Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Levator Syndrome


Parswa Ansari

, MD, Hofstra Northwell-Lenox Hill Hospital, New York

Reviewed/Revised Jan 2023
Topic Resources

Levator syndrome is sporadic pain in the rectum caused by spasm of a muscle near the anus (the levator ani muscle).

  • The cause of the spasm of the muscle near the anus is generally not known.

  • Pain may be brief or may last for several hours.

  • The diagnosis is based on an examination.

  • Treatment includes pain relievers and sitz baths and sometimes physical therapy.

The rectum is the section of the digestive tract above the anus where stool is held before it passes out of the body through the anus.

The anus is the opening at the end of the digestive tract where stool leaves the body.

The Digestive System

The Digestive System

Proctalgia fugax is fleeting pain in the rectum. Coccydynia is pain near the tailbone (coccyx). Both of these disorders are variations of levator syndrome.

It is not known why the levator ani muscle spasms.

Symptoms of Levator Syndrome

The muscle spasm causes pain that typically is not related to defecation. The pain usually lasts less than 20 minutes. Pain may be brief and intense or a vague ache high in the rectum. It may occur spontaneously or with sitting and can waken a person from sleep. The pain may feel as if it would be relieved by the passage of gas or a bowel movement.

In severe cases, the pain can persist for many hours and can recur frequently.

A person may have undergone various unsuccessful rectal operations to relieve these symptoms.

Diagnosis of Levator Syndrome

Treatment of Levator Syndrome

  • Pain relievers and sitz baths

  • Physical therapy of the pelvis

The doctor explains that this condition is not life-threatening or severe.

An episode may be relieved by the passage of gas or a bowel movement or by a mild pain reliever (such as aspirin). An episode may also be relieved by soaking the anus in warm (not hot) water in what is known as a sitz bath. The soaking is accomplished by squatting or sitting for 10 to 15 minutes in a partially filled tub or using a container filled with warm water placed on the toilet bowl or commode.

When the symptoms of levator syndrome are more intense, people can undergo physical therapy of the pelvis.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
quiz link

Test your knowledge

Take a Quiz!