Hello all,

I have just had a bad replase of an AF (40 year old male, UK, who had LIS 20 years ago with great success until recently). The pain is high from the spasms and is lasting from all day and night, making work impossible and sleep poor so I am looking for some more pain relief. I have been using Sitz baths, GTN cream and a heat pad. Parecetemol and ibuprofen don't seem to have any effect.

Is there anything else that can be done to reduce pain? Do any other drugs help? Does internal massage work or just aggravate it further?

I am taking Movicol (Macrogol 3350) to try and heal it and eating all the right foods but in the meantime I can barely function. I've not had pain at night before, normally sleep seems to relax it but that's not the case here. I think I have developed stenosis through taking Movicol but every time I try and wean off it, I relapse. Previously the relapse was minor.

It might be worthwhile to ask your doctor about nerve pain medication like gabapentin, or a muscle relaxant to reduce the spasms. Take care.

Is there anything else that can be done to reduce pain? Do any other drugs help? Does internal massage work or just aggravate it further?

You might try pregabalin - at any rate, I have found it effective for reducing the pain of spasms.

So sorry to hear about the relapse. I am in a similar camp of old injury returning a decade later and am most definitely in the spasms at night club…

I would caution against internal massage, whilst I understand the temptation, my view is that poking around too much was likely the cause of my fissure becoming a fistula. I would highly recommend avoiding that.

Cuprofen and paracetamol has helped me somewhat but rarely. Likewise, CBD oil under the tongue at night has helped on bad days. Turmeric milk at night and turmeric lattes (Pret do them) have helped also.