Rectal Pain

Pain in the anus or rectum is often called rectal pain. There are different types of rectal pain. Functional rectal pain syndromes are caused by spasms of the muscle around the rectum. This muscle is called the levator ani muscle. Many successful treatments are available. Rectal pain can be worse with inactivity, stress, having a bowel movement (pooping), constipation, or menstruation. It can also occur without a specific cause.

PROCTALGIA FUGAX

Proctalgia fugax is the medical term for sharp and brief muscle spasms around the rectum. These can be very painful and occur without a specific cause. The spasms frequently occur at night. This feeling lasts less than 30 minutes.

LEVATOR ANI SYNDROME

Levator ani syndrome is the medical term for rectal pain that lasts longer than 30 minutes. It is often described as a dull ache or pressure feeling in the rectum. This pain is more likely to occur sitting rather than standing or lying down. If your healthcare provider touches the rectal muscle, it will be tender.

UNSPECIFIED ANORECTAL PAIN

Unspecified anorectal pain is similar rectal pain that also lasts more than 30 minutes, but the muscle is not tender to the touch.

ANORECTAL PAIN SYNDROMES ARE TREATABLE

Physical therapists who specialize in treating pelvic floor muscles are the most qualified. Your therapist can teach you how to relax your pelvic muscles to lessen your
pain. They will give you exercises and strategies to help your symptoms. If you have difficulty pooping, your therapist will teach you ways to make it easier and pain-free. In addition to
physical therapy, your medical provider may offer other treatments such as oral and topical medications or nerve blocks.

References

• Simren, M., Palsson, O. S., & Whitehead, W. E. (2017). Update on Rome IV criteria for colorectal disorders: implications for clinical practice. Current gastroenterology reports, 19(4), 15.
• Rao, S. S., Bharucha, A. E., Chiarioni, G., Felt-Bersma, R., Knowles, C., Malcolm, A., & Wald, A. (2016). Anorectal disorders. Gastroenterology, 150(6), 1430-1442.

This patient education handout was developed by the Academy of Pelvic Health Physical Therapy (APTA Pelvic Health) and is meant to provide general information, not specific medical advice. It is not intended to substitute for the judgment of a person’s healthcare provider. Additional information can be found at www.aptapelvichealth.org.