Anal/Rectal Pain

Common causes for rectal pain include:

- Hemmroids:  Swelling of the veins that are located in the rectal canal.  External hemmorids are visible on the outside of the rectal canal and  internal hemmroids are located inside of the rectal canal.  Hemmroids occur in about 40% of patients over the age of 50. Common causes include obesity, increased straining during defection, certain gastrointestinal disorders and pregnancy.

- Fissure: A crack or tearing of the tissue around the anal canal.  Patients almost always have pain during a bowel movment with or without bleeding.  Pain can be so severe that patients are sometimes unwilling to have a bowel movement further leading to pain and constipation.  

- Proctalgia fugax:  Brief, severe, intermittent anal pain, typically at night, that can last from seconds up to several minutes. Patient is painfree between episodes.  Etiology is spasming of the sphincter and levator ani muscles.  

- Levator ani syndrome: Episodic or Chronic Pain, pressure, burning or discomfort in the area of the rectum, sacrum, coccyx regions.  Pain can especially increase with sitting or pressure in the perineal region.

Symptoms of the above conditions can include rectal burning, stabbing, dull to severe ache, etc. This muscular pain can be very severe to the point that many admit themselves the emergency room.  Typically most patients are sent home with pain medications and asked to follow up with their primary care physician or colorectal specialist.  This follow up appointment usually leads to nothing more going on then pain that is muscular in origin.  

Physical therapy can help my addressing the muscles that can cause this pain.  Manual therapy can reduce muscular pain and trigger points (muscle spams) and biofeedback can help to reduce muscle tone and teach patients how to effectively use their muscles to reduce straining.