Proctalgia

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.

Causes

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

• stress
• hemorrhoids
• rectal ulcers, also referred to as solitary rectal ulcers
• abcesses
• a fissure in the lining of the rectum
• inflammatory bowel disease

As you can see, diagnosing the primary cause of proctalgia can be very difficult and may require several approaches before a successful strategy is developed for each sufferer. There may be structural anomalies in the area of the pelvic wall; however, no study has found a specific anatomical cause. Several studies have shown that only a small portion of people who suffer from proctalgia have an organic disease that could be the cause of the condition.

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. You may recall feeling sick to your stomach during stressful events. Over the counter medications for gastric pain may alleviate the symptoms, but the root cause of the pain must be also addressed. This may mean adopting stress-relieving therapies.

Treatment

Natural Vegetable Powder

There are several treatments for proctalgia. The first is natural vegetable powder in a dose of three heaping tablespoonfuls per day. With this dose, a person should have large, soft bowel movements that stretch out the muscles and help prevent muscle spasms.

If natural vegetable powder does not work, muscle relaxants can be used to help achieve the same results.

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 anesthesiologist puts a small needle into the person's back and injects a solution that numbs the nerves in the pelvic area.

Pelvic Muscle Retraining

Pelvic muscle retraining may also be helpful. If voluntary muscles are in spasm, a person can be trained to relax these muscles by doing special exercises.

The main focus of pelvic muscle retraining is to teach individuals how to relax and contract (squeeze) the muscles at the anal sphincter. A small sensor is placed at the rectum or vagina. The person stays dressed, and sits in a comfortable lounge chair. The sensor is connected by a cable to a computer. The computer records and measures the muscle movement while the individual watches the computer screen.

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.

A helpful way to remember to do the exercises is to do them once an hour or at various "cues" during the day, such as hanging up the phone, stopping at red lights or watching commercials on the TV. A person can do more sets as the muscles get stronger. It is important to continue doing these exercises for two to three months to strengthen the pelvic floor muscles adequately. After that time, the exercises must be continued in order to keep the muscles in shape, or they will weaken again. After the symptoms are under control, the exercises should be done at least several days each week.