I have chronic muscle spasms and discomfort around my anus probably from years of fissures. My bum has been really hurting me a lot lately. Lying down and walking doesn't usually alleviate the pain. One night last week it was really bad that I decided to massage my anal sphincter by inserting my index finger without going into my rectum. I discovered rubbing a certain area (the right side) on the anal sphincter helped ease the pain and spasms, but it felt like I was rubbing a 2 day old bruise. Yesterday I repeated the massage and felt the bruised area again. There are no lumps or fissures in that area. Rubbing it gave me the shivers. Can a healed anal fissure cause this or is it something else?

Db,

I feel as though I have a bruised a.s. too.. When my pt massages that area, I am in pain! I've been told that the cause if my pain is there is tension in the sphincter (tight internal sphincter) so I will be getting Botox into the internal sphincter. What have you done/ tried to relieve yourself?

Do you have pain with bm, burning pain while sitting, and just a general ache when standing? Those are my symptoms..

All I have done is massage my anal sphincter. Since it seems to work I'm going to keep doing it. Soaking in the bathtub also helps.

Defecating hurts most of the time. Sometimes I have bleeding and pain low in my abdomen. Sitting doesn't cause burning pain, but it is uncomfortable and tends to make my bum pain worse. Standing alleviates the pain somewhat. Sometimes it makes it worse.

I have done some research and discovered that I probably have levator ani syndrome along with my other problem. Some of my symptoms fit. I don't feel the gulf ball sensation in my rectum or left sided tenderness though.

Db,

In April I was told that my chronic pain was due to tight pelvic floor muscles so then Botox was injected into them... But some pain still remains (Botox) helped but now it's only my sphincter that I have tension on. My physical therapist has suggested to use a dilator to release the tension in there... Just waiting to get a pressure test before beginning...

I has bleeding too... I was getting papercuts around my anus since my muscles were so tight but now that they are relaxed, the only pain that remains is at the internal sphincter.

I don't have the golf ball sensation either.. My pain is all around the anus not in a specific spot..

I have been diagnosed with pelvic floor dysfunction.. Have you been seen by a doctor?

If a tense anal spincter causes paper cuts this could explain all the superficial fissures I get. They appear even without an episode of constipation or diarrhea. Most of them are small (~ 4 or 5 mm) and heal within 3 or 4 days. The deeper ones take longer. They don't hurt like the first fissure I had in 2009 when all this started. Five years later the spot where the original fissure was still hurts. I'm sure this is the spot that is making my entire sphincter tense. It has to be, since it is the most painful area. The rest of it just feels tight and uncomfortable.

I don't have problems with voiding and defecating. My pain is limited to my anus and sometimes the tip of my tailbone. Sometimes I get really bad tenesmus that will result in two or three BMs. Once my rectum is empty it goes away. Did you get that as well?

I went to see my family doctor in September. She did a rectal exam and found nothing abnormal. I left her office with a referral to a GI. When I saw the GI all she did was ask questions and told me I probably had mild Crohn's Disease. I don't think Crohn's is my problem. Now, I have to do a colonoscopy. I'm going back to my family doctor in two weeks to discuss possible levator ani syndrome. It wouldn't surprise me if this is my problem because I have GAD.

Is the Botox injection very painful?

"I don't have problems with voiding and defecating. My pain is limited to my anus and sometimes the tip of my tailbone. Sometimes I get really bad tenesmus that will result in two or three BMs. Once my rectum is empty it goes away. Did you get that as well?"

No I have not experienced that... I had the papercuts too because when I would wipe I would see light pink blood on the to.. After getting Botox, I do not feel the papercuts sensation and the irritation has decreased. Botox to the pelvic floor muscles (not the sphincter) was not painful at all but it was done under sedation. I'm scheduled to get Botox on the sphincter next week to relax the sphincter. I don't have any issues having a bm if the stool is thin but if its thicker (nickel sized or a little bigger) I have to strain to get it out.

I had a colonoscopy too but it showed nothing... I was sent to pelvic floor physical therapy and referred to a pelvic pain specialist.. Check out the book "a headache in the pelvis" for more information. You can also check out the chronic pain forum for more information.

When do you get your injections Alyssa? Are they going to do the sphincter and the pelvic floor? Are you being sedated again?

Msimon,

How are you doing? I'm getting Botox to the sphincter but it will not be done under sedation scared that it will be painful.

I'm not doing very well at all. I can't seem to beat my post-LIS infection and my pain levels are super high. The swelling has reduced a lot (I can actually find my butthole again!) but the pain is increasing so it's difficult to celebrate that. I think the pelvic floor/external sphincter are very aggravated by the change in muscle tone (weakening of the internal sphincter) and all the other pain in the area. Due to the infection, and me having to squeeze out the puss twice daily my wounds are not healing yet either so it has been really difficult to say the least. Just standing still it seems.

How are you doing? I have had botox into the sphincter with no anesthetic and I won't lie it does hurt but the pain subsides surprisingly quickly. I know I would definitely prefer to have it done that way than under anesthetic as it seems to be much more to recover from. Just take a deep breath and know that the pain dies quickly.