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Digestive Disease Center

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Just as spasms of neck muscles cause headaches, spasms of the pelvic muscles causes proctalgia.

Proctalgia is pain due to a spasm, or "charley-horse" 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.


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

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.


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 this does not work, muscle relaxants such as Diazepam can be used to relax the muscles.

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.

Another possible treatment is electrical stimulation. A small probe about the size of person's finger is inserted into the anal canal. 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.

Epidural nerve blocks help some people. For this treatment, an anesthesiologist puts a small needle into the person's back and injects a numbing solution, similar to Novocain, which numbs the nerves in the pelvic area.

The muscles of the rectum are not under voluntary control, and cannot be trained to relax. Medicines like Levsinex SL may relieve involuntary rectal muscle spasm.

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Your doctor will probably agree with you about your preference to come to MUSC. We offer excellent patient care at a state-of-the-art facility, in a historic setting in the southeastern United States. Our doctors are nationally ranked among the highest in the nation. We employ a multidisciplinary approach to the treatment of patients using the latest technology in medicine.

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