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What is Levator Ani Syndrome?

H. Colledge
H. Colledge

Levator ani syndrome is a disorder in which a person experiences pain in the rectum. The rectum is the last section of the gut, where feces collects before leaving the body through the opening known as the anus. In this syndrome, rectal pain is thought to be caused by spasms in the muscles of the pelvic floor. The pain keeps returning, and typically lasts for hours or even days. Many people are too embarrassed to consult a medical professional about the condition, although treatments are available to ease the symptoms and the disorder is not harmful.

Around 6% of people in developed countries are thought to suffer from levator ani syndrome, although no more than a third consult a healthcare professional about the problem. The main symptom is a dull pain which is experienced in the upper part of the rectum. Lying down or sitting can make the pain worse, while walking may ease it. Painful episodes occur on a regular basis and, when examined, the levator ani muscles may feel tender and unusually tight.

Levator ani syndrome involves pain in the rectum.
Levator ani syndrome involves pain in the rectum.

Levator ani syndrome appears to be closely related to another condition, known as proctalgia fugax, which causes short episodes of pain in the anus or the lower end of the rectum. The pain lasts for only minutes or seconds, and it is thought to be due to cramping of the anal sphincter, the ring of muscles that controls the anal opening. Both conditions are thought to be associated with irritable bowel syndrome, in which people experience pain in the abdomen together with constipation or diarrhea.

Levator ani syndrome is associated with irritable bowel syndrome.
Levator ani syndrome is associated with irritable bowel syndrome.

Diagnosis involves ruling out other causes of tailbone pain, or coccodynia, and anal pain, or proctodynia. Common conditions that may give rise to similar symptoms around the anus include swollen veins, or hemorrhoids, and skin tears, or fissures. The symptoms of this syndrome are usually quite distinctive, but a thorough examination is made to rule out other problems.

Levator ani syndrome may be treated by soaking the painful area in a hot bath.
Levator ani syndrome may be treated by soaking the painful area in a hot bath.

Treatment first involves reassuring the sufferer that the condition is not harmful. Taking pain-relieving drugs and massaging the levator ani muscles may help ease the pain. Soaking the painful area in a hot bath may provide relief and, in some cases, what is called electrogalvanic stimulation can be beneficial, where a probe is used to electrically stimulate the muscles. Other treatments, such as biofeedback, where people learn to relax the levator ani muscles, have proved useful for some. Further research needs to be carried out to determine which are the most effective treatment options.

Discussion Comments

anon347114

I've had this for over four years. I thought I was crazy and everyone else did, too. I went to all kinds of doctors. I thought I had a tumor; it feels like I have one trying to come out! I have no digestive issues (I've been almost vegan for five years), no hemorrhoids, no cancer, etc. Finally a doctor that I heard was the best where I live gave me an answer!

I go back tomorrow morning for my one month check up, and I feel a little better but I lived over four years with it so it's going to take time. But really, I wanted to take a knife a cut this pain/uncomfortable feeling out!

anon344352

I was just told I have levator ani syndrome. I finally found out what this pain has been about. It hurts and I can't move, sometimes for hours. I am hopeful for a cure.

settermom

What can you do to try and alleviate the pain from Levator Ani? I homeschool my kids and have to sit for hours a day with them and the pain is really terrible. I also feel like I have to have a BM all the time but when I go to the toilet nothing happens. I also get the sharp pains once in a while as well. It feels like I'm sitting on a golf ball and the pressure is terrible.

I try to sit up perfectly straight and on the edge of the chair which helps a little, but it's hard to get comfortable. I read magnesium helps but wanted to hear from others who actually have this to see what has helped them deal with the pain. Also- how long does a flare up usually last and how often does it come back? Thanks for the help. I really appreciate it!

ZipLine

Has anyone had surgery for levator ani syndrome symptoms?

I'm undecided about having surgery, I heard it doesn't work at all in some people.

stoneMason

@donasmrs-- Levator ani syndrome and hemorrhoids can definitely be confused, especially when someone has a history of internal hemorrhoids. This was the case with me as well. I thought I was having hemorrhoids pain but I wasn't experiencing any other symptoms of hemorrhoids. I wasn't very constipated and there was no bleeding.

I was diagnosed with levator ani syndrome only after a physical examination. This is the only sure way to know if you have this syndrome or not. But I can tell you that if the pain is due to a levator ani spasm, you will feel a lot of tightness and pressure in your rectum. Sometimes it causes a sharp pain which is not something I ever had with hemorrhoids. The pain from levator ani syndrome is much more intense and debilitating.

The sad news is that, if you do have levator ani syndrome, there aren't any cures for it. I've been dealing with it for the past four years. So I hope you don't have it.

donasmrs

How can I tell apart levator ani muscle pain from hemorrhoids pain?

I do have a history of hemorrhoids, but I have been experiencing a slightly different kind of pain in my rectum for the past several weeks.

I'm not sure if I have levator ani syndrome or if I'm confusing it with the pain from hemorrhoids.

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    • Levator ani syndrome involves pain in the rectum.
      By: Alexandr Mitiuc
      Levator ani syndrome involves pain in the rectum.
    • Levator ani syndrome is associated with irritable bowel syndrome.
      By: JackF
      Levator ani syndrome is associated with irritable bowel syndrome.
    • Levator ani syndrome may be treated by soaking the painful area in a hot bath.
      By: Gennadiy Poznyakov
      Levator ani syndrome may be treated by soaking the painful area in a hot bath.
    • Levator ani syndrome may be associated with irritable bowel syndrome.
      By: joshya
      Levator ani syndrome may be associated with irritable bowel syndrome.
    • Symptoms of IBS may include abdominal pain.
      By: toomler
      Symptoms of IBS may include abdominal pain.
    • Levator ani syndrome pain is caused by spasms in the muscles of the pelvic floor.
      By: michaeljung
      Levator ani syndrome pain is caused by spasms in the muscles of the pelvic floor.
    • Levator ani syndrome is a disorder that brings on pain in the rectum.
      By: kocakayaali
      Levator ani syndrome is a disorder that brings on pain in the rectum.
    • Hemorrhoids may give rise to similar symptoms of levator ani syndrome.
      By: Andrea Danti
      Hemorrhoids may give rise to similar symptoms of levator ani syndrome.