I've had multiple botox injections into the anal sphincter with no success and healing my pain. Although I feel the pain in my anal sphincter, the fact that the botox doesn't work on it suggests to me that the pain is likely referred by one of the levator ani muscles.
Has anyone here ever had botox and/or trigger point injections directly to muscles in the pelvic floor? If yes, I would love to hear more about your experience?
I am on the pelvic floor dysfunction Facebook site and also the levator ani I Facebook site and we discuss these things extensively amongst us and there are thousands of members so you might want to join that..... I myself have done pelvic floor physical therapy for over a year and it helped especially what she showed me to do at home as far as the breathing and calming down my nervous system and stretching also self work on the anal sphincter like sitting on a tennis ball etc.... She sees a lot of men too for this condition and it does involve internal work because that's the only way to reach some of the muscles......I see that Botox works for a lot of people but then again it doesn't work for a lot of people so I think some people have Pudental nerve irritation connected to the muscle tightness . I was on muscle relaxers for about a year and they helped a lot but I decided against any procedures until I tried different things for a couple of years asI did .Going on a low dose of nerve medication which is also an anti-anxiety and antidepressants has helped me quite a bit. There is so much that can be done for this so keep researching and definitely check out the Facebook groups which have helped me so much
Thanks for your suggestions to join the group, brilliant idea!
"I see that Botox works for a lot of people but then again it doesn't work for a lot of people so I think some people have Pudental nerve irritation connected to the muscle tightness "
Excellent insight. It looks like you're someone who is really taking this condition seriously and doing their home work. The other thing I would add is that if the pundendal nerve block doesn't work, blocking the inferior hypogastric plexus may be another option.
I'm glad to hear the muscle relaxers worked for you, it sounds like I may benefit as well. Sounds like you might be using a baclofen suppository. If I'm wrong please correct me.
I have levator ani syndrome where my levator muscles contract and lock in painful spasms. I also have slow transit colon which affects my ability to have a bowel motion. My "push" muscles don't work so have to do daily trans anal irrigation and manual extraction. Sounds gross but I've been like this for many years and it is just part of my daily routine. I take anti spasmodics and ammitryptiline which helps a bit.Best thing for me is great success with vaginal internal/external trigger point therapy with my bladder and bowel specialist physio. It can be very painful but I can get a couple of weeks where I can sit more comfortable. Along with this I get 3 monthly Botox injections into levator muscles. It does help ease the tight pelvic floor and also helps with the bowel spasms.
It took me a very long time to find a combination of meds and treatments.that work for me. Hope you find treatments that work for you and wish you good health.
Very good information Thank you very much
This was very helpful, thank you for posting. If you don't mind me asking, what kind of anti spasmodics did you take. It sounds like I may benefit from them.
I'm doing physiotherapy as well and it certainly helps. When you say, they inject into the muscles of the levator ani do they specify which muscle e.g pubcoccygeus?
Do you get pain after bowel movements too??
The short answer is yes, big time!
I've had this for 15 years and the first symptom I ever experienced was extreme pain during and after bowel movement that was literally last for 8 to 12 hours.
However, over time the pain evolved so that now I find it difficult to walk sit and stand. I'm fairly certain the issues has to do with the levator ani muscles or corresponding nerves because the referral pattern is to the sacrum and coccyx. I've also had a surgeon inject Botox into the anal sphincter and it did not help. This is actually very enlightening because I think the problem is the puborectalis is so spasms that it is cutting off the blood and oxygen supply to the anal sphincter which is one of the center points of the intense pain. Additionally, during a pelvic floor physiotherapy session, when the physiotherapist helped me release the anterior iliococcygeus, the anal pain drastically reduced.
Have you tried any nerve pain medications or muscle relaxers or CBD etc?
Yes, I have tried CBD orally and I've also tried to use it internally as a part of pelvic PT. Also, yes to the nerve medications which included: amaptritalene, duloxitine, estilopram, clonezepam and now gabapentin. In terms of muscle relaxers a number of people have suggested baclofen, but I haven't tried it.
Have you had success with these options or any others?
Yes muscle relaxers are a lot of help.... I have baclofen and cyclobenzaprine... I was on cyclobenzaprine for about a year and a half then felt like it was good I didn't need it anymore but I had a flare recently and I tried the baclofen and that seems to help a lot too... Baclofen is a little weaker than the cyclobenzaprine so I thought I would try that first and if it didn't do the trick I would try the cyclobenzaprine the reason being that I can only take the cyclebenzaprine once a day because I'm also on the Cymbalta where as the baclofen doesn't interact with the Cymbalta so I can take that multiple times a day... You can take them out on an as-needed basis too which is good
It sounds like we might have a similar pelvic floor dysfunction. When taking the cyclobenzaprine and baclofen are you taking these orally or as suppositories. Also, if you don't mind me asking, what dosages are you taking? Hopefully my doctor can prescribe me something similar.
Yes very much so. I also have severly compromised bowel caused by levator ani syndrome, colitis andI also have adhesions on bowel,bladder and abdomen due to many surgeries. Most days after bowel prep I have to lie down for a bit depending on level of evacuation and pain.I have to manage my life around this and it can be frustrating as I never know how I will feel on any given day. Mornings are the worst for me so I always try to plan my day around afternoon time.
I have been like this for many years but combination of meds, physio and Botox injections do give me some relief.
What anti-spasmodic med do you take and what kind of doctor does your Botox if you don't mind me asking?
I take alverine and colofac antispasmodics and my Botox is done by my nurogyneacologist not sure of spelling lol.
My spasms are rectal so my colorectal doc can do Botox if I decide to try it ...I am on Cymbalta for the nerve pain and anxiety and I have antispasmodics baclofen and cyclobenzaprine which I can take on an as needed basis..I will look up your antispasmodics....questions about the botox....do you just get a light anesthesia for it?and how long after do you feel it's effect... also did you go to pelvic floor PT?
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