I am 38 years old female, very healthy and acrive living on upstate NY. I have got an anal fissure 8 months ago when I tried to pass a hard stool (caused by iron suppliments). After extreme painful few days it was healed (what I thought). Few days later just before my period I have got an 9/10 episode of pain in my buttock lower left abdomen rectum and calf that lasted for 20-30 min. After that I had dull ache in my buttock and thigh. It was painful to sit and when I tried to sit my hip flexors and all buttock muscles becomes extremely stiff.
1 month later, just before my period same episode happened. My PCP ordered ultrasound (clean) and refered me to gyne since she thought its cyclical. Gyne put me on combination contraceptive pill to help me with pain but the painful episodes started to repeat everyday twice a day. Dr wasn't convinced that ocp can cause this so she forced me to complete atleast 2 packs. As soon the 3 weeks of pills finished and iron pills started the spasm like episode went away. When my period ended, it started again so I stopped the ocp and the episodic pain stopped.
PCP ordered spnial MRI (clean) since my calf was involved and they suspected it to be sciatica. I went to neuroglist and PT. Neurologist said no nerve is involved in back and referred me to a physiaitrist/pain managment thinking that it could be piriformis syndrome. They gave a piriformis injection (didn't work).
5 months have been passed, gyne referred me to pelvic pain specialist as she was cluleless and said it can't be gyne related. Physiatrist gave me another injection in my SI joint thinking it could be SI joint dysfunction (didn't work). It was extremely painful and expensive.
6 months: pelvic pain specialist saw me, did thorough examination. While she was doing my rectal digital exam, I felt pain like there is a wound inside. I told her its painful but she didn't notice anything unusuall. She sent me to pelvic floor PT and ordered pelvic MRI (clean). I begged her to refer me to gastro (referral was require). Nobody was refering me because I didn't have any symptom other than pain in rectum.
7 months: Pelvic PT did internal exam (vaginally) and identified that my obturator internus is very sore as well as where it attaches to piriformis. She started soft tissue therapy (helped a little). Meanwhile my pelvic pain specialist ordered a pudendal nerve block since the pain was no referring to half of my vagina. (Didn't work). Went to gastro and showed my very old reports with mild colitis which made them order a colonscopy although they weren't convinced.
After colonscopy my wounded pain inside rectum increased a lot. They gave me 2% diltiazem for 2 months (twice a day). 2 weeks have passed and I haven't seen any difference.
8 months - current pain area is rectum, buttock and thigh (left, sometimes on right too but less intense on right). Can't sit and its painful to lie down too.
Before period I still get painful episode where pain goes to me calf however intensity went down from 9 to 6.
Can anybody relate? I am trying to believe that its because of fissure since no other cause was found. My gastro isn't sure and my friend (internal medicine) thinks its not because of fissure.
Please anyone? I need hope
