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Chronic anal pain | Specialized diagnosis and treatment in Madrid

If it hurts down there and no one finds anything, it doesn’t mean that nothing is wrong with you.

There are few things more frustrating than being in pain… and being told everything is fine.

What is psychological?

Or that “you’ll get over it.”

But you know it doesn’t happen.

That it is not just “a nuisance.”

Something tenses, contracts, or ignites down there, and it doesn’t let you live normally.

This is what we call chronic anal pain, also known as chronic proctalgia, often due to levator ani syndrome.

And although many confuse it with hemorrhoids (which don’t actually hurt), the truth is that this pain has an explanation and, most importantly, it has a treatment.

Common symptoms of chronic anal pain

  • Pain or pressure inside the anus or rectum without a clear cause.
  • The pain appears when defecating… or even for no apparent reason.
  • It is sometimes accompanied by a feeling of heaviness, throbbing, or cramps.
  • It can be confused with hemorrhoids, fissures or other pathologies.
  • It impacts daily life: from avoiding long trips to fear of defecating.

The key is to understand that anal pain does not always have a visible cause in the skin or veins, but is often in the muscles or nervous system.

What we hear most often in consultations: "I think my Hemorrhoids hurt."

But Hemorrhoids don’t hurt.

At least, not if they’re uncomplicated.

If you have persistent pain when defecating, burning, pressure, or cramping in the anal area, it’s most likely something else.

And at ProctoPelvis, we’re serious about finding that something else.

Common causes of chronic anal pain

Chronic anal pain, or proctalgia, can have many causes. Some of the most common are:

  • Levator ani syndrome (an internal muscle contracture, like anal torticollis)
  • Post-surgical or postpartum scars
  • Pelvic floor tension due to stress, trauma, or compensatory habits
  • Sensitization of the nervous system, which amplifies pain
  • And many times, there is no single cause, but rather a combination of physical, functional, and emotional factors.

All of this is tailored to your case. We don’t use generic prescriptions, and we don’t take anything for granted.

Diagnosis of chronic anal pain in Madrid

At ProctoPelvis, the first thing we do is listen. Take your time.

Then we perform a full assessment that may include:

  • Pelvic floor and anus ultrasound
  • High-resolution anorectal manometry
  • Functional and muscular examination adapted to your pain level
  • And if necessary, other imaging tests to rule out hidden injuries

Because if we don’t know what’s wrong, it’s impossible to design an effective treatment.

Treatment options for chronic anal pain

The goal is not just to relieve pain momentarily, but to break the vicious cycle of pain and tension that perpetuates it.

Conservative treatments

  • Education and changes in bowel habits.
  • Relaxation techniques and pelvic tension control.
  • Analgesia adapted to the case.
  • Psychological support, if there are signs of central sensitization, associated anxiety or a history that requires it.

All of this is tailored to your case. We don’t use generic prescriptions, and we don’t take anything for granted.

Pelvic floor physiotherapy

  • Manual techniques to relax the muscles.
  • Biofeedback to relearn how to coordinate sphincters and other muscles.
  • Breathing and postural control strategies.
  • Radiofrequency and non-invasive neuromodulation, which help relax muscles and reduce hypersensitivity.

Botulinum toxin

  • Temporarily relaxes contracted muscles.
  • It allows pain to decrease and physiotherapy to be more effective.
  • It is an outpatient, safe and well-tolerated procedure.

Our approach to ProctoPelvis

  • First extensive assessment, without rushing, to listen to your story thoroughly and understand the context.
  • Functional exploration, beyond what is seen with the naked eye.
  • Complementary imaging and functional tests, depending on each case.
  • Combined treatment: from physiotherapy and botulinum toxin to nutritional and psychological support when needed.

Why is this important?

Because chronic pain isn’t just a symptom.

It’s a physical, emotional, and nervous experience.

And it’s treated with respect, evidence, and strategy.

Is this treatment for you?

You should consider a consultation if:

  • You've had anal pain for a while and no one has explained why.
  • You've been told it's "Hemorrhoids," but the treatments haven't worked.
  • You feel like your body is protecting itself… even when it shouldn’t.
  • You have lost quality of life due to fear, shame or frustration.
  • You're looking for a different approach, with evidence and without taboos.

Book your proctology and pelvic floor consultation in Madrid

Proctology



You can find us here

Address: Vía de las Dos Castillas 9A, Pozuelo de Alarcón, Madrid 28224

Email: info@proctopelvis.com

WhatsApp: +34623781848

Hours:

Monday – Friday 10am to 2pm

Tuesday – 10am to 7pm

Saturday and Sunday – Closed