Rectal Pain: Causes, Symptoms, Physical Therapy Treatment

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.  

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 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 health care provider touches the rectal muscle, it will be tender.

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

Rectal pain can be worse with inactivity, stress, having a bowel movement (pooping), constipation or menstruation. It can also occur without a specific cause.

Anorectal pain syndromes are treatable.

Physical therapists who specialize in treating pelvic floor muscles are most qualified.  Your therapist can teach 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.

Find an experienced physical therapist here. 

Resources used in the development of this document:

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.