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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18673
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello I am a 30 year old male recently I did some exercises

Customer Question

Hello
I am a 30 year old male recently I did some exercises which involved lying on my back and putting my knees together and then pulling them forwards towards my upper body. This was aboutt 5 days ago, since then I have had some pain in the anal muscle particularly when I urinate or when I have bowel movement it's a pain as the muscle contracts.

I have had prostatitis in the past but was treated for this and I have no urniary symptoms no pain on urination no freqent urination or urge to urinte. Also no fevers or chills. My bowel movements are fine.

The pain is a dull ache and only occurs when the anus contracts during urination and bowel movements. It is not a hemmorhoid or a fissure as it is not that type of sharp pain. I thought it might be proctalia fugax but this doesn't seem like it. Does this sound like a muscle strain or a prostate related thing? The pain has reduced a lot in the last few days but is still there. Please advise?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Thank you for using JustAnswer. I will be glad to assist you today.

This does sound like it is more likely a muscle problem, particularly if it was precipitated by recent exercises. It is not the typical presentation for proctalgia fugax, but there can be atypical presentations of this problem. By the same token, it is also possible that it could be from hemorrhoids or a fissure, since these conditions also can have atypical presentations.

It certainly does not sound like it is related to your prostate. Some men can feel pain in the anal area from prostate disease, but it is typically not exacerbated by contraction of the anal muscles. Certainly, prostate disease can also have various presentations, but it is not even an uncommon presentation to have anal pain that is exacerbated by contraction of the anal muscles.

Since the pain has already partly improved, it is reasonable to give it some more time, while also providing supportive care for symptomatic relief. Soaking in very warm or hot water is generally soothing for many different causes of anal pain. It is also reasonable to use an over the counter anti-inflammatory medicine, such as ibuprofen or naproxen.

If you have any further questions, please let me know.


Customer: replied 3 years ago.

Thank you for your response? Does this sound like something serious? I noticed that the pain is there only when I contract the muscles so during bowel movement and urinating, do the anal muscles contract also when urinating? What I also notice is that the area feels genrally tense particularly when having a bowel movement. As I mentioned my bowel moments are fine and I am not constipated.

When walking or sitting I have no pain with prostatitse there is pain and discomfort most of the time even when sitting so I don't think it would be a flare up of prostatitis.

It's been about 5 days but as I mentioned the pain has reduced, could it be a groin strain or pelvic muscle strain? Or even a sphincter muscle strain? What makes you think it is not prostate related? Thank you
Expert:  Dr. D. Love replied 3 years ago.
No, this does not sound like anything serious. It is likely that the pain will continue to improve until completely resolved.

As for the muscles, it is actually a more complex situation than just "anal muscles." In common discussion, we refer to the anal sphincter as if it is one muscle that encircles the anus and relaxes and contracts according to the situation. However, it is much more complex. The anal sphincter, itself, has multiple layers, plus there are several muscles that support the pelvic floor, including the anus, including the levator ani muscleand the pubococcygeus. It is these latter muscles that are involved in both urination and defecation, rather than just the anal sphincter. These latter muscles are also the muscles that cause pain in proctalgia fugax. These latter muscles also are part of the pelvic floor muscles, so yes, it could be considered to involve the pelvic muscles.

However, the pain that you describe is not the type of pain that occurs with a groin sprain, which is actually muscles in the thigh that insert into the bone deep to the groin.

I explained above why I do not think that it is prostate related.

Customer: replied 3 years ago.

Okay thank you for your response but from the description what type of muscle strain do you think this would be?
Expert:  Dr. D. Love replied 3 years ago.
It would most likely be the levator ani and/or pubococccygeus muscles possibly along with the anal sphincter. It would not be the anal sphincter alone, since there also are urinary symptoms.