Rectal and Anal Pain
Condition Overview
Rectal pain is any pain in the anus, rectum, or lower part of the GI tract.
It can be caused by a number of issues including but not limited to
Anal fissures
Hemorrhoids
Constipation
Ulcerative colitis
Crohn's disease
Irritable bowel syndrome
Tailbone pain
Pelvic floor dysfunction.
Despite the more scary diagnoses, rectal pain is usually caused by muscle spasms and/or constipation which can lead to anal fissures and hemorrhoids.
(*Speak to your doctor if you notice blood in your stool, pain that is worsening and spreading to the lower half of your body, or if you have associated fever or chills.)
Symptoms of Rectal Pain:
Rectal pain can be described as
Dull
Achy
Sharp
Stinging
Itching.
This pain may worsen with prolonged sitting, constipation, straining, and coughing. It may be associated with discharge and/or bleeding.
These symptoms may affect your quality of life and start a vicious cycle of fear of pooping which can cause more constipation and further pain. So getting in with a therapist sooner rather than later will help improve pain management and bowel habits.
What to Expect in Physical Therapy
Upon our initial evaluation, we will discuss the onset of your symptoms and what makes the pain worse or better. We will also discuss your bowel, bladder, sexual health, and gynecological health for females.
With this information, we are taking note of habits and patterns that may be associated with the root cause of the pain - such as straining, urgency, frequency, incomplete bowel emptying, anal incontinence, and fiber/water intake.
We will perform a low back and hip screen and assess your pressure management and breathing mechanics. We will also assess your abdominal wall since the colon lives underneath these tissues and if there is excessive tension in this area it can affect colon motility.
With your consent we may perform an external and internal rectal pelvic floor muscle assessment to determine muscle function, strength, endurance, and coordination. If the pain is too great for an internal assessment, we will forgo this until the future when the pain has subsided through our external work and behavioral changes.
From our findings we will set-up a treatment plan depending on your pelvic floor characteristics! There may be lifestyle modifications that we need to address (changes in water or fiber intake, pooping habits, use of squatty potty, appropriate bearing down techniques, and exercise routine).
The first step is to reduce your pain through use of low back, hip, and pelvic mobility, diaphragmatic breathing, and manual treatment including dry needling, cupping, and connective tissue mobilization. However, it will be important to retrain these muscles out of their typical habit that created pain in the first place - therefore, we will teach you how to appropriately lengthen these muscles during pooping to avoid straining which will reduce the chance of hemorrhoids or fissures.
If necessary we may also use balloon training which is very effective in learning how to lengthen and bear down appropriately.
With each session we will progress as able and learn new activities to include in your daily routine to manage and prevent worsening symptoms!