Pain-in-the-, rear. Proctalgia Fugax?

Originally Published: April 2, 1999 - Last Updated / Reviewed On: August 26, 2011
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I get severe cramping in my rectal area. It only happens at night when I'm asleep. I happened to mention this to several male friends, and they all eventually confessed to having this same severe problem. One of them said it was "Ass Cramps." Ever hear of this? Is this another problem that men get that no one ever hears of?

Dear Reader,

Your pains-in-the- …er, rear may not be a mystery "male thing," but rather could be due to muscle cramping, constipation, hemorrhoids, proctalgia fugax, or levator ani. Say what?! Here's an explanation.

Proctalgia fugax is characterized by a sudden, intense spasm of the anal opening usually lasting less than a minute, but in some rare cases can last up to an hour. These sharp stabbing cramps can occur a few times daily, then be absent for weeks or months. They are intense enough to wake someone from sleep, and often do. This condition is experienced by about 13 percent of adults and is actually more common among women than men.

The most common treatment for proctalgia fugax is simply to push on or massage the anal area or the perineum. This may be done manually, or by straddling the edge of an empty bathtub (carefully) or sitting on a tennis ball (which could make for a great scene should your roommate or partner chose to walk in. "What?" you ask innocently, "I'm just trying to hatch this tennis ball!"). Other measures that might help are soaking in a warm bath, and including plenty of fiber and liquids in your diet to keep the stools soft. The asthma drug Salbutamol can be prescribed by your health care provider. Lastly, because one possible cause is stress, you might lessen the number of attacks by practicing relaxation techniques such as deep breathing or looking into other stress management techniques.

A similar condition is levator ani syndrome. Distinct from proctalgia fugax, this pain is felt higher up in the rectal passage as more of a tight pressure than sharp cramps, and often lasts for 20 minutes or longer. You can ease an attack of levator ani syndrome by soaking in a bath of hot water, standing or walking around, massaging the levator ani muscles (by inserting a clean finger up the rectum), or taking an over-the-counter anti-inflammatory like ibuprofen or naproxen.

FYI, cramps come from prolonged contraction of muscle fibers. Cramping often occurs during or right after exercise, when you sweat a lot or have a fever, from repetitive motion (such as writing — writer's cramp), and as a result of poor blood circulation (sometimes associated with leg cramps). Some cramp-reducers include:

  • Massaging the affected area, which often reduces the pain and duration of the cramping.
  • Adding more potassium-rich foods to your diet (such as bananas and walnuts), which could help alleviate and prevent future cramps.
  • Using medicine prescribed by your health care provider if you're chronically cramped.

How often do you experience the night cramps? If the self-care measures mentioned above aren't working, or if you're sleep is interrupted frequently, you might want to be checked out by your health care provider to investigate causes of the pain. Columbia students can make an appointment through Open Communicator or by calling x4-2284. While a diagnosis should be helpful for treatment and peace of mind, it's unlikely the name of the condition could rival the raw descriptive power of "Ass Cramps," as your friend labeled his experience. Just don't want you to be disappointed.

Hope this helps you find relief,


March 22, 2012

I have this condition for many years now and it's pretty severe when it does come on. I've been in pain to the point where I'm pacing around my room like a caged animal and one time I even tried...
I have this condition for many years now and it's pretty severe when it does come on. I've been in pain to the point where I'm pacing around my room like a caged animal and one time I even tried slapping myself as hard as possible to detract myself from the pain. I know this sounds extreme but I've done research and heard of many other men that have the same thing. Some even pass out from the pain. I was watching sports one day and I saw that an athlete had severe cramping in his leg. The solution was for him to get an IV to pump liquids into his body. That got me thinking, so I started an experiment of my own. When I feel this coming on...(usually it takes about 5min to come on full blown) I get up and drink about 2 tall glasses of water and I go to the bathroom and take a super hot bath...usually in the cross legged position. I keep replacing the water with very hot water as it cools down. I stay calm and keep my mind active thinking about things other than the pain. Sometimes I even bring a magazine into the tub to distract me. I've done the water experiment now for my last five attacks and the severity has been greatly reduced. I used to do the hot water thing but that only seemed to help so much. Saturating my body with liquid has made a considerable difference in the pain. I had an attack tonight...a pretty bad one. The drinking water trick helped greatly. Since I started doing this I've never had pain as severe as it used to be. I hope this helps. It took me over ten years to figure this out.