Effects of Manual Therapy and Dry Needling Techniques for Managing Hypertonicity in the Male Pelvic Floor: A Case Report

Background: Dry needling is beneficial for decreasing hypertonicity and improving musculoskeletal dysfunction within various tissues of the body. There is limited research using dry needling for pelvic floor hypertonicity. The purpose of this case report is to describe the effectiveness of a multi-modal intervention utilizing dry needling for a 27-year-old male with a hypertonic pelvic floor. Study Design: Case study with review of literature. Case Description: This patient was a 27-year-old Caucasian male with a diagnosis of chronic prostatitis/epididymitis. His primary complaint was pain with prolonged sitting in the right testicle. Treatment consisted of dry needling trigger points, myofascial release, manual therapy, and exercise for hip and core stability. Outcomes: The patient attended 38 sessions over 7 months of physical therapy. The patient had a baseline Focus on Therapeutic Outcomes (FOTO) score of 67, with an overall change of 50 points at discharge. Initially, he reported pain based on the Numeric Pain Rating Scale (NPRS) of 10/10 at worst that gradually decreased to a 2/10 at worst. The patient demonstrated clinically meaningful functional and symptomatic improvements from initial evaluation to discharge. Discussion: Dry needling and manual therapy techniques demonstrated significant improvement for addressing pelvic floor hypertonicity in this patient. He demonstrated increased hip strength, decreased pelvic floor tenderness, and pain. He refused internal assessment and treatment, which may have been a contributing factor to the increased number of overall visits. Further investigation is recommended to determine whether dry needling can be utilized independently of other manual therapy interventions