Pelvic Floor Condition
Chronic Pelvic Pain Syndrome (CPPS)
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Your cultures are clean, your scans look fine, and you have finished more than one round of antibiotics. The pain is still there. In many people, no infection is involved. The pain comes from a pelvic floor that will not let go, nerves that have become touchy, and a pain system stuck on high alert.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
What CPPS Is
Chronic pelvic pain syndrome is a diagnosis given when pain in the pelvis, perineum, genitals or lower abdomen lasts for months and no infection or structural disease explains it. That label can feel like a dead end. In practice, it usually points to a cycle that feeds itself.
It often starts with something real: an infection, a hard stretch of sitting, a surgery, heavy training, childbirth, or months of stress. The pelvic floor tightens to protect the area. If that guarding never fully switches off, the muscles develop tender knots, blood flow drops, and nearby nerves like the pudendal and obturator get squeezed and irritated. Over time the spinal cord and brain start to treat ordinary signals, like sitting, a full bladder, or intercourse, as threats. Pain rises, the muscles guard harder, and the loop tightens.
That is why CPPS responds poorly to treatments aimed at a single organ. The goal of care at the clinic is to find which muscles and nerves are keeping your loop running, calm them directly, and work alongside your urologist, gynecologist or pelvic floor physical therapist so everyone is pulling in the same direction.
CPPS at a Glance
Also called
Chronic pelvic pain, pelvic floor tension myalgia and levator ani syndrome in women and men. In women, often called pelvic floor dysfunction or pelvic myofascial pain. In men, often called chronic prostatitis / CPPS or nonbacterial prostatitis.
Who it affects
Men and women of all ages, often active, often under long-term stress or sitting load
How long
Pelvic pain present for three months or more, frequently for years before the right diagnosis
Typical workup results
Negative cultures, normal imaging, little change with antibiotics or anti-inflammatories
Main drivers
Pelvic floor overactivity, nerve irritation, hip and trunk load patterns, pain sensitization
The Gap in Care
Why CPPS Keeps Slipping Through the Cracks
Standard testing is designed to catch disease. That is important and should always come first. But the things most likely to keep CPPS going do not show up on a lab slip or an MRI.
What the usual workup is looking for
- Bacterial infection of the bladder or prostate
- Stones, cysts, masses or other structural changes
- Inflammation visible on imaging or scope
- Hormonal or organ-specific disease
What often keeps CPPS going
- Pelvic floor muscles that stay contracted at rest
- Trigger points that refer pain to the genitals, rectum, bladder or tailbone
- Nerves that are sensitive to stretch, pressure and sitting
- Hip, abdominal and breathing patterns that load the pelvis
- A nervous system that amplifies normal input
None of the items on the right can be found without putting hands on the tissue and testing how it behaves. That is the center of every evaluation Dr. Gordon performs.
Signs & Symptoms
Does This Sound Like You?
CPPS rarely looks the same in two people, and symptoms often move around. These are the patterns Dr. Gordon sees most.
Deep pelvic, perineal or rectal ache
A pressure, burning or "something is sitting in there" feeling that builds through the day and after long stretches in a chair or on a bike.
Urinary urgency, frequency or burning
Needing to go often or right away, with cultures that keep coming back negative. Symptoms often track with stress more than with fluid intake.
Pain with sex, orgasm or ejaculation
Discomfort during intimacy or a flare in the hours or day after, commonly tied to tension in the deep pelvic floor and inner thigh muscles.
Groin, testicle, vulvar or inner thigh pain
Pain that shifts sides, zings, tingles or burns. This usually points to an irritated nerve rather than an injured organ.
Bowel discomfort or tailbone pain
Pain during or after bowel movements, a sense of incomplete emptying, or aching at the tailbone that gets worse when you sit down.
Low back or hip tightness that flares with it
Back, hip or sacral tension that rises and falls with your pelvic symptoms, often after lifting, running or a long day on your feet.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Identifying which one leads is what makes treatment efficient.
Pelvic floor overactivity and trigger points
The levator ani, obturator internus and coccygeus can hold tension around the clock. Tender points in these muscles refer pain outward and can mimic bladder, prostate or gynecologic problems.
Nerve irritation
The pudendal, obturator, ilioinguinal and genitofemoral nerves pass through and around tight tissue. When they are compressed or tethered, they produce burning, tingling and position-dependent pain.
Hip, trunk and breathing mechanics
Tight adductors, deep hip rotators, a gripping abdominal wall and shallow chest breathing all push extra pressure down into the pelvis and keep the floor from resting.
Pain system sensitization
After months of flares, the nervous system turns up the volume on normal signals. Treatment aims to make your body more predictable and tolerant over time.
Your First Visit
How Dr. Gordon Evaluates CPPS
The initial evaluation runs 60 to 75 minutes. You leave with a working diagnosis of your specific drivers, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon goes through your urology or gynecology workup, imaging, medications and past treatments so he knows what has already been ruled out.
External muscle and nerve mapping
Hands-on assessment of the abdomen, hips, inner thighs, buttocks and low back to find trigger points and nerve sensitivity that reproduce your pain.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Movement and load testing
Sitting tolerance, hip mobility, breathing and trunk control to see which positions and tasks drive the floor into guarding.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or stool
- Sudden, severe testicular or pelvic pain
- Unexplained weight loss
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for CPPS, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Fine filiform needles reach the deep pelvic floor muscles that are hard to release by hand, turning off trigger points and reducing the guarding that compresses irritated nerves. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Targeted electro-acupuncture along the pudendal, sacral and lumbar nerve pathways to settle nerve sensitivity and help the nervous system turn down the volume.
See servicesBetween visits
Flare Plan & Team Coordination
Practical guidance on sitting, breathing, pacing and flare control, plus shared goals with your physician or pelvic floor PT so you are not getting mixed messages.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the lead driver
Dr. Gordon confirms which muscles and nerves are running the show. Many people notice early changes like longer comfortable sitting time or fewer sharp spikes.
Visits 4 to 8
Lower the baseline
Daily pain intensity comes down and flares become shorter and less frequent. Work, workouts and travel start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as function holds steady. You leave with a maintenance and early-flare plan instead of reacting to every symptom.
Most CPPS patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
CPPS Questions
Answers About Chronic Pelvic Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
No. Clear results tell you infection, stones, tumors and other serious causes have been looked for and not found. That is good news, but it does not rule out pain driven by the pelvic floor muscles, the nerves that run through them, and a nervous system that has become more reactive. Those drivers are real, and they are exactly what Dr. Gordon assesses and treats.
The terms overlap. In men, many cases labeled chronic prostatitis have no infection and are formally classified as chronic prostatitis / chronic pelvic pain syndrome. Women develop the same muscle and nerve pattern under names like pelvic floor tension myalgia or levator ani syndrome. Your urologist or gynecologist manages the medical diagnosis and medications. Dr. Gordon focuses on the muscle and nerve contributors.
Many people with CPPS have a pelvic floor that is already holding too much tension. Adding more squeezing, such as Kegels, can increase compression on irritated nerves and tissue. The first goal is usually to help the muscles let go and coordinate, then build strength once they can fully relax.
No. The pelvic floor muscles are examined externally, with no internal exam. Gentle pressure around the perineum, sit bones, tailbone and inner thighs shows Dr. Gordon where the tension and trigger points are. Treatment options are explained before anything begins, and you decide what you are comfortable with.
Long-standing CPPS usually needs a course of eight to twelve sessions with reassessment along the way, typically weekly at first and then spaced out as symptoms settle. Dr. Gordon gives you an estimate at your first evaluation based on how reactive your symptoms are and what you need to get back to.
Yes, and Dr. Gordon encourages it when it is helping. Pelvic floor PT is excellent for retraining coordination, breathing and activity. Dry needling and acupuncture add direct release of deep trigger points and irritated nerves. With your permission he coordinates so both treatments support each other.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For CPPS, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. CPPS affects people of every gender, and Dr. Gordon treats adults of all genders and identities in a respectful, welcoming setting.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioFurther Reading
Men Have Pelvic Floors Too: Signs Something Is Off
From the blog: Men have a pelvic floor that helps control the bladder, bowel and sexual function. The everyday signs that it may be too tight or out of sync.
Hard Flaccid Syndrome: What It Is and Why the Pelvic Floor Matters
From the blog: Hard flaccid syndrome is poorly understood and not yet a formal diagnosis. What men describe, what the limited research shows, and the pelvic floor view.
Pain at the Tip of the Penis: A Pelvic Floor Cause
From the blog: Pain at the tip of the penis with clear tests can be referred from tight pelvic floor muscles. Why it happens, what to rule out first, and what helps.
Book an Evaluation for Chronic Pelvic Pain Syndrome
Book a full evaluation with Dr. Gordon and leave with a clear picture of what is driving your pain and what to do about it.
Early morning, evening and weekend appointments available. Free on-site parking.
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