Depending on the bowel movement, I may have a burning achy pressure or tightness around my anus afterwards.

It may calm down after I take a sitz bath. However I notice around 6 or 7 hours after a bowel movement I feel the tightness, achy and burning feeling coming lightly and then building to excruciating pain for another 5 or 6 hours and then it quickly drops off.

If I have the bowel movement in the morning I get the pain in the mid to late afternoon.

If I have the bowel movement late afternoon / evening I have the pain just after midnight.....sometimes it rolls over into the mid morning and early afternoon the next day.

I've noticed it occurs after every bowel movement.......so if I go 2 days without a bowel movement....the second day is usually pain free.

I'm concerned it may be rectal spasms associated with my pelvic floor. However I don't have any pain elsewhere such as my lower back, thighs, or groin. Strictly at the anal area.

The other frustrating issue is that I have some hemorrhoidal problems. I can see a thrombosed hemorrhoid and may also have inflamed internal hemorrhoids. I'm thinking after I have a bowel movement, shortly there afterwards I may be irritating and inflaming the hemorrhoids causing the pain I'm experiencing. I examine my hemorrhoids with my finger when I'm having the pain and they are hard and painful. When I have periods of no pain they don't feel inflamed or painful.

However this pain has been occurring regularly for almost 4 months. I don't know if hemorrhoid pain would be this aggressive.

It’s very frustrating there is no easy diagnosis but you and I sound like we have very similar maladies.

I am getting some trigger point injections next week, and possibly a nerve block

Are you in physio?

No this is being done at the specialty pain clinic

So you don't do any pelvic floor exercises / physio?

Biofeedback? How is that going?

Also is any of this covered by OHIP ?

Another day. Don't feel like I've gained any ground. Pain came back again today.

So tired. Just worn out.

I really feel you. It’s the most horrible pain. I am 3 days post surgery after having a sphinctorectomy and I am feeling much better. Still sore but nothing like what I did before. I can’t recommend it enough. It’s scary but just so worth it. In the end everything was so super tight down there and this helped to release it so I could go so much easier. I really hope you get relief, this site has been so important to me.

Oh! I should note too because I saw you mention the spasms. That’s what I found to be the worst!! After the surgery, I haven’t felt any! Not saying that it’s the be all end all for you but you might find the surgery plus hemorroid banding may work? They were going to band mine during the colonoscopy if they were bad enough.