may also experience bitter taste, bad breath, and sticky stools. The tongue is red with a yellow, greasy coating, and the pulse is slippery and rapid.

This type is common among people who drink alcohol, eat spicy food frequently, or live in hot, humid environments. Damp-heat accumulates in the lower body, obstructing the Qi flow, which leads to pain.

3. Cold-Damp Obstruction Type

Pain feels cold or dull, worsens with cold exposure, and improves with warmth. The perineum, lower abdomen, and lumbosacral areas feel cold and sore, especially during winter or rainy weather. Patients often feel chilly, with cold hands and feet and clear, frequent urination. The tongue is pale with a white coating, and the pulse is deep and slow.

This occurs in individuals with a cold constitution or those who live in damp, cold environments. Cold and dampness invade the meridians, block circulation, and cause pain.

4. Kidney Deficiency Type

Pain mainly affects the lumbosacral region, dull and lingering, worsening with fatigue and easing with rest. Accompanying symptoms include weakness in the lower back and knees, fatigue, dizziness, and tinnitus. The tongue is pale or dark, and the pulse is deep, thin, and weak.

This pattern often affects older individuals or those with long-standing disease and sexual overexertion. Deficiency of kidney Qi weakens the movement of Qi and blood, leading to pain from poor nourishment of the meridians.

Targeted TCM Treatment Approaches

Qi Stagnation and Blood Stasis – Soothing and Unblocking Method

Main Formula: Xue Fu Zhu Yu Tang (Blood Mansion Eliminating Stasis Decoction)

Ingredients:

Peach Kernel 12g, Safflower 9g, Angelica 12g, Rehmannia 12g, Ligusticum 10g, Red Peony Root 12g, Bupleurum 10g, Aurantii Fructus 10g, Platycodon 6g, Achyranthes 12g, Licorice 6g.

This classic prescription from the Qing Dynasty physician Wang Qingren treats Qi stagnation and blood stasis. It activates blood circulation (Peach Kernel, Safflower, Ligusticum), soothes the liver and regulates Qi (Bupleurum, Aurantii), and guides the medicine downward to the pelvic region (Achyranthes).

For pronounced perineal pain: add Corydalis (Yuan Hu) 15g and Toosendan Fruit (Chuan Lian Zi) 10g.

For lumbosacral pain: add Eucommia (Du Zhong) 15g and Dipsacus (Xu Duan) 12g.

For testicular distension: add Lychee Seed (Li Zhi He) 10g and Tangerine Seed (Ju He) 10g.

Acupuncture Therapy

Points: Zhongji (CV3), Guanyuan (CV4), Ciliao (BL32), Sanyinjiao (SP6), Taichong (LR3), Xuehai (SP10).

These points regulate Qi and blood, soothe the liver, and unblock meridians. Insert needles with a balanced reinforcing-reducing method for 30 minutes once daily or every other day. Many patients report immediate relief after sessions, with better long-term results through consistency.

Damp-Heat Type – Clearing and Draining Method

Main Formula: Long Dan Xie Gan Tang (Gentiana Liver-Draining Decoction)

Ingredients: Gentian 6g, Gardenia 10g, Scutellaria 10g, Bupleurum 10g, Rehmannia 15g, Plantago Seed 15g, Alisma 12g, Akebia Stem 6g, Angelica 10g, Licorice 6g.

This formula clears damp-heat from the liver and bladder, promoting urination and reducing inflammation.

For severe urinary burning: add Imperata Root (Bai Mao Gen) 20g and Talc (Hua Shi) 15g.

For burning perineal pain: add Sophora (Ku Shen) 12g and Phellodendron (Huang Bai) 10g.

For constipation: add Rhubarb (Da Huang) 6g (add last).

Herbal Sitz Bath

Ingredients: Sophora 30g, Phellodendron 20g, Cnidium 20g, Sichuan Pepper 10g, Clematis 15g.

Boil for 30 minutes, cool to 40–45°C, and soak for 20 minutes once or twice daily. This method clears heat, removes dampness, improves circulation, and relieves pain.

Cold-Damp Type – Warming and Unblocking Method

Main Formula: Shao Fu Zhu Yu Tang (Lower Abdomen Blood Stasis Decoction)

Ingredients: Fennel 6g, Dried Ginger 6g, Corydalis 10g, Myrrh 10g, Angelica 12g, Ligusticum 10g, Cinnamon Twig 6g, Red Peony 12g, Typha Pollen 10g, Trogopterus Dung 10g.

This formula warms meridians and dispels cold while promoting blood flow.

For severe lumbosacral pain: add Morinda (Ba Ji Tian) 12g, Curculigo (Xian Mao) 10g, and Cinnamon Bark (Rou Gui) 6g.

For lower abdominal cold pain: add Evodia (Wu Zhu Yu) 6g and Lindera (Wu Yao) 10g.

Moxibustion Therapy

Points: Guanyuan (CV4), Zhongji (CV3), Shenshu (BL23), Ciliao (BL32), Sanyinjiao (SP6).

Use mild or ginger-separated moxibustion for 15–20 minutes per point, until the area feels warm. Many patients report a “flow of warmth” through the perineum, with pain relief and improved circulation.

Kidney Deficiency Type – Tonifying Method

Main Formula: Ji Sheng Shen Qi Wan (Kidney Qi Pill with Enhancements)

Ingredients: Rehmannia 20g, Dioscorea 15g, Cornus 12g, Poria 15g, Alisma 10g, Moutan 10g, Cinnamon Twig 6g, Aconite (pre-decocted) 6g, Achyranthes 12g, Plantago Seed 15g.

This prescription warms kidney Yang and promotes urination.

For weak lower back and knees: add Eucommia 15g, Dipsacus 12g, and Mulberry Mistletoe 15g.

For frequent night urination: add Alpinia Seed (Yi Zhi Ren) 10g and Mantis Egg Case (Sang Piao Xiao) 10g.

Dietary Support

Walnut-Black Sesame Paste: grind 30g walnuts, 30g black sesame, and 15g goji berries into powder; mix with hot water daily. This nourishes the kidneys and strengthens the lower back.

Clinical Note:

The Diuretic and Anti-inflammatory Pill is widely used in such cases. It not only promotes blood flow and clears stasis but also eliminates heat and dampness, making it suitable for long-term management of prostatitis-related pain.

Daily Pain-Relief Techniques

1. Pelvic Floor Relaxation Exercises

Many patients have tense pelvic floor muscles. Relaxation training helps reduce muscle spasm and pain.

Lie down or sit comfortably, relax the whole body.

Inhale deeply and contract the pelvic muscles (as if holding urine) for 5 seconds.

Exhale slowly and relax completely.

Repeat 10–15 times, 3–4 sets daily. The key is full relaxation during exhalation.

2. Hot Compress Therapy

Apply a warm water bag or heating pad (40–45°C) to the perineum or lower abdomen for 20–30 minutes, 2–3 times daily. It boosts local circulation and relieves pain. Avoid during acute inflammation or severe testicular pain.

3. Avoid Prolonged Sitting

Sitting too long increases pelvic pressure and worsens pain. Stand up every 40–50 minutes for light movement. Use cushions with central openings to reduce perineal pressure, and take breaks while driving long distances.

4. Moderate Exercise

Jogging, brisk walking, or swimming 3–5 times weekly for 30 minutes each helps improve blood flow and strengthen the body. Avoid cycling or strenuous activities that compress the perineum.

5. Emotional Balance

Chronic pain easily causes anxiety and depression, which in turn aggravate symptoms. Practice meditation, deep breathing, or listen to music. If emotional distress persists, seek professional counseling. In TCM, “the liver governs Qi flow,” so a calm mood promotes smooth Qi circulation and pain relief.

Treatment Duration and Expectations

Pain relief is gradual. Most patients experience:

• 1–2 weeks: pain intensity decreases from sharp to mild.

• 1–2 months: pain frequency and area reduce.

• 3–6 months: symptoms are mostly controlled with occasional discomfort.

Fluctuations during treatment—such as pain after fatigue or cold exposure—are normal. With consistent therapy and proper self-care, most patients achieve long-term improvement.

Final Thoughts

Pelvic pain from chronic prostatitis is stubborn but not incurable. Through syndrome-based TCM treatment, combining internal and external therapies with lifestyle adjustments, pain can be effectively relieved and quality of life restored. The key is patience, individualized treatment, and trust in the healing process—recovery is absolutely achievable.