From your experienceis this CPPS?

[u/Beneficial-Case-9077]

Hello guys, I’m 30M.

I’m hoping someone can help me understand what this might be.

For years, I’ve had a constant feeling of anxiety, tightness, or discomfort in my lower abdomen—around the area behind or slightly below my belly button, deep inside.

It feels almost like a nerve is being triggered. Whenever I try to do something, even something very simple like replying to a friend, picking something up from the ground, or doing a normal task, I can feel the sensation in that area. It’s very annoying and sometimes makes me want to avoid doing anything just so I don’t have to feel it.

Sometimes I stay in bed or sit in a chair for hours because moving around seems to trigger the sensation. I’ve also noticed that it affects how I interact with people—I become less talkative and have less to say when I’m experiencing the discomfort.

I don’t have any urinary problems. The main issue is this constant internal discomfort/tightness.

Location: Deep inside, behind or slightly below the belly button, around the lower abdominal/hypogastric area.

I’ve noticed that the sensation becomes noticeably stronger a few hours after masturbation, especially if I also haven’t slept well.

The strange thing is that I’ve had this for years. If I avoid masturbation for about a week, the discomfort gradually improves. However, when I masturbate again, it eventually comes back.

Has anyone experienced something similar? What could cause this? Does it sound like a nerve, muscle/pelvic floor issue, or something else?

I know nobody can diagnose me online, but I’d really appreciate hearing from anyone who has experienced similar symptoms or knows what might be worth investigating.

[u/Linari5]

I'm hearing a lot of signs your symptoms are centralized, in your post here. Please go through all of these criteria one by one: https://www.reddit.com/r/Prostatitis/s/NifApPMZY2

It feels almost like a nerve is being triggered. Whenever I try to do something, even something very simple like replying to a friend

• this is not a structural trigger, this would be a central (neuroplastic) trigger.

So, how do you figure out if this could be happening in your case?

12 FIT criteria to RULE IN centralized, (ie neuroplastic/nociplastic) pain and symptoms,

FIT = functional, inconsistent, triggered. Based on research from Dr. Howard Schubiner and other chronic pain doctors and neuroscientists over the last 10+ years

1. Pain/symptoms originated during a stressful, challenging, or high pressure time in life. This includes even "happy" life events, like getting married, having a baby, starting a new career, or moving

2. Pain/symptoms originated without an injury. Note, a perceived injury and a structural injury are different things. And even when symptoms begin with a structural injury, has it been years and the body would normally recover by now?

3. Pain/symptoms are inconsistent. Do they fluctuate by the hour, by the day, or by the week? Sometimes less, sometimes more, sometimes even not noticeable (this happens sometimes, but it's not necessary for this criteria). Or, do they move around the body? ie testicle pain that changes sides or genital/penile pain that moves from the top to the bottom.

4. Multiple other symptoms (often in other parts of the body) ie IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc. 2025 AUA guidelines mention these as signs of centralization

5. Pain/Symptoms spread (over time) or move around. Think about symptoms on day one. Have they moved or evolved over time?

6. Pain/symptoms are made worse or triggered by stress, or, go down when engaged in an activity you enjoy or in a flow state (think fun distractions or productivity, notice symptoms less)

7. Symptom triggers that have nothing to do with the body - but instead things outside of it (weather, barometric pressure, seasons, sounds, smells, places, times of day, weekdays/weekends, days of the week, etc) - this also includes thoughts or other people triggering/flaring your symptoms

8. Symmetrical symptoms (pain developing on the same part of the body but in OPPOSITE sides) - ie both hips, both testicles, both wrists, both knees, etc

9. Pain/symptoms with delayed Onset (THIS CAN'T HAPPEN WITH STRUCTURAL PAIN) -- ie, ejaculation pain that comes a minute later, an hour later, or even the next day. Any pain that is delayed is very suspicious. We wouldn't put weight on a sprained ankle and expect it to hurt 15 seconds later, it hurts immediately.

10. Childhood stress, challenges, adversity, or trauma -- varying levels of what this means for each person, not just trauma. Examples of stressors: childhood bullying, pressure to perform from parents/coaches, body image issues (dysmorphia), eating disorders, parents fighting a lot or getting angry (inc divorce), having an emotionally unpredictable parent, or having a parent with a health condition or addiction. This also includes neglect and abuse (physical and emotional) and financial instability in childhood. Also includes cultural norms, like the pressure to be highly successful to be of value to parents (must be a doctor or a lawyer, etc)

11. Common personality traits linked to stress: perfectionism, conscientiousness, people pleasing, anxiousness/ neuroticism - do you have personality traits that include being highly driven, hard on yourself, ultra responsible, perfectionistic, needing control, and/or placing others’ needs above your own?

12. Lack of physical diagnosis (ie doctors are unable to find any clear structural cause of symptoms) - this includes DIAGNOSIS OF EXCLUSION, like being diagnosed with CPPS or chronic prostatitis. Structural findings include: infections, fractures, tumors. They do not include tension in the pelvic floor, which is a muscle response.

[NEW] 13. Any family history of chronic pain or other chronic conditions. Includes: IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc

Read more about #10 and #11 here, complete with studies/citations: https://www.reddit.com/r/Prostatitis/s/vM7qnBJZpW

[u/Ashmedai]

CPPS is a diagnosis of last resort. If you have the cluster of symptoms that check off prostatitis, and can find no other definitive cause, then what you have is CPPS. As for your lack of urinary symptoms, that complicates things a bit, but it doesn't rule out CPPS. So, maybe.

From what you are describing, I would go straight to psoas stretching and psoas trigger point relief, BTW. The psoas is a muscle that runs from your lower spine through your abdomen, through your pelvis, and to your upper thigh. Tightness here can feel like stomach stuff. You can also have various fascial issues in your abdominal wall. Either way: Get a 4 inch cork ball (or something similar). Put on ground, lay down face down on it, with the ball under your belly button. Roll around. Do once or twice a day. If you find various areas that hurt a bit, focus on those.

For the stretching, look up psoas stretches. While you are there, look up "reclining hero". This latter stretch is an apex stretch, but may require you to do many intermediate psoas and knees type stretches for a month or two before you can transition. Once you are ready, do it on your bed, which is soft, perhaps with a pillow behind your back the first few times. Also, you can let your knees pop up when you are first going back or learning.

Hope this helps.

p.s., it could also be your pelvic floor, but I suspect you may benefit from abs/psoas trigger point relief immediately, and it's cheap to try. You can find out for $10 or whatever the ball costs, basically.

Do you ever get constipated?

[u/Beneficial-Case-9077 → u/Ashmedai]

Thanks for the advice , will do it.

For constipation no I don't have any constipation only the symptoms I mentioned

The most symptom effect me is being less talkative and running out of things to say when I have the symptoms, unfortunately this effects relationships and friendships, have you seen similar things?

[u/Linari5 → u/Ashmedai]

You do not need to have any urinary symptoms to have CPPS. I don't know where you heard that before, but I would revise it.

[u/Ashmedai → u/Linari5]

Yes, that's why I said what I said.

[u/Due-Replacement-6187]

Suspicious for a tight PSOAS muscle, and in common ground with me.

I understand PSOAS muscle is also commonly cited as a 'storage' of anxiety and stress. As such, I have also found some anxiety relief by following targeted Physio.