Are these trigger points or hemorrhoids? Please HELP...

[SteveMalk]

Hi there, I've had "levator ani syndrome" for over 14 years now. My may pain issue is the cramping, spasm, tightness high in my rectum.

Just about a month ago I went in to have a colonscopy again. I hadn't had one in years, just to make sure everything looked ok. The doctor said everything looked fine, and sphincter tone was normal to just a bit tight. But overall, looked good. This does not equate to the amount of discomfort I have as far as the spasm and tightness.

Anyway, I've started to do some internal work on my sphincter. Just about half an inch in, right in the bands of the sphincter, I feel gritty points and strands that really hurt. When I push on them, they feel sharp and burn.

So my question is this...are these tiny trigger points with the sphincter or are they hemorrhoids? The doctor never mentioned he noticed hemorrhoids when I had the colonscopy. Plus, I rarely have any blood from bowel movements. Sometimes I may have just a small trace at times, but very rarely.

Can someone please help me or give me some insight as to if these are TP's? If so, should I just do internal PT maybe 3X a week and just rub them out?

What advice can you give?

THANK YOU!!

[critthinker]

Steve, I've had this EXACT same experience. There are tight nodules just inside the sphincter that burn like nothing when pressed. I also was curious about whether they're hemorrhoids or TrPs, and never really came to find out. However, I did notice improvement on palpation of these points, though.

[SteveMalk]

Anyone else know if these are indeed TP's? It seems like this forum has really lost it's steam over the years...

[webslave]

Steve, as far as "losing steam" — a lot of people have improved to the point that they no longer need to read the forum. That's actually a sign of success!

If you are in doubt about a hard lump being a TrPt or not, read the Travell and Simons book
https://www.amazon.com/dp/0683083678

Or the Claire Davies book
https://www.amazon.com/dp/1572243759

Both books clearly describe how to identify TrPts

[SteveMalk]

Yes, I agree Webslave...that is a good sign and hopefully people are better! :)

I'm well aware of those books, and have actually read through those. I guess I was just asking here to see if others thought those were indeed TP's vs. Hemorrhoids. In those books, they describe trigger points as knots inside muscle. But what I'm talking about are small, sand-like and gritty strands under the surface right around the sphincter.

Thanks! :)

[webslave]

Unless they are painful, they are not trigger points.

[SteveMalk]

Yes, they are painful. When pressed or massaged, they feel sharp almost knife-like pain. They feel like they are more under the skin near the rectal sphincter bands themselves. No blood at all or anything when doing it though.

[webslave]

The anus is certainly a muscle that can be held tense and develop trigger points. Looks like you may have found some!

[SteveMalk]

Thank you so much Webslave, I believe you are right, and that would make sense why I have the spasms in them, and also that "golf ball" feeling. I think the reason a lot of my internal work before was not successful was because I was expecting bigger ones and also, I just did basic stretches internally.

But these TP's are tiny and sand-like, and once I dig a bit in the sphincter itself, I find them and then

Now I just have to get to work on them

[critthinker]

Steve, the terms "grain" or "sand" perfectly describe these points for me as well. They are very small, and when you press on them it feels like you're pressing down on an open wound. Really sharp, burning pain. My only recommendation would be to make sure you're pressing down for 90 seconds, which can be hard to do when it's really sharp pain. I've noticed these points are the hardest to get rid of. I'm seeing a dry needling PT, but they're not willing to treat these points for fear of infection of incontinence.

[critthinker]

Steve, one tip...when I worked on these points I noticed A LOT of pain afterwards (likely from soreness). Try using a hot water bottle (I highly recommend the Fashy one) for 40 min after treatment.

[jhferry]

Wow, I was just searching to board. Just in the last week I am having some sitting pain again. Its pretty sore but under my rectum and entire perineal area hurts. I have been sitting a lot lately... Was mainly searching to see if other people got pain there as well. Going to sit in a hot bath and try to relax it down there tonight...

[Alphalifestyle]

I have exactly the same, all around the sphincter. Some points feel like little sandcorns, I also have some longer more like ricecorn, in on area it feels almost like a scar. Especially after ejaculation my sphincter seems to get horrible inflamed and massaging the tissue produces a burning feeling as if the skin was scratched of. Horrible. Also after month of massaging the tissue with Vaseline I am not really making progress. Very frustrating.

Anyone who had success in treating the anal sphincter muscle with internal massage? Do you just rub the burning points repeatedly, press down on them? Stretch the muscle with finger/objects?

[critthinker]

Alpha, I have noticed success with pressing down on them for 90-120 seconds. I haven't been dealing with them as much lately because I took the leap and went through the excruciating pain for 90-120 seconds for each point (about 4-5 points) about a month ago. Still have some points, but it's not nearly as bad as it was before.

[Alphalifestyle]

Critthinker, thx for the input.

Actually in the last few days while working on the outer anal sphincter muscle I realized that the little grains I feel are not in the muscle but UNDER THE SKIN, I suspect its the connective tissue? It's like a fine web of little grains I can feel all around the anal sphincter muscle, more externally than internally. Pressing/rubbing them creates excruciating pain and burning, but interestingly enough, after a session of working on those strange grains, I feel actual relaxation and got some stronger erections than before, so it seems to be worth to continue working on those. :)