Levator Ani Syndrome
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Levator Ani Syndrome
Levator ani syndrome is a condition characterized by burning pain or tenesmus of the rectal or perineal area, caused by spasm of the levator ani muscle.Levator Syndrome, by Parswa Ansari, MD 7/2014, Merck Manuals The genesis of the syndrome is unknown; however, inflammation of the arcus tendon is a possible cause of levator ani syndrome. Signs and symptoms Symptoms include a dull ache more often to the left 2 inches above the anus or higher in the rectum and a feeling of constant rectal pressure or burning. The pain may last for 30 minutes or longer, and is usually described as chronic or intermittent with prolonged periods, in contrast to the brief pain of the related disorder proctalgia fugax. Pain may be worse when sitting than when standing or lying. Precipitating factors include extended sitting, defecation, stress, sexual intercourse, childbirth, and surgery. Palpation of the levator ani muscle may find tenderness. Cause Levator ani syndrome is characterized by pai ...
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Levator Ani
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and painfully contracts during vaginismus. It also contracts rhythmically during orgasm. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx and a ...
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Gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the ''GI tract,'' which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which includes the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes ''GI doctors''. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, irritable bowel dise ...
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Rectal Tenesmus
Rectal tenesmus is a feeling of incomplete defecation. It is the sensation of inability or difficulty to empty the bowel at defecation, even if the bowel contents have already been evacuated. Tenesmus indicates the feeling of a residue, and is not always correlated with the actual presence of residual fecal matter in the rectum. It is frequently painful and may be accompanied by involuntary straining and other gastrointestinal symptoms. Tenesmus has both a nociceptive and a neuropathic component. Often, rectal tenesmus is simply called tenesmus. The term rectal tenesmus is a retronym to distinguish defecation-related tenesmus from vesical tenesmus. Vesical tenesmus is a similar condition, experienced as a feeling of incomplete voiding despite the bladder being empty. Tenesmus is a closely related topic to obstructed defecation. The term is from la, tēnesmus, from Greek , from to stretch, strain. Considerations Tenesmus is characterized by a sensation of needing to pass stool ...
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Levator Ani Muscle
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and painfully contracts during vaginismus. It also contracts rhythmically during orgasm. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx and a ...
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Arcus Tendineus Fasciae Pelvis
At the level of a line extending from the lower part of the pubic symphysis to the spine of the ischium is a thickened whitish band in this upper layer of the diaphragmatic part of the pelvic fascia. It is termed the tendinous arch or white line of the pelvic fascia, and marks the line of attachment of the special fascia (pars endopelvina fasciae pelvis) which is associated with the pelvic viscera In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a f .... It joins the fascia of the pubocervical fascia that covers the anterior wall of the vagina. If this fascia falls, the ipsilateral side of the vagina falls, carrying with it the bladder and the urethra, and thus contributing to urinary incontinence. References External links * - "The Female Pelvis: Muscles of the Pelvic Diaphragm" * ...
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Symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indicati ...
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Proctalgia Fugax
Proctalgia fugax, a variant of levator ani syndrome, is a severe, episodic pain in the regions of the rectum and anus. It can be caused by cramping of the levator ani muscle, particularly in the pubococcygeal part. Signs and symptoms It most often occurs in the middle of the night and lasts from seconds to minutes; pain and aching lasting twenty minutes or longer would likely be diagnosed instead as levator ani syndrome. In a study published in 2007 involving 1809 patients, the attacks occurred in the daytime (33 percent) as well as at night (33 percent) and the average number of attacks was 13. Onset can be in childhood; however, in multiple studies the average age of onset was 45. Many studies showed that women are affected more commonly than men, but this can be at least partly explained by men's reluctance to seek medical advice concerning rectal pain. Data on the number of people affected vary, but prevalence may be as high as 8–18%. It is thought that only 17–20% of pati ...
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Palpation
Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine its size, shape, firmness, or location (for example, a veterinarian can feel the stomach of a pregnant animal to ensure good health and successful delivery). Palpation is an important part of the physical examination; the sense of touch is just as important in this examination as the sense of sight is. Physicians develop great skill in palpating problems below the surface of the body, becoming able to detect things that untrained persons would not. Mastery of anatomy and much practice are required to achieve a high level of skill. The concept of being able to detect or notice subtle tactile signs and to recognize their significance or implications is called appreciating them (just as in general vocabulary one can speak of appreciating ...
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Minnesota Multiphasic Personality Inventory
The Minnesota Multiphasic Personality Inventory (MMPI) is a standardized psychometric test of adult personality and psychopathology. Psychologists and other mental health professionals use various versions of the MMPI to help develop treatment plans, assist with differential diagnosis, help answer legal questions (forensic psychology), screen job candidates during the personnel selection process, or as part of a therapeutic assessment procedure. The original MMPI was developed by Starke R. Hathaway and J. C. McKinley, faculty of the University of Minnesota, and first published by the University of Minnesota Press in 1943. It was replaced by an updated version, the MMPI-2, in 1989 (Butcher, Dahlstrom, Graham, Tellegen, and Kaemmer). A version for adolescents, the MMPI-A, was published in 1992. An alternative version of the test, the MMPI-2 Restructured Form (MMPI-2-RF), published in 2008, retains some aspects of the traditional MMPI assessment strategy, but adopts a different t ...
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Massage
Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet or a device. The purpose of massage is generally for the treatment of body stress or pain. In European countries, a person professionally trained to give massages is traditionally known as a masseur (male) or masseuse (female). In the United States, these individuals are often referred to as massage therapists, because they must be certified and licensed as "licensed massage therapists". In professional settings, clients are treated while lying on a massage table, sitting in a massage chair or lying on a mat on the floor. There are many different modalities in the massage industry, including (but not limited to): deep tissue, manual lymphatic drainage, medical, sports, structural integration, Swedish, Thai and trigger point. Etymology The word comes from the French 'friction of kneading', which, in turn, comes either from the A ...
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Muscle Relaxant
A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics. Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system (CNS) activity. They are often used during surgical procedures and in intensive care and emergency medicine to cause temporary paralysis. Spasmolytics, also known as "centrally acting" muscle relaxant, are used to alleviate musculoskeletal pain and spasms and to reduce spasticity in a variety of neurological conditions. While both neuromuscular blockers and spasmolytics are often grouped together as muscle relaxant,
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Cyclobenzaprine
Cyclobenzaprine (sold under the brand name Flexeril, among others) is a medication used for muscle spasms from musculoskeletal conditions of sudden onset. It is not useful in cerebral palsy. It is taken by mouth. Use is not recommended for more than a few weeks. Common side effects include headache, feeling tired, dizziness, and dry mouth. Serious side effects may include an irregular heartbeat. There is no evidence of harm in pregnancy, but it has not been well studied in this population. It should not be used with an MAO inhibitor. How it works is unclear. Cyclobenzaprine was approved for medical use in the United States in 1977. It is available as a generic medication. In 2020, it was the 39th most commonly prescribed medication in the United States, with more than 16million prescriptions. It was not available in the United Kingdom as of 2012. Medical use Cyclobenzaprine is used, in conjunction with physical therapy, to treat muscle spasms that occur because of acute m ...
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