Men with chronic pain from prostate inflammation may get lasting relief from acupuncture, a new clinical trial finds.
At issue is a condition known as chronic prostatitis/chronic pelvic pain syndrome, in which the prostate gland becomes inflamed and nerves supplying the area are irritated. That can cause pain in the perineum, penis, scrotum and low belly, as well as urinary problems and sexual dysfunction.
An estimated 10% to 15% of U.S. men develop chronic prostatitis, according to the U.S. National Institutes of Health. And the mainstays of medical treatment -- including antibiotics and anti-inflammatory painkillers -- often fail to help.
In the new trial, Chinese researchers found that 20 sessions of acupuncture often did help. Over eight weeks, the treatments eased symptoms in more than 60% of study patients who received them, according to findings published Aug. 17 in the Annals of Internal Medicine.
That compared with 37% of patients who were given a "sham" version of acupuncture for comparison, the study authors said. And the benefits were still apparent six months after the acupuncture sessions ended.
The findings came as no surprise to Dr. Geovanni Espinosa, a clinical assistant professor of urology at NYU Grossman School of Medicine, in New York City.
Espinosa, a naturopathic doctor, uses acupuncture as part of a "holistic" approach to managing chronic prostatitis. To manage the condition, needles are inserted in areas like the low back and buttocks.
"This trial confirms what we've known," he said. "In my opinion, it really takes an integrative approach to treat this condition."
Prostatitis refers to any inflammation of the prostate. In some cases, a bacterial infection is to blame and antibiotics can help.
But chronic prostatitis/chronic pelvic pain is by far the most common form, Espinosa said.
The initial causes are typically hard to determine, and Espinosa said that by the time patients go to see him, they may have been suffering symptoms for anywhere from six months to 16 years.
Besides the physical symptoms, he noted, many men are depressed, too. Chronic pain is always difficult to deal with, and in the case of longstanding prostatitis, Espinosa said, the pain affects a particularly sensitive area of the body.
So he approaches the condition from various angles, including diet changes to help address the inflammation, stress-reduction techniques like deep-breathing practices, and gentle exercises to help stretch muscles of the pelvic-floor.
Acupuncture, which is rooted in traditional Chinese medicine, fits into that bigger picture, Espinosa said.
It's not clear exactly why acupuncture can have lasting effects on chronic prostatitis symptoms, according to Dr. Zhishun Liu, senior researcher on the new trial.
"The underlying mechanisms are still unclear and require further research," said Liu, of the department of acupuncture at Guang'anmen Hospital in Beijing.
Acupuncture involves inserting very fine needles into the skin at specific "acupoints." According to tradition, that alters the flow of energy, or "qi" (pronounced "chee"), throughout the body.
Modern research suggests the needle stimulation can trigger the body to release its natural stores of pain-dulling and inflammation-fighting chemicals, according to Liu.
The current trial involved 440 men aged 18 to 50 who had chronic prostatitis and no evidence of an infection. Half were randomly assigned to 20 sessions of acupuncture over eight weeks; the other half received a "sham" version where needles were inserted very superficially, at non-acupuncture points on the skin.
After eight weeks, 61% of men in the acupuncture group had responded -- meaning their scores on a measure of chronic prostatitis symptoms dropped by at least 6 points. Six months later, the same percentage were still responding.
"Acupuncture is effective and durable for [chronic prostatitis], with a good safety profile," Liu said. "It is a promising choice for patients."
If 20 sessions sounds like a big time (and financial) investment, Espinosa said it does not necessarily take that many.
He has adapted traditional acupuncture to meet the practical realities of patients' lives, and starts with six sessions, done once per week -- adding more if needed.
Cost can be a barrier if patients have to self-pay. But, Espinosa said, some insurers do cover the treatment.
For men who are interested in holistic approaches to chronic pelvic pain, he advised seeking out a licensed professional, whether a naturopathic doctor or acupuncturist.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on chronic prostatitis.
SOURCES: Zhishun Liu, MD, PhD, department of acupuncture and moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing; Geovanni Espinosa, ND, LAc, clinical assistant professor, urology, NYU Grossman School of Medicine, New York City; Annals of Internal Medicine, Aug. 17, 2021, online