The patient was a Gen-X guy with intractable testicle pain. He had tried everything, been to all the doctors, done all the screenings…and gotten no clear answers. But his testicles hurt, sometimes badly enough that he couldn’t walk easily or stand comfortably. He finally, and in complete desperation, decided to “try acupuncture” (as one does when one is utterly desperate and has been completely failed by biomedicine). And so–probably because I have a number of blog posts about men’s health–he found me and hobbled into my office.
The patient was a young guy, in his early thirties. He was sent to me by his doctor because he struggled with erectile dysfunction and neither ED drugs nor talk therapy were resolving the issue. Discussion during the new-patient intake revealed that his rectum felt heavy, like there was a constant sense of dull pressure, and that just above his public bone he felt a sense of tightness and discomfort. Oh, and his tailbone often hurt.
The patient was a man with occasional shooting pains in his perianal region. What about his testicles, I asked; do they ever ache? And the answer is: not currently, but a few months ago he had to spend a weekend laid out on his couch because they hurt so badly that he couldn’t move without experiencing a heavy, tugging pain that left him seeing stars. None of the doctors he went to found anything remarkable, but he remained concerned (and uncomfortable) so he found me via one of my blog posts and was hoping that Chinese medicine could give him some answers and a plan.
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This is not one patient’s story. They are composites because (1) I don’t tell patient stories in blog posts and (2) this is actually a common narrative. I’ve had a number of guy patients with intractable testicle pain or dull pressure in their groin area or aching rectums or erectile dysfunction that doesn’t respond well enough to meds. The undercarriage is not happy and neither are they. They went to their primary care physician and got shuttled off to specialists but never managed to find relief or even any meaningful information about pelvic floor health or how to resolve their pain and dysfunction.
Just recently, one of my patients forwarded an article to me: “The Stress of Wall Street Is Sending Men to Pelvic Floor Therapy” (Bloomberg, 2025).1 Oh, did I ever read it with great interest because it absolutely validated what I’ve seen in my office as a practitioner with a specialty in men’s health. I screamed “THIS!” out loud when I read the sentence “[…] many men with pelvic floor dysfunction are diagnosed with “nonbacterial” prostatitis — a kind of industry catch-all for pelvic pain with no good explanation or simple solution” because I have heard this story from my own patients so many times.
“Nonbacterial prostatitis”, OMG. I mean, really. Yeah, yeah, yeah…it’s great to know that it’s not a bacteria issue (or cancer, for that matter) but this milquetoast “diagnosis” does not help the patient and actually, in a way, it gaslights them.
The strangest part about all of this, at least to me, is that none of their doctors ever looked at their feet.
Yes, their feet.
That’s one of the first places I look. Yes, I check out the guy’s feet. Interestingly, I have found that many of my guy patients who suffer from pelvic floor pain have very high, very tight arches. Working on their feet resolves their issues, and relatively quickly too. It doesn’t fix things for everyone, but for a good percentage of my undercarriage agony men? It works AND it’s not too hard to learn how to take care of your own feet in a way that prevents recurrence.
What’s going on here, though? And why are guys having these problems and what can they do about it?
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Guys are having these problems because…
Pelvic floor pain can be caused by any number of factors. Too much sitting can start forming muscle patterns that are unhealthy. Anxiety and a tight, clenched undercarriage might be the ongoing root cause and maybe an injury exacerbates the problem. Bad posture can pull your pelvic floor in one or the other direction, as can trauma. Some guys live with a chronic condition (one of my niche areas within my speciality in men’s health is Ehlers-Danlos syndrome and that, like any other chronic condition, can also affect the pelvic floor).
From the perspective of Chinese medicine, we would look at problems here as issues related to specific organs: the Spleen, the Liver, and the Kidneys. The Spleen holds up the organs, and when it’s weak, there is prolapse. The Liver in this context reveals its dysfunction via the tightness, stress, and emotion surrounding the issue. Kidney controls the lower orifices and the Jing, or Essence, so that too is one avenue for treatment. And if we add in Chinese body geography, we can also note that the Spleen, Liver, and Kidney channels all begin at the feet.
Feet can tell you a lot, trust me…
The foot factor, whether you view it from the Chinese medicine or the Western anatomical, is pretty straightforward. Truly, even after all the years I’ve been practicing it still surprises me to see how unaware most people are of their feet. If a person can walk without undue pain (it is hard to ignore things like Morton’s neuroma or plantar fasciitis pain, yes), then they usually don’t notice that–say–their arch is super high and their toes are like rigid blocks. Someone like this is also usually surprised when I palpate up the medial aspect of their legs because they realize, suddenly, that their adductor muscles are not only tight but also painful. And it doesn’t always have to be tight feet; weak feet can also have a strong effect up the line and straight to a guy’s undercarriage.
I can get a lot of information about a guy’s undercarriage just by looking at and palpating his feet. True fact!
Pelvic floor PT or Chinese medicine? It depends…
First step: It is important to check in with a biomedical doctor when you have testicular pain or any other dysfunction in your pelvic region. There are things that can go wrong that do need allopathic attention. You do want to know if this is an infection that requires antibiotics. It is crucial to do something right away if it’s a matter of testicular torsion (this is a painful condition where the testicle rotates and twists the spermatic cord and impedes blood flow to the scrotum). If there’s a possibility of cancer, you need to know what’s what. So it is important to begin at the biomedical doctor’s office.
But where do you go next?
Let’s be real here: pelvic floor therapy can be extremely effective and there is NO REASON to be uncomfortable about it. However, the therapist may do internal work (this, in men, means internal massage via the anus) or acupuncture (aka “dry needling”) on the perineum (aka the taint). This is something to consider. After seeing an MD to rule out anything that requires biomedical intervention it can be worthwhile to see if working on one’s feet resolves the problem before trying some of the more invasive pelvic floor PT options. Obviously, I am biased in favor of Chinese medicine but…a guy does have other possibilities.
In my practice, I rely on a few things besides my license to practice acupuncture and herbal medicine:
- I have a solid exercise background and a great eye for kinesiology (body movement). Even though I no longer offer personal training or yoga instruction, I’ve been certified to do both for over a decade at this point, plus I have decades of experience working with personal trainers for my own training (most of whom were competitive bodybuilders) so I not only can observe with an analytical eye but I can also offer corrective movement options;
- I am, and have been for over a decade, a dedicated tui na (Chinese manual therapy) practitioner and I have considerable experience working on feet; and–last but not least–
- I specialize in men’s health.
This is all well and good, and if you’re in Austin (or can travel to see me), then great! I can also consult with you with a virtual visit, so that’s an option.
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But what if neither of these options work? Well, then it might work to look around and find a reflexologist or, if you’re in a place with abundant Chinese medicine options, maybe see if you can find a local practitioner who specializes. Or try something creative, like dance lessons for adults or yoga for feet and ankles (google it and see what you find). Tai chi is great for balance and strength too, and there are lots of options for strengthening and getting to know your own feet if you take a wander around the internet.2
Keep in mind that acupuncture is a great option and yes, it is often part of my treatment protocol. But an acupuncturist is not going to be needling in intimate areas and you can often get the results you want with manual therapy, be it tui na or other options like cupping and/or gua sha. Depending, I might also be inclined to prescribe an herbal formula for anxiety or even perhaps for muscle tightness and pain. When treating your pelvic floor, I’m thinking about your whole self and the root causes, not just the physical location of your pain.
Knowledge is power, though. How a guy wants to heal his own body is his own choice. But if your testicles ache or your tailbone is sore, you do have options and you can make meaningful change if you start from the ground up. And if all your doctor has to say is “Nonbacterial prostatitis” to your ongoing pelvic floor dysfunction, you might just want to thank them politely (or think, in your best Southern accent, “Bless your heart”) and then find someone to give you some meaningful help. That could be a pelvic floor PT, it could be an acupuncturist who specializes in men’s health, it could be a really savvy yoga teacher or personal trainer or dance instructor.
The TL/DR? Self-awareness and creativity with body movement (stretching, exercise, knowing when and how to adequately rest) are all avenues for healing. Finding the right practitioner to work with can change things for the better.
But you do not have to live with testicle pain. And if you feel pressure on your rectum, an aching tailbone, suprapubic discomfort, you have to get up to go pee several times at night, and/or you have erectile dysfunction at young age or for no apparent reason (and your testosterone levels are fine plus Viagra doesn’t seem to be helping) then–more likely than not–it’s related to the pelvic floor.
And you can do something about that, so why wait?
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Dr. Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, a health coach, and an author. She maintains an active and growing practice at her Austin, TX office. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and wellness support for all persons.
She is the author of Chinese Medicine and the Management of Hypermobile Ehlers Danlos Syndrome: A Practitioner’s Guide. Dr. Bruno also maintains a second website, holistichealthandheds.com, with resources and information curated specifically for people with hEDS and HSD.
When you are ready to discover what traditional medicine plus a vibrant and engaged approach to holistic health can do for you, either contact Dr. Bruno or book an appointment online.
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Note: Material on this web site site is not intended to diagnose, prevent, treat, or cure any disease, illness, or ailment. A Chinese medicine practitioner in Texas identifies syndrome patterns but does not diagnose illness. Material on this web site does not purport to identify syndrome patterns.
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- I’m not linking this one because it is behind a paywall but it’s easy to find via web search. ↩︎
- Look up “foot and ankle stabilization exercises,” for instance, and see what you find. There are many ways to improve your balance and it can be fun to experiment. Have you heard of the GiBoard, for example? So much fun, and great for restoring balance and core strength. ↩︎
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