Levator Syndrome or Proctalgia Fugax?

Levator Syndrome or Proctalgia Fugax?


Common, painful issues involving the rectum, pelvic floor, and even the lower back can often be linked to Levator syndrome or proctalgia fugax. Many are easily confused by the differences in these conditions and this article can help you to better understand the two.


Levator Syndrome

Levator syndrome is a type of pain in the rectum, anus, sacrum, or coccyx, that also comes with a heavy side of pressure in the thighs and the buttocks. The exact cause or trigger of Levator syndrome are unknown, but many specialists link this condition to inflammation and spasms in the muscles of the pelvic floor. The pain may vary or be localized to the rectum, anus, rear of the pelvis, or the tailbone.

Proctalgia Fugax

A variant type of Levator syndrome is fleeting rectal pain called proctalgia fugax. This is best defined and characterized by brief, intense pain in the rectum that lasts for seconds, minutes, or longer. The spasms are often enough to wake people from sleep but also happen during the day. Proctalgia fugax can be difficult to treat due to the intermittent pain episodes but can also be diagnosed on history and symptoms alone.


Do I have Levator Syndrome?

By gauging your symptoms and keeping track of them for a few weeks, you can take this information to your doctor to begin the evaluation of this possible condition.

  • Pain during or after intercourse
  • Spasms and pain in the pelvic floor muscle
  • Sensation of sitting on a “bump,” or a “ball” where pain is worse when sitting (with or without a bowel movement.)
  • Pain in the thighs and buttocks
  • Deep, dull aching in the rectum or vagina
  • Testing done that showed no sign of inflammatory bowel disease, infection, ulcers, or other bowel problems.


Treatment for Levator Syndrome

The most effective treatment includes physical therapy, with specialized pelvic floor exercise and massage. Biofeedback therapy also helps to relieve the pain by modifying pelvic daily activity. If more help is needed, prescription muscle relaxers can be given, but do come with their own side effects. Local anesthesia and/or steroid injections have also been done for patients, but these options have varying results.

Other options for possible treatment are:

  • Prescription medications to decrease pain and muscle spasms.
  • Electrical stimulation to the pelvic floor muscles can help to relax these muscles and increase circulation to help healing.
  • TENS unit electrical stimulation (transcutaneous electrical nerve stimulation) can help the pelvic floor nerves in the lower spine.
  • Heat and ultrasound can be used by physical therapists to relax pelvic floor muscles.
  • Specialized rectal and buttock massage can be done by the doctor or physical therapist to decrease pain and spasms. In some cases, using specialized insertable wands for internal pelvic floor massage can help.


If you are struggling with random rectal pain or spasms, do not wait to seek out an evaluation from your medical care team to begin finding relief today!



Resources Used:

Reclaiming Intimacy


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