Levator ani syndrome

Levator ani syndrome is a condition characterized by brief intermittent burning pain or tenesmus of the rectal or perineal area, caused by spasm of the levator ani muscle. The genesis of the syndrome is unknown, however it has been suggested that inflammation of the arcus tendon is the possible cause of levator ani syndrome. Levator ani syndrome is a condition characterized by brief intermittent burning pain or tenesmus of the rectal or perineal area, caused by spasm of the levator ani muscle. The genesis of the syndrome is unknown, however it has been suggested that inflammation of the arcus tendon is the possible cause of levator ani syndrome. Symptoms include a dull ache to the left 2 inches above the anus or higher in the rectum and a feeling of constant rectal pressure or burning. The pain may last for 30 minutes or longer, and is usually described as chronic or intermittent with prolonged periods, in contrast to the brief pain of the related disorder proctalgia fugax. Pain may be worse when sitting than when standing or lying. Precipitating factors include extended sitting, defecation, stress, sexual intercourse, childbirth, and surgery. Palpation of the levator ani muscle may find tenderness. Proctalgia fugax and levator ani syndrome have not been found to be of psychosomatic origin, although stressful events may trigger attacks. Patients with levator ani syndrome also have 'significant elevations on the hypochondriasis, depression, and hysteria scales of the Minnesota Multiphasic Personality Inventory,' which is also the case in general among chronic pain sufferers. The discomfort may be relieved by walking or pelvic tightening exercises similar to Kegel exercises. Other treatments include massage of the muscle, warm baths, muscle relaxant medications such as cyclobenzaprine, therapeutic ultrasound and biofeedback. Electrical stimulation of the levator ani muscle has been used to try to break the spastic cycle. Injection of botulinum toxin A has also been used.