The presence of pain in the anus for more than 3 months is called chronic proctalgia or chronic anal pain. Whether patients experience a sharp burning pain or a more dull pain, it nevertheless is a debilitating condition.

About 1/3 of patients with chronic anal pain do not get diagnosis and proper treatment, and this may affect their physical and psychological wellbeing. That’s why it is important to see a specialty doctor that can help patients find the right diagnostic and therapy.

Chronic Anal Pain Causes

  • Anal Fissure
  • Anorectal Abscess and Fistula
  • Hemorrhoids
  • Chronic Prostatitis
  • Pelvic Endometriosis
  • Rectal Ischemia
  • Puborectalis Syndrome
  • Pudendal Neuralgia

Chronic Anal Pain Treatments

There are different ways to treat chronic anal pain, depending on the cause. Anal fissure, anal fistula, and hemorrhoids require medical and surgical therapy. Local infiltration may be performed for patients with coccygodynia, but only after complete evaluation from an orthopedic consultant. Those with chronic prostatitis are referred to an urologist while a patient with pelvic endometriosis must get checked by a gynecologist.

Rectal ischemia is more common in elderly patients. Surgeons may do a CT scan and non-invasive techniques to improve blood circulation.

Puborectalis Syndrome and Pudendal Chronic Neuralgia are diagnosed by examining the levator ani and other trigger points. Nerve conduction studies are then done, if necessary. Treatments include biofeedback, pelvic floor rehabilitation, and in rare cases, direct infiltration with local anesthesia and corticosteroids on the nerve.