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Anorectalis Syndrome, Not Just an Anal Problem
Hello, I’m Dr. Sangchul Hwang, an autonomic nervous system researcher and therapist. Anal retentive syndrome is a functional pain condition characterized by pain deep in the anus, a heavy feeling of pressure, or discomfort that worsens when sitting. Often no specific inflammation or tissue damage is found on examination, but the patient experiences a distinct pain. Because of these characteristics, it is important to understand this as a functional problem involving tension in the muscles, nerves, and pelvic structures, rather than a simple anal condition.
The anal sphincter and tailbone are connected as one structure
The levator ani muscle is an important muscle in the pelvic floor that provides support for the anus and pelvic organs. It connects the pubic bone in the front to the tailbone in the back, which means that the position and alignment of the tailbone can directly affect the level of tension in the levator ani muscle. If the tailbone is curled inward or has restricted movement, the attached anal sphincter will also remain in a constant state of tension.
Why Tailbone Tension Irritates the Nerves
The area around the tailbone has a variety of nerve structures passing through it, as well as the pelvic floor muscles. When the muscles in this area become tense, the surrounding nerves can become compressed or sensitive. In this condition, pain signals can occur continuously without any particular stimulus. This is why pain can be particularly painful after prolonged sitting, as the structures around the tailbone are under constant pressure.
It’s often a structural issue, not just a muscle issue
While many people understand anal sphincter syndrome as a simple muscle strain, it often involves tension in the pelvic structures, including the tailbone. When structural tension persists, muscles don’t relax easily and nerves remain sensitive. This can lead to recurring or prolonged pain.
Anal Pain: It May Not Be Hemorrhoids, But Anorectalis Syndrome – 두근한의원
Why Sitting Worsens Pain
In a sitting position, your body weight is concentrated around your tailbone. If the tailbone is curled inward or strained from its normal position, this pressure further irritates the surrounding muscles and nerves. The result can be characterized by increased pain when sitting and relative relief when standing or lying down.
What matters is the tension in the tailbone and pelvic floor muscles
At the core of psoas syndrome, the muscles and nerves remain overly tense. Because the tailbone is directly connected to the pelvic floor muscles, it can be difficult for the muscles and nerves to relax if tension in this area persists. Therefore, it is important to understand the tailbone and pelvic floor muscles as a functional unit.
Recurrent Anal Pain, Understood from a Structural Perspective
Anal sphincter syndrome can be viewed as a problem related to the tension and balance of the entire pelvis, rather than just one area. In particular, tension in the muscles and nerves that connect to the tailbone play a role in the development of pain. Approaching it from this structural perspective will help you understand the cause of your pain more clearly.
