Surgery vs. physical therapy

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Surgery vs. physical therapy

Postby dmcff » 26 Jul 2015, 10:35

While reading the book A Headache in the Pelvis by David Wise and Rodney Anderson I was particularly struck by the following passage:

"Unfortunately, behavioral treatment for anal fissures to reduce the high muscle tone of the anal sphincter is not generally a focus of colorectal surgeons who are consulted for this problem. If you seek treatment from a colorectal surgeon, you will often end up with surgery. This approach does not take into consideration the fact that someone with a tight anal sphincter can learn to voluntarily loosen it with proper physical therapy and behavior instruction..."

In the same passage, the authors point out that while an orthopedic surgeon would cause dismay were he/she to propose cutting a patient's back muscles in order to alleviate the pain of back tension, the cutting of the anal sphincter is accepted as a normal procedure. The process of learning to relax the anal canal simply doesn't lie within the remit of conventional medicine.

It's an interesting and thought-provoking point, and makes one wonder if the difference in approach is culturally determined.
2014 Anal fissure
2015 CAT scan, EUA, sigmoidoscopy, 2 MRI scans - 4 hospital stays
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
2021 Better, but AF is still a recurring problem
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Re: Surgery vs. physical therapy

Postby Savaici » 26 Jul 2015, 18:54

I used anal dilation and that helped me to get through the hard times. Use the search facility (the one between FAQ and Portal above, not the one on the right) and see how this physical therapy worked for others. Also invest in a Sitz Bath to help blood to circulate in the area which helps in healing AFs.
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