Deep ache in the perineum or rectum
Often worse after long sitting, after cycling, or later in the day, and sometimes described as sitting on a golf ball.
CPPS often feels like a deep ache, pressure or burning in the perineum, rectum, genitals, bladder area or low back. It tends to flare with sitting, cycling, stress, bowel movements or sex. Tests for infection usually come back normal.
What’s commonly happening is a loop. The pelvic floor muscles stay guarded and tight, which adds pressure around sensitive nerves. Trigger points, which are tight spots in a muscle, can send pain to other areas. Over time the nervous system becomes more reactive to ordinary input.
I look for the specific muscles and nerves keeping that loop going. My main tools are dry needling, a form of acupuncture, and electroacupuncture. If the levator ani and obturator internus are crowding the pudendal nerve, needling those muscles helps give the nerve room. An irritable pudendal nerve gets electroacupuncture, fine needles placed near it with a gentle current, to help change its signaling. Where the nervous system is amplifying pain, I work at S2 to S4, the sacral segments serving the perineum, to help calm it. I coordinate with urology and pelvic floor PT where that helps.
Most people have had urine tests, imaging, and often antibiotics or anti-inflammatories. Those steps matter, because they rule out infection and other medical causes. When tests are negative, care often shifts to managing symptoms. Muscle tension, trigger points and nerve sensitivity don’t show on imaging, so they can be missed without a hands-on exam. If pelvic floor PT has only partly settled your CPPS, needling adds a different tool. New York law keeps PTs and chiropractors from dry needling.
I start by asking what your urology workup has ruled in or out, what sets off your flares, and where the pain travels. Then the exam:
Urology and pelvic floor PT are the providers I work alongside most for CPPS. If my exam points to something your urologist should look at, I’ll tell you and pass along my findings.
Yes. Normal tests mean infection and serious disease have been ruled out, which is important. CPPS is usually driven by pelvic floor tension and nerve sensitivity, and those don’t show on standard tests.
Urology handles medical diagnoses such as bacterial prostatitis, and decisions about medication. I treat the muscle and nerve problems that commonly overlap with these conditions. I often coordinate with your urologist and with pelvic floor PT.
It is usually a combination, because in CPPS more than one of these problems is often involved. Needling the levator ani and obturator internus relieves pressure on the pudendal nerve, and electroacupuncture targets the nerve’s irritability. Sacral-level work aims to quiet an overactive pain system. I also give you guidance on pacing and managing flares.
In CPPS it is often too tight rather than weak. Strengthening alone can sometimes make symptoms worse by adding more tension. My first goal in CPPS is helping those muscles let go and work in sync.
Yes. Pelvic floor PT is a good complement for retraining coordination, breathing and activity. My part is usually precise needling of the muscles and nerves involved. I keep my goals aligned with your therapist’s so you don’t get mixed messages.
Get prompt medical care if you have fever, new difficulty emptying your bladder, blood in your urine, or unexplained weight loss. Rapidly worsening numbness or weakness, or sudden severe testicular or pelvic pain, also needs a doctor. Those should be evaluated before any needling for CPPS.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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118 W. 72nd St, Rear Lobby, New York, NY 10023
Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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