Chronic rectal pain refers to persistent pain in the rectal or anal region lasting longer than 3 months with or without surgical cause. It is a heterogeneous condition often associated with functional anorectal disorders, neuropathic pain, pelvic floor dysfunction, or structural pathology. It is more frequently seen in adults aged 30–60 years and is slightly more prevalent in women.
Management is structured and multidisciplinary, focusing on excluding serious pathology and targeting pain mechanisms. Following initial pharmacotherapy and pelvic floor strengthening exercises if the pain persists, I offer following interventions tailored to individual need and requirement that can be complimentary to other treatment modalities, aiming towards reducing pain and improvement in quality of life-
Interventional Pain Management-
- Pudendal nerve blocks
- Inferior rectal nerve blocks
- Trigger point injections (levator ani muscle)
- Botulinum toxin injections for pelvic floor spasm
- Radiofrequency ablation (selected refractory neuropathic cases)
- Neuromodulation (spinal cord or dorsal root ganglion stimulation in severe chronic cases)
You can request your GP to arrange a named consultant referral to the Barts neuromodulation service to access these advanced treatment options if they are not available in your area.