Rectal pain, which is commonly diagnosed as proctalgia or proctalgia fugax (a condition of fleeting rectal pain), affects roughly 15 percent of the U.S. population at one time or another. Proctalgia fugax occurs more commonly in women and in individuals younger than 45 years.
How does rectal pain develop?
The source of rectal pain can be difficult to diagnose. As a result, a number of different causes have been associated with it. It may occur with diarrhea and constipation, or with hemorrhoids, which occur in 25 percent of all Americans. Rectal pain may also be caused by an anal fissure, which is a small tear in the muscles in the area. Levator ani syndrome involves pain in the group of muscles that surrounds and supports the anus. Less likely causes of rectal pain include cancer, infection, inflammatory diseases such as Crohn’s disease and ulcerative colitis, and foreign bodies in the rectum, or rectal prolapse.
While many of the above conditions usually respond to treatment, if rectal pain lingers and no known source is found, injured, loose or weak ligaments may be the cause. The most commonly affected areas are the ligaments around the sacrococcygeal junction, as well as the iliolumbar ligament.
Chronic Rectal Pain
If rectal pain is caused by numerous conditions such as bacterial infections, skin disorders, or GI disturbances, modern treatments do well to cure the underlying issue and resolve acute pain. However, rectal pain that lasts longer than three months is considered chronic. In these cases, an underlying cause must be determined. Often times, medical practitioners find that the underlying relates to uncontrollable muscle spasms in the pelvic floor. Both old and new research has shown a significant relationship between muscle spasms in the pelvic floor and chronic rectal pain.1
Unfortunately, there is no clear distinction as to which treatment options best address this issue. Patients are often recommended to continue with massage, traction, electrical stimulation, or biofeedback therapies to alleviate the spasms and pain. However, these treatments do not address the underlying condition. Often, the underlying condition relates to loose or injured ligament tissues, so a more appropriate treatment is to repair the injured ligaments with Prolotherapy.
Our approach for Rectal Pain of Unknown Origin
Typically, when a patient comes to Caring Medical for Prolotherapy for their chronic pain condition, they have exhausted all other treatment options without relief. This is because the other treatments have failed to get at the root cause of their pain – as mentioned above, this root cause is often related to ligament laxity. Numerous ligaments help to hold our pelvis stable. When they become injured or lax, muscles contract as a way to help stabilize the area. These painful muscle spasms can cause chronic rectal pain. Even when treated with massage, electrical stimulation, etc. they may continue to come back because the underlying ligament problem is still present. It is not uncommon for weak ligaments (such as the sacrococcygeal or iliolumbar ligaments) to cause instability in the pelvis and consequent pelvic floor muscle spasms.
Prolotherapy works to heal these injured ligaments. At the site of injection, Prolotherapy treatments create a mild inflammatory response which stimulates the body to repair weak and damaged tissue. Once the weakened ligaments have been identified and treated with Comprehensive Prolotherapy, chronic rectal pain usually goes away within three to six visits.
- Chiarioni, Giuseppe et. al. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options. World Journal of Gastroenterology. 2011; 17(40): 4447-4455. Accessed July 3, 2013.