Anal pain from lying on my side

[Pelviccrusader]

Hi all. I was wondering if anyone has the following condition and if they have found methods to treat it. I have had anal pain for five years which severely limits my sitting. It’s been pretty clear that the burning and throbbing is a result of damage to the rectal branch of the pudendal nerve as a result of excessive bicycle riding. For the last two years, the same anal pain is brought on by lying on my sides even though the anal area is nowhere near being contacted when I am lying on my side. My physical therapist does not seem to have a handle on this at all. It may correlate with tightness in my external hip rotators but I am not sure how this would lead to anal pain. Any insights would be much appreciated.

[kalecolbe12]

Does your pt do external mobilization on you?mine does and it helps a lot ..she also does pudental nerve flossing where she places her finger externally on anal portion of pudental nerve and rotates my leg....I am also on cyclobenzaprine muscle relaxer 5 mg 3 a day while I am getting pt to relax the pelvic floor...some people have orthopedists as well as or instead of pts....has...another treatment is Botox in pelvic floor muscles...in fact Dr hibner who is the go to doc for pudental nerve issues has a protocol where he does the 3d MRI and then pt and last Botox either way PT seems to be called for before other steps are taken...some insurance covers Botox for this and some don't but they usually only cover it if you have tried pt first....

[Pelviccrusader in reply to kalecolbe12]

Thanks for the info. Have tried everything but the pudendal nerve flossing-will ask my pt about it

[kalecolbe12]

Forgot to add that some people have tried the nerve pill Lyrica and it has helped them

[Cardinal]

Yes, I have that (mine's not caused by cycle riding though). I take methadone and it takes half the pain away.

[Pelviccrusader in reply to Cardinal]

Do your sides hurt in addition to the anal pain? I get greater trochanter pain which seems to predispose to the anal pain. Pain killers never seem to do much other than give me constipation but thanks for the info

[kalecolbe12 in reply to Cardinal]

Have you tried Flexeril or cymbalta?they help a lot?

[Cardinal in reply to kalecolbe12]

I tries Flexeril and it was like taking a sugar pill for me - absolutely no reaction. I haven't tried Cymbalta, but I tried something similar and it also didnt help. Only methadone has helped. It's been my miracle drug.

[Godsgurl]

I get the same rectal sensation especially for last 8 months. I haven't sat even on a cushion for all that time. Have gone through numerous procedures and doctors even Dr. Hibner. Pressure and pain. Got a great pelvic therapist so lets see if that will help. Trying to avoid Tarlov cyst surgery

[kalecolbe12 in reply to Godsgurl]

Did dr. Hibner suggest Botox to you ?his protocol seems to be the 3D imaging and then the botox so I'm just wondering what he did she try to help you... As I have said on my other post my PT does pudendal nerve flossing where I am on my stomach and she puts 2 fingers on the external pudendal nerve path next to the anal opening and then she moves my leg from calf back and forth she said this loosens up the nerve from the muscle and it certainly seems to have helped

[Godsgurl in reply to kalecolbe12]

Yes, I have had Botox once. It seems to have relaxed some internal muscles but not removed the pain. However, my therapist described it today that it takes a while for the nervous system to catch up once there have been adjustments. I hope that is the case. I still flare big time after PT therapy sessions but I will give it a good shot.

[kalecolbe12 in reply to Godsgurl]

I flare after pt too... Then it's better....I am gonna try a personal ultrasound

[Yacoub]

Possible Levator Ani

[glenbanchor]

Maybe haemoroids (piles) no ? Lidocaine (Germaloids helps). I kind of have this too I think after lying on my side I have noticed. Essential to have empty bowels I've found. Take laxatives if bowels not working properly. Pain when I pee. Sometimes cant pee only relief when I do. This at night. Waiting to see urinologist. Gyne said no prolapse although doctor said I had. Doing pelvic floor exercises and drinking lots of water as advised. Helps.