Anal and Pelvic Pain

In this article

What is the pelvic floor? What causes pain in the anus and pelvic floor? How is it treated? What is proctalgia? Treatment

What is the pelvic floor?

The pelvic floor is composed of muscles that work to Support the organs like the bladder, the intestines and the uterus in females, control urinary as well as faecal continence, and stabilises connecting joints.

What causes pain in the anus and pelvic floor?

Pelvic pain and anal pain are often the result of an underlying condition that can be mild and temporary or be the signal of more serious disease.

Anorectal and pelvic pain may also be the result of many different conditions:

  • Proctalgia
  • Rectal ulcers, also referred to as solitary rectal ulcers (SRUS)
  • Haemorrhoids
  • Perianal Abcesses
  • Anal fissure
  • Inflammatory bowel disease
  • Anal cancer

How is it treated?

Main goal is to correctly diagnose the reason for the anal pelvic pain. 

What is proctalgia?

Proctalgia is a specific kind of pelvic pain. Just as spasms of neck muscles cause headaches, spasms of the pelvic muscles causes proctalgia.

Proctalgia is pain due to a spasm of the pelvic floor muscles, the muscles of the anal sphincter, or the muscles of the rectum. This causes severe stabbing pain like a knife sticking into the rectum. This type of pain may originate without warning. It may vary in severity and duration. It may pass quickly or might last much longer.

Often the pain will be severe enough to awaken a person at night out of a sound sleep. If the person gets up and walks around, moves his bowels, or passes gas, the pain could resolve in a matter of minutes.

Chronic proctalgia

A person with chronic proctalgia will experience pain that lasts more than twenty minutes. Some people have spasms of these muscles which lasts continuously through the day and for many weeks at a time. Persons with chronic proctalgia may experience pressure or aching after sitting for extended periods. Defecation may also be painful.

Proctalgia and Stress

Proctalgia can be related to stress. It is common for doctors to refer to the mind-body connection when a person is dealing with considerable stress in their daily lives. The continued emotional stress causes the body to react, and the internal organs of the digestive system are acute receptors of stress. 


Pelvic Muscle Retraining

The main focus of pelvic muscle retraining is to teach individuals how to relax and contract (squeeze) the muscles at the anal sphincter. 

When doing these exercises, tighten the pelvic floor muscles as if trying not to pass gas or trying to stop the flow of urine. A woman may feel the muscles tighten around the vagina. A man may feel tightness at the anal sphincter. Try to hold these muscles tight for several seconds while breathing normally and keeping all other muscles relaxed. For example, the abdomen and buttock muscles should stay completely relaxed during this exercise. The only muscle that should feel tight is the muscle at the anal sphincter or the vagina.

When the muscles are weak, it is hard to hold them for very long. Gradually, over the course of several weeks (or several months) it is easier to hold the muscles tight for a longer time (up to ten seconds). After tightening the muscles, let go and relax the muscles for ten seconds. If the muscles do not feel completely relaxed after ten seconds, then continue to try to relax them for another ten seconds.

Electrical Stimulation

Another possible treatment is electrical stimulation. A small probe about the size of person's finger is inserted into the rectum. A low voltage vibrating current is passed through the spastic muscles for approximately thirty minutes for each treatment. This may cause the muscles that are in spasm to relax.

Nerve Blocks

Epidural nerve blocks help some people. For this treatment, an anaesthesiologist puts a small needle into the person's back and injects a solution that numbs the nerves in the pelvic area.