Has anyone here had levator muscle problems?
I had some left-sided rectal pain recently and got checked out by two different CRS's. Both did a digital exam and also looked inside my butt with an anuscope. The anuscopy wasn't comfortable but it certainly didn't hurt like bloody hell like when I had the fissure (with an active fissure there's no way I would've tolerated it). Both CRS's say that my fissure is almost completely healed after one BOTOX treatment, months of nitroglycerin, and a careful diet of mostly veggie soup and chicken. There's still some sphincter tightness but not as much as before. They didn't see any hemorrhoids or tailbone problems that could account for the pain either.
Anyway the CRS's conclusion is that I'm having spasms of the levator muscle. One actually massaged the muscle a bit and it seemed to provide very momentary (maybe 20 minutes) relief. I was told to do some Kegel exercises and was also given a prescription for nortriptyline (a tricyclic antidepressant to block nerve pain) if it gets worse.
Just curious if anyone else here has had levator muscle problems, and what you did to alleviate the associated discomfort. Hopefully I'm the only one but if anyone else has been unfortunate enough, I'd love to hear your experience :) I'm probably going to try some of the recommended exercises first before I give the nortriptyline a go.

It's great that your almost healed after Botox NG, you're right though, it's a combination of the nitro and diet that's most likely contributed to the healing together with the botox, was like a triple whammy kicking the fissure's butt into shape
As for the levator ani syndrome, i've heard of that but unsure of the symptoms, I never thought so many things could go wrong down there, I have hemmies and a fissure, couldn't cope with another pain too, there's way too many nerves in the a$$.

Yup supposedly my fissure is nearly healed after nitro, BOTOX, and a strict diet. Who knows though. Every time I think I'm out of the woods with this thing, yet another boogeyman jumps out of the shadows! Even if the fissure is healing, it seems that my sphincter is still tight which probably needs to be treated at some point...
Yeah I never knew so many weird things could happen in such a small area of the body either. I always thought the butt was a pretty simple thing, I mean sheesh it's just a hole for poop to come out of right??? Guess ignorance really was bliss there :)

NG,
Did you ever have the anal rectal manometry test to check your pressures?????????

I mean sheesh it's just a hole for poop to come out of right??? Guess ignorance really was bliss there Smile

LOL - it is actually so fine tuned that one doctor told me it is like a "Swiss clock" LMAO
Sorry to hear about possible lavator - if you think you have a problem there , than I would definitely go and seek help from somebody who is into physical therapy to show you proper exercises.
That muscle when contracting non-stop can be painful I just do not see how Kegel can help with THAT muscle hmmmm... know what ... I will do some research !!!! I would guess that Yoga would help much more with stretching that "sucker" ... BRB

Find No.1 :
Levator ani syndrome is one cause of chronic pelvic pain. The typical symptoms of levator ani syndrome include rectal butt spasms, rectum pain and tightness, and a sensation of fullness. It is sometimes associated with proctalgia fugax, which is defined as a short, sharp pain in the rectum. Levator ani syndrome, on the other hand, tends to be more constant pain. The pain is located in the pelvic floor muscles in the rectum, mainly the levator ani muscle.
The root cause is pelvic floor muscle tension or myalgia. In simple terms, it is muscle knots in the internal walls of the rectum. These "knots" are usually referred to as trigger points. When these tiny knots are active, they can cause great pain and a sensation of tightness and burning in the rectal area. This is typical of levator ani syndrome.
Common Levator Ani Syndrome Symptoms
* Rectal Pain and Burning
* Rectal tightness and muscle spasm
What is the treatment for Levator Ani Syndrome?
The common types of treatment for levator ani syndrome are usually muscle relaxants, hot baths, and proper diet and exercise. In most cases, there is an underlying element of chronic stress and anxiety which causes these muscles to tighten up and spasm. This pelvic floor muscle tension causes pain and burning. In order for most cases of levator ani syndrome to be resolved, trigger point therapy or internal massage on the levator ani/rectal muscles can bring great relief. The treatment itself can be very painful, but the overall relief from treatment can be felt almost immediately.

Second find :
Treatment of Levator Syndrome
Periodic massage of the painful spastic muscle combined with warm baths and muscle relaxants may be useful. The patient should be instructed to take hot baths nightly for 20 minutes. Sleeping on an electric heating pad applied to the anal area is also effective. Biofeedback training is also effective.
In those patients who do not respond to massage, electrogalvanic stimulation is employed. Galvanic muscle stimulation for the treatment of levator syndrome is based on prior experience of physiatrists in using this modality to treat spastic muscle groups. The rationale on which this therapy is based is that a low frequency oscillating current applied to the muscle induces fasciculation and fatigue which breaks the spastic cycle.

Those guys are in CA and they do physical therapy for pelvic floor pain - including levator ani... long but good read !
http://www.pelvicpainhelp.com/physical_therapy.php

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFX-4Y34W8S-1&_user=10&_coverDate=01%2F04%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1236421817&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c213d8a4d1bacbdfdb09cc6fb290a82f
Geeeezzzz - what a length of a link ... anyways - nobody ever mentions Kegel - so just do not "try that at home " LOL
From above article - bio-feedback gave the best result , so you might try that !!! Cheryl definitely relaxed her pelvic floor using that !
And, maybe muscle-relaxant as Flexaril would help more than what you were prescribed :roll:
I still hope though you do not have this condition : ((, but even if you do - so many things that can fix it - do not worry !!!!

Hey guys, thanks for the feedback :)
Cheryl, no, I never got the manometry test done. It was mentioned as an option by one CRS that I saw but I don't know what kind of useful info it could yield. I've been through so many tests over the last year, and a lot of things have been happening with my son lately, so I'm just kind of lazy about it right now, I guess.
Fiss, yeah I was confused about the Kegel exercises too. I've never seen anything saying they're useful for levator muscle problems, just a lot of stuff about it being useful for premature ejaculation which definitely has nothing to do with my butt pain Funny that you would mention Yoga, because my boss at work actually has a chronic knee and hip problem and says Yoga has helped him a lot, both physically and mentally. He's asking me to go try Yoga with him because he knows I've had problems for a while now. I used to be pretty active with mountain biking and snowboarding, but have just kind of sat around on my couch since life started getting weird last year, so I'm kind of on the fence about it. I can't see how Yoga would hurt, but everyday after work I just feel tired and want to come home and do nothing. Maybe more of a mental than physical thing, I suppose. In the next week or two I'm going to try get off my ass and at least give it a try :)
And yeah I'm in no hurry to use nortriptyline. I didn't fill the prescription yet and that one's my last resort. My primary care doctor actually did give me some Flexeril to try, but I didn't use any yet. I'm still tapering down my diazepam dose so I'm not sure about taking Flexeril at the same time. I've been told that it's okay though (pharmacist says it'll just make me sleepy) so there's probably not much to worry about.
Thanks a bunch for the info and the link to the PT place. They look like they're a bit north from here and definitely drivable should the need arise. Interesting that there's usually an element of chronic stress and anxiety -- life has been a bit weird for me over the last year, and I've always been relatively high strung anyway, so maybe that factors in. Anyway this problem is a pretty big nuisance, but it doesn't hurt as bad as an active fissure, so at least I can kind of take my time and explore my options with it.
Thanks again :)