Pain Between the Anus and Coccyx: Causes and Solutions

Pain in the muscles between the anus and the coccyx?

Hello doctor! I have pain and a sharp sensation when pressing on the thick muscle on the left side between my anus and coccyx.
I initially thought it was an anal fissure and considered the side effects of using a steroid suppository.
I consulted a general surgeon and took anti-inflammatory medication for a month, then saw a traditional Chinese medicine practitioner who suggested I see a colorectal specialist.
I also visited an orthopedic doctor who diagnosed me with periostitis and prescribed anti-inflammatory medication and muscle relaxants, advising me to apply heat if the pain worsened.
However, I sought help because I was uncomfortable.
The colorectal specialist found no issues with my anus and noted that there were only muscles around the buttocks, stating there wasn't a significant problem, and prescribed another 20 days of anti-inflammatory medication.
Despite taking anti-inflammatory medication for over three months, it only alleviates the pain temporarily, and the pain returns once I stop the medication.
Could you provide me with some advice or possible diagnoses? Thank you.

Mr. Chen, 20~29 year old female. Ask Date: 2015/02/07

Dr. Chen Wayda reply Rehabilitation

Please have Chih Da Hospital conduct an examination to confirm the diagnosis.

Reply Date: 2015/02/07

More Info

Understanding pain between the anus and coccyx can be quite complex, as it involves multiple anatomical structures and potential underlying conditions. The pain you are experiencing could be attributed to several factors, including muscle strain, nerve irritation, or even issues related to the pelvic floor. Here, I will provide a comprehensive overview of possible causes, diagnostic considerations, and treatment options.

Possible Causes of Pain Between the Anus and Coccyx
1. Muscle Strain or Tension: The area between the anus and coccyx is supported by various muscles, including the pelvic floor muscles. Overuse, strain, or tension in these muscles can lead to localized pain. This is often exacerbated by prolonged sitting, heavy lifting, or certain physical activities.

2. Coccydynia: This condition refers to pain in the coccyx or tailbone area. It can result from trauma (such as a fall), prolonged sitting on a hard surface, or repetitive strain. Coccydynia can cause pain that radiates to the surrounding areas, including the anus.

3. Nerve Irritation: The sacral nerves, which innervate the pelvic region, can become irritated due to various reasons, including herniated discs in the lower spine or pelvic floor dysfunction. This irritation can manifest as pain in the area you described.

4. Pelvic Floor Dysfunction: Conditions affecting the pelvic floor, such as pelvic floor muscle dysfunction or myofascial pain syndrome, can lead to pain in the perineal region. This may be associated with other symptoms like urinary or bowel dysfunction.

5. Inflammatory Conditions: Conditions such as proctitis (inflammation of the rectum) or pelvic inflammatory disease can cause pain in this area. While you mentioned that the rectal examination showed no issues, it’s essential to consider that inflammation can still occur in deeper tissues.

6. Cysts or Abscesses: Occasionally, cysts or abscesses can form in the perianal area, leading to localized pain and discomfort. These may require surgical intervention if they become significant.

Diagnostic Considerations
Given the complexity of your symptoms and the various specialists you have consulted, it may be beneficial to pursue further diagnostic imaging, such as an MRI of the pelvis, to assess for any structural abnormalities. Additionally, a referral to a pain specialist or a pelvic floor physical therapist may provide insights into muscle-related issues that could be contributing to your pain.

Treatment Options
1. Physical Therapy: Engaging in physical therapy focused on the pelvic floor can help alleviate muscle tension and improve function. A specialized therapist can provide exercises to strengthen and relax the pelvic muscles.

2. Pain Management: Since you have been on anti-inflammatory medications, it may be worth discussing other pain management strategies with your healthcare provider. This could include nerve blocks or other interventional pain management techniques.

3. Heat Therapy: Applying heat to the affected area can help relax tense muscles and alleviate pain. This can be done through warm baths or heating pads.

4. Lifestyle Modifications: Avoiding prolonged sitting and incorporating regular movement can help reduce strain on the pelvic area. Ergonomic seating and cushions designed for coccyx pain may also provide relief.

5. Alternative Therapies: Some patients find relief through acupuncture or chiropractic care, which may help address underlying musculoskeletal issues.

6. Medication Review: Since you have been on multiple courses of anti-inflammatory medications, it may be beneficial to review your medication regimen with your healthcare provider to ensure that you are receiving the most effective treatment for your symptoms.

Conclusion
In summary, the pain you are experiencing between the anus and coccyx can stem from various causes, including muscle strain, nerve irritation, or pelvic floor dysfunction. A multidisciplinary approach involving physical therapy, pain management, and possibly further diagnostic imaging may be necessary to identify the underlying issue and develop an effective treatment plan. It is essential to communicate openly with your healthcare providers about your symptoms and any changes you experience, as this will aid in tailoring the best approach for your situation.

Similar Q&A

Understanding Deep Anal Pain: Causes and When to Seek Help

Hello Doctor: I have a history of irritable bowel syndrome, and whenever I experience frequent diarrhea, I feel a deep aching pain in my anus, which resembles coccyx pain. This discomfort radiates from the coccyx to the lower abdomen in a triangular pattern. I felt quite uncomfor...

Dr. Xu Kaixi reply Surgery
The soreness deep in the anus may be due to nerve pain associated with the contractions of the colon before, during, or after the process. Pain relievers can be taken to help alleviate this discomfort.

Unexplained Anal Pain: Exploring Causes and Treatment Options

Hello, doctor! I have been experiencing anal pain accompanied by a sensation of incomplete evacuation since April of this year, lasting for 7 months. The pain is located between the coccyx and the anus, and it is triggered by straining during bowel movements, pressure on the butt...

Dr. Ke Fangxu reply Surgery
This phenomenon is often not caused by hemorrhoids but rather by nerve root symptoms in the coccyx or sacrum. You may consult a neurologist to explore effective treatment options. As nerve block procedures are not my area of expertise, I apologize for not being able to provide pr...

Understanding Pain Near the Anus and Genital Area: Causes and Solutions

Hello doctor, I have a question. Recently, I've been experiencing a sharp, painful sensation near my anus and genital area. I'm not sure which specific area is hurting, but it hurts when I sit down. The pain feels sharp and strange, and occasionally I have some abdomina...

Dr. Ke Fangxu reply Surgery
Hello, in response to your question, the area between the anus and the genitals is referred to as the perineum. Pain in this area can sometimes be related to issues with the anus or the urogenital system. If it is an anal issue, it could be due to hemorrhoidal swelling, anal fiss...

Understanding Coccyx Pain: Causes, Symptoms, and Treatment Options

One night, I suddenly experienced severe abdominal pain that radiated from my lower abdomen to my rectum. The next day, I visited a gynecologist who said everything was fine and referred me to a gastroenterologist. The gastroenterologist mentioned that I had gas in my intestines,...

Dr. Luo Zhongwei reply Orthopedics
DEAR BOBO: I have never liked diagnosing or treating patients through letters or written communication, as there is no opportunity for a personal physical examination or objective evidence to refer to. Please come to the clinic in person for a thorough examination, and I will pro...