Why Does My Penis Hurt? Common Causes You Might Not Expect
Penis pain can be confusing, frustrating, and honestly scary. Many men worry that pain automatically means infection, nerve damage, or something “seriously wrong.” While those causes do exist, a large percentage of penile pain—especially when tests come back normal—is actually related to the pelvic floor, surrounding muscles, connective tissue (fascia), and the nervous system.
The penis doesn’t work in isolation. It relies on coordinated muscle activity, healthy nerve signaling, good blood flow, and proper posture. When any part of that system becomes irritated or overactive, pain can show up at the tip, shaft, base, or even deep inside the pelvis.
Below are some of the most common reasons men experience penis pain—and how pelvic floor physical therapy can help.
1. Overactive or Tight Pelvic Floor Muscles
One of the most overlooked causes of penile pain is excessive tension in the pelvic floor muscles. These muscles support the bladder, prostate, and rectum and play a major role in erections, ejaculation, and urination.
When the pelvic floor stays clenched—often due to stress, chronic holding, pain, or guarding—it can:
Refer pain into the penis
Cause burning or aching sensations
Trigger pain at the tip of the penis or urethra
Make symptoms worse after sitting, ejaculation, or exercise
Pelvic floor physical therapy focuses on restoring normal muscle tone, not strengthening already tight muscles. Treatment may include manual release, breathing techniques, and retraining how the muscles relax and contract appropriately.
2. Nerve Irritation or Sensitization
The pudendal nerve and other pelvic nerves provide sensation to the penis. These nerves can become irritated without being “damaged,” especially when surrounding muscles or fascia are tight.
Nerve-related penis pain may feel like:
Burning or stinging
Electric or sharp sensations
Hypersensitivity to touch or clothing
Pain without any visible cause
Pelvic floor therapy addresses nerve irritation by reducing mechanical pressure, calming the nervous system, and improving mobility around nerve pathways. This often reduces pain even when imaging and tests are normal.
3. Pain After Ejaculation or Orgasm
Pain after orgasm is common in men with pelvic floor dysfunction. Ejaculation requires strong, rapid pelvic floor contractions. If the muscles are already tight or poorly coordinated, that contraction can trigger pain in the penis, perineum, or pelvis.
This pain can last minutes or hours and may feel worse over time.
Pelvic floor physical therapy helps by:
Improving muscle coordination
Reducing baseline muscle tension
Teaching strategies to prevent post-ejaculatory flare-ups
4. Posture and Sitting Mechanics
Long hours of sitting—especially with poor posture—can place sustained pressure on the pelvic floor, nerves, and connective tissue. Slouched posture, posterior pelvic tilt, or uneven weight distribution can all contribute to penis pain.
Men often notice pain:
After prolonged sitting
While driving
When standing up after sitting
Pelvic floor therapy looks beyond the pelvis alone. Treatment includes posture correction, hip and core mobility, and education on sitting mechanics to reduce ongoing irritation.
5. Fascial Restrictions and Connective Tissue Tension
Fascia is the body’s connective tissue network that links muscles, nerves, and organs. Restrictions in the abdomen, hips, low back, or pelvic region can transmit tension into the penis—even when the penis itself is healthy.
Scar tissue, inflammation, prior surgeries, or repetitive strain can all affect fascial mobility.
Pelvic floor physical therapists are trained to assess and treat these restrictions using gentle, targeted techniques that improve tissue glide and reduce referred pain.
6. Chronic Pelvic Pain Syndrome or Prostatitis-Like Symptoms
Many men diagnosed with chronic pelvic pain syndrome (CPPS) or non-bacterial prostatitis experience penile pain despite negative lab results. In these cases, the issue is often muscular and nervous system-driven rather than infectious.
Pelvic floor physical therapy is considered a first-line treatment for CPPS because it addresses the underlying contributors rather than masking symptoms.
7. Penis Pain After Surgery or Catheterization
Penis pain after a medical procedure is more common than most men are told. Even when a surgery is successful, or a catheter was only in place temporarily, the tissues and nerves of the pelvis can remain irritated long after the procedure itself has healed.
Catheterization in particular can:
Irritate the urethra and surrounding tissue
Trigger protective muscle tightening in the pelvic floor
Sensitize nerves involved in penile sensation
This can lead to lingering symptoms such as burning at the tip of the penis, aching along the shaft, pain with urination, or discomfort during erections or ejaculation—even weeks or months later.
Pelvic and abdominal surgeries (such as hernia repair, prostate procedures, bladder surgery, or colorectal surgery) can also contribute to penis pain. Scar tissue, altered movement patterns, and changes in muscle coordination can place ongoing tension on the pelvic floor and surrounding fascia, even when the incision site feels “fine.”
Pelvic floor physical therapy helps by:
Reducing protective muscle guarding that develops after procedures
Improving mobility of scar tissue and connective tissue
Calming irritated nerves and restoring normal sensation
Retraining coordination for urination and sexual function
Importantly, post-operative pain does not always mean something went wrong medically. In many cases, the body is still in a protective state. Addressing the muscular and nervous system response can significantly reduce pain and prevent it from becoming chronic.
How Pelvic Floor Physical Therapy Helps Penis Pain
Pelvic floor physical therapy doesn’t just treat symptoms—it looks at the entire system involved in pain. Treatment may include:
Internal and external muscle release
Nervous system down-regulation
Breathing and pressure management
Postural and movement retraining
Education on pain patterns and flare-ups
Most importantly, therapy is individualized. Not all penis pain has the same cause, which is why a personalized assessment matters.
You Don’t Have to “Just Live With It”
Penis pain is not something men should ignore or push through. If medical tests haven’t given you answers, that doesn’t mean the pain isn’t real—it means the source may be functional rather than structural.
Pelvic floor physical therapy offers a non-invasive, evidence-based approach that helps many men finally understand and resolve their pain.
If you’re experiencing ongoing penis pain, working with a pelvic floor physical therapist trained in male pelvic health may be an important next step. Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.