Levator ani syndrome
- Other names: Levator ani syndrome is also referred to as levator spasm, puborectal syndrome and chronic proctalgia.
- Description: Recurrent and chronic anorectal pain described as dull, pressure sensation or foreign body feeling. The pain can last from several hours to days and is associated with tenderness to palpation of the levator ani.
- 6.6 % of the general population
- Closely associated diagnosis
signs and symptoms
- Pain in the perineum, anorectum, coccyx and lower sacrum
- What makes the pain worse?
- Arising from sitting
- Standing too long
- Bowel movements
- Digital rectal examination
- Sexual intercourse
- Location of the pain can mimic a discogenic problem
- Digital rectal examination by a licensed practitioner: palpation of the contracted levator ani should reproduce the patient ‘s pain.
- Episodes of rectal pain have to last at least 20 min
- Physical therapy for relaxation of pelvic floor muscles
- Hot baths
- Muscle relaxants
- Anti-inflammatory drugs
- Non-steroidal drugs
- Goodman CC, Snyder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th ed: Saunders Elsevier, St. Louis, MO; 2007.
- Mazza L. et al. Anorectal and perineal pain: new pathophysiological hypothesis. Tech Coloproctol. 2004, 6:77-83
- Nikolaos P. et al. Chronic Perineal pain: current pathophysiological aspects, diagnostic approaches and treatment. Europen Jounral of Gastroenterology & Hepatology. 2011, 23:2-7.