Massage/Massage to relieve pain
QUESTION: I am a 25 year old woman. Since childhood I have been experiencing severe pain in my anus almost on a daily basis. The pain was diagnosed as being the result of a condition called as proctalgia fugax. It is characterized by intense spasms that last for a few minutes and usually occurs during the night while sleeping. I have tried many remedies but nothing seems to work. My doctor has suggested massage therapy to reduce the pain. I have tried to massage my anus myself but can't do it properly on my own. I also don't have a sexual partner who can help me with it. So I was wondering if a massage therapist would be willing to massage my anal region to reduce the pain. Do you know of anyone who would agree to do this?
ANSWER: Thank you for your question, Manju. It's a good one.
Here's the link to a webpage I found: http://www.listentoyourgut.com/symptoms/23/rectal-spasm-and-levator-ani-syndrome
This page has helpful information about the muscles that are going into spasm and things you can do to help them relax.
As far as I know, in all states, Massage Therapists are prohibited from working in the lower body openings. If you happen to be in Florida, however, I may have a suggestion for you.
This type of therapy MAY be in the scope of practice of chiropractors. I have heard of some who do inter-rectal work. A few weeks ago I read an article about a physical therapist who did inter-vaginal treatment to help strengthen the vaginal muscles, so that may be another option.
You may be able to do your own anal massage following any of the relaxation technique suggestions found in the webpage. Do those first to relax the muscles.
If you are fairly flexible, lean forward. You might find this easiest if you are in squatting position. Use your thumb (no nails!) to insert and to press against the sides and back of the anus. Your fingers will be behind your tailbone, pointing up to your neck, in essence.
You don't want to press on the tailbone but rather on the softer muscles or off to the sides of the tailbone. Not on the bone.
Use any type of oil or lubricant and explore slowly and thoughtfully. If you run into tender areas, those are good places to hold for several seconds and to go back to again, later.
The muscle tissue you are after can be accessed from inside and to a lesser degree, from outside. Using your thumb, you may also find tender, tight areas inside the vagina, on the sides and the backside.
You could use a finger but using the thumb seems to keep your arm in a more neutral position so is less likely to strain muscles and cause arm pain.
I hope this helps. Even though this work is outside the scope of practice for massage therapists, I'm wondering whether your doctor would write a prescription for you? If so, the prescription may allow a massage therapist to provide the work if one is comfortable doing it. Remember, there are all types of massage training and some may have the knowledge and talent to do this type of muscle release and others won't. I wonder whether your doctor might have a referral to a massage therapist?
Take care and please feel free to write again,
---------- FOLLOW-UP ----------
QUESTION: Thank you for the prompt reply. I will ask my doctor about writing a prescription. But do you know how this massage will be done? Like how frequently it would have to be done, the duration of it, and the technique that the massage therapist will use on me.
You're welcome. I'm suspecting it might be somewhere between once and several times, depending on how your muscles respond. The technique will be to access the muscles, ask you for feedback on discomfort, apply pressure to the tight muscles for several seconds to allow them to relax. The therapist would work around the area seeking tight muscles with your feedback. She would probably go back to tight areas, either in the same session or future sessions, if required.
The length of the session would probably be at least half an hour of treatment time but perhaps more. It will possibly involve helping you become relaxed (with relaxation techniques like breathing or music, etc.) so you aren't tensing your muscles.
Sometimes babies have a sphincter muscle that is too tight to allow the bowel movement to pass. In that case, the doctor inserts his finger to stretch the muscle and it's only a one-time procedure. In your case, there may be more muscles to treat.
I would probably expect some discomfort but not pain. The therapist will use lubrication.
You will be the one who will know if you need more than one session after the first time.
I hope your doctor can write the prescription and have a referral, too.