A biopsychosocial approach as a part of an osteopathic intervention in the management of chronic prostatitis/chronic pelvic pain: A case report

Abstract

IntroductionThe aetiology behind chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains unknown, which makes treatment challenging, while the diagnostic uncertainty related to CP/CPPS creates confusion and frustration for both patients and clinicians. As CP/CPSS may be persuaded by nociplastic pain mechanism and is associated with psychosocial and lifestyle factors, interventions should address biopsychosocial factors in combination with the treatment of the biomechanical impairments. Case descriptionThis is a case study of a 71-year-old man diagnosed with CP/CPPS who was referred to the osteopathic clinic by his urologist. His main complaint was a constant dull aching pain in the urethra and right groin that had started almost 10 years previously. The patient was treated six times over a time period of 5 months using a multimodal osteopathic approach. OutcomesThe osteopathic intervention significantly decreased the numeric pain rating scale score, improved quality of life and reduced pain and dysfunction as measured with the National Institutes of Health chronic prostatitis symptom index. DiscussionAs CP/CPPS may be a nociplastic pain syndrome, and a multimodal osteopathic approach may therefore be needed that includes treatment of the biomechanical impairments with osteopathic manipulative treatment while also addressing various biopsychosocial factors via education, dietary modifications, advice about physical activity, breathing exercises, sleep and stress management. ConclusionsApplication of the biopsychosocial model in addition to a biomedical osteopathic model seems to be a beneficial intervention strategy to improve quality of life, pain and dysfunction in a patient with CP/CPPS.