help for anal/rectal pain

[kathyd]

Hi everyone,
Hope everyone is doing well. I have aquestion ..Ive asked this before,but checking again, in case anyone new sees my information. and can relate.
Does anyone have throbbing/ aching anal rectal pain? --directly at the opening of the anus and the area just outside of the anal opening on each side. My pain began on the right but eventually became bilateral.
If you do, and have found any medicine or treatment that has helped you would you please share it?

I have the above, it is constant. I had been doing a bit better for a little while but have had a bit of a relapse,after some medicine changes that probably disturbed the balance of my body, and caused me to worry, which then caused tension,in pelvic floor and then pain!
I believe that constant unconscious clenching of the pelvic floor muscles, and some other factors, are causal.

We all are different, but if you've experienced pain of this sort, in this area of the body, and had improvement, could you let me know what helped you? (At this point, Im not considering further surgery., as it would not suit my particular case.

Thx so much in advance...and I wish everyone the best!

[mexico2003]

I also suffer from continuous rectal pain, very like you describe. I am 2 mos post-op and recovery seems to be very slow. My pain did not diminish yet. Lyrica helps with fair success. As for the rectal pain, I am tortured. I have tried an ointment that contains lidocaine, which numbed the outer areas, but cannot be used internally. I could tolerate my many other pains, if not for the rectal nightmare. I feel as if I need to "go" all the time. My pelvic floor tightness has rendered me almost unable to have a bm. Laxative use, fruit, water, etc, are my remedies, but don't always work well. My GI doc said my sphincter tightness is the worst advanced he has seen for my age(62). I am trying to minimize my tension through pelvic floor exercise with a physiotherapist who specializes in these disorders. Also, I try not to get upset because I always hurt much worse afterwards. This condition has been most baffling to me. I am a Registered Nurse of some 30 yrs, and I have been unable to do anything to help this maddening, painful condition of 2yrs. I have thoroughly researched every piece of info I come across, asked a million questions, seen many doctors........only to end up absolutely frustrated. My entire way of life has changed from a tireless, outgoing person to a depressed recluse. I hope you are able to find relief. I would not wish this pain on my worst enemy.....never give up!!!!!

[make-it-stop]

Mexico2003:
Have you tried taking oral xanax or valium or a more traditional muscle relaxer such as soma or zanaflex? I also have anal pain in addition to all of my other pelvic pain. Xanax seems to work the best so far (besides the methadone). I'm about to try zanaflex though, because the xanax does make me drowsy. Also, a gel ice pack wrapped in a paper towel or 2 gives instant relief when I've pushed myself beyond my limits. I also use the external lidocaine ointment. Helps a bit.

[blightcp]

Hi everyone,
Hope everyone is doing well. I have aquestion ..Ive asked this before,but checking again, in case anyone new sees my information. and can relate.
Does anyone have throbbing/ aching anal rectal pain? --directly at the opening of the anus and the area just outside of the anal opening on each side. My pain began on the right but eventually became bilateral.
If you do, and have found any medicine or treatment that has helped you would you please share it?

Yes, I have had pain and numbness in that area, I also have had poor muscle control of the sphincter both internal and external. If I sweat, I have to worry about anal seepage, basically I have to wipe a lot.

My understanding is that this small area you mention is controlled by the PN and is in the motor control region also the "shelf" muscle that you use to push stool out.

Specialized PT can help with the muscle tone and control. I ultimately had a implanted nerostimulator along the PM, that made a huge difference in the bowel and bladder control issues. The motor control issues are its design purpose but it also help with the pain some.

[kathyd]

Hi Blight CP
Thanks for your ideas
I will pass them along to my PT to get her take, on this....She has just returned from another weekend education seminar. I trust her knowledge levels and opinions very much as takes the time to explains it all clearly etc.
BTW my pain is a a bit different than many here ...for instance I've never had numbness (would love to have a bit of numbness at times! so I couldn't feel pain!...(tho I don't mean to downplay numbness!)

When you mentioned the neurostimulator along the area of the "PM" ....did you mean the "PN"? i assume so but just wanted to check..
I had a sacral nerve stimulator test a few years back, without response , but the "test" wires were not put near the PN or area of pain, but intstead in the back.
Would appreciate hearing more about your placement of your device
So glad it helps with your issues.
Thx!

[mexico2003]

Hello, make it stop!!!!!! I appreciate your input about help for rectal pain. I have tried using valium suppositions, and now use a compounded vaginal insertion containing lido, amitriptyline and neurotoxin at night , lying down is torture. Am now also using canal and soma oral for severe spasms. I had decompression surgery in January, and my neuropathy has worsened since. Started Lyrica, however my feet and ankles swell terribly as a side effect. Savella did not work. This is the most terrible chronic illness I know about. I keep hoping I will wake up from this nightmare.....we must all try to help each other, there are few doctors who are aware.....thanx and hang in there!!!!

[make-it-stop]

Awww...so sorry to hear how much you are suffering. I definitely have some intense nerve pain at times and always at least a small amount, but those 4 things give me at least short-term relief, so I feel somewhat in control.

Again, the 4 things that help when I have severe rectal nerve pain are
1) oral xanax (looks like you're taking this)
2) oral methadone (1/2 a 10mg pill three times per day)
3) a bit of Recticare (lidocaine rectal ointment)
4) a gel ice pack wrapped in a paper towel or two

I'm sending good thoughts your way.

[kathyd]

To make it stop: and all who have anal rectal throbbing pain
first, thanks for your kindness! I appreciate it.

I was wondering if your pain is throbbing in nature too. Mine feels like a baseball bat is hitting me in that area..
Interestingly I had a glass of wine on Easter and sat/knelt with a cushion-- at a restaurant and felt no pain.I ate a full course meal probably "sat" way too long. .To think a simple glass of wine can numb what opiates can't thus far. I usually stay away from wine..as my pain originally was bladder related, but this brand was not acidic and my un-predictable bladder did ok...
But when "wine buzz" wore of, I was in anal agony,and still am.

i will be more diligent about taking Xanax..I usually wait until Im really upset then reach for it.-- should be pro-active like you.
i struggle so much with the "feeling" of constipation and backup ( more so than true constipation) ie i have BMs regularly but small amts over and over rather than one big normal one . I try to force myself to poop with laxatives. bran, prune juice , water, etc just to get rid of that pressure and urge but my Pt says that is often coming from the spasm,
So much pooping in my painful area is just killing me, while one BM a day would be fine..

---I don't think Xanax would be as constipating as some other drugs.
------I took methodone at approx the dose you are at, from about 2013 ish until around 14mos ago, Not much relief. but I feel like it along with my pain pump which had different meds back then, I was a bit better than now...so hard to know as pain has gone onfor so long. My family, pain pump nurse and my great PT think I'm better now as I am trying activities that I would not do back then,, and able to enjoy the distraction..However I pay dearly with severe after -pain when I get home and the next day! But for sanity one must get out on our own!
----Ice is alway with me .. as we know it helps a bit! -on and off
BTW what is Recticaire lidocaine ointment? Is is a cream you rub on anal area? ...does it numb things?

You've given me some more ideas to ask my pai doc about; .we are speaking by phone soon.
I feel that this pain is so unbearable at times I just cant take it anymore! But as a Mom and a "believer" I must hang in there.
In this new millenium, there's got to be something that knocks out this severe pain!
My PT's exam shows severe severe spasm, and trigger pts which makes sense to me due to the fact that I've been clenching out of fear since my first symptoms began nine years back. I began researching constantly, saw several horror stories and scared myself silly! Thus all the clenching!
Wish I had left well enough alone!
Hubby also says I hold tension in my belly right above the pelvic floor..I do!
Thank again for these tips and I wish you much relief!
If anyone else has found relief from throbbing anal rectal pain could you pls share what helped? ....Thank again folks, and for listening!

[make-it-stop]

Kathy, my pain is a burning pain (I think because my nerves are compressed or irritated). Usually it comes on as soon as I lay on my back (so I don't do that except for while in PT), or when I sit.

Since a glass of wine gave you relief, that would lead me to believe a bit of Xanax would give you relief too, because for all of my pain that is helped by a glass of wine, the Xanax helps. It's so much easier for me to have a Xanax than wine because alcohol irritates my stomach, while Xanax doesn't. Both make me drowsy, unfortunately.

Oh, dear, trying to force a BM is a big no-no when you have spasms in the rectal area. My PT taught me that can be a cause of the pain. I take mineral oil a couple of times a week and that makes it easy to go without trying. I tried more traditional laxitives, but all of them were a disaster for me (I quickly became tolerant to Sennakot so had to keep upping my dose; and ex-lax made me miserable). It's very important to drink a lot of water - that is one of the main things that will help you go without having to try. Fiber and changes in diet did not help me at all, but works for some.

Oh, I'm surprised the methadone didn't give you relief. It has reduced my pain by over 50% very consistently. But, again, I have a nervy burning pain and methadone helps with that type of pain but maybe doesn't help your throbbing pain. I could see that.

Yes, the RectiCare is a cream that helps numb the anal area a bit. Doesn't completely numb the pain, but I'd say for me it numbs it about 30% or so, and you know every bit helps. It is an OTC cream so you don't need a prescription. I just buy mine on Amazon - it's about $5 cheaper on Amazon (and I have Prime shipping), but any pharmacy can order it for you if they don't have it in stock, or they have it at walgreens.com and other drugstore websites. I learned it doesn't help vaginally, though - kinda burned when I tried it there.

If you haven't done biofeedback at your PT yet, you should definitely do that. It shows you how much tension you are having in a certain area. I like to try out different positioning and relax different areas (abs, pelvic floor, rectum, etc) to see what brings the tension number down so that I can apply it to outside of therapy. It's told me a lot about how I should stand (don't need to bend my knees a bit like I thought, for example, and also don't need to let my stomach relax out as long as pelvic floor is relaxed), and best ways to sit. Also, do relaxation exercises and gentle stretching. Check yourself throughout the day to make sure you are not tensing your pelvic floor - I was doing that without knowing it. Try warm baths with Epsom salt. Also, right now I'm trying to find someone local who does dry needling or trigger point injections for trigger points, because it helped me in the past at one provider (I've moved though, so can rarely see him).

[kathyd]

To make it stop
thx so much for all ur tips!
Will wirte later as am off to bed,,
BTW I Showed your post about biofeedback (which Id done with a previous PT).
My current PT is so much better tho.
Will write later
Thx!
Kathy