Pelvic Floor Symptom
Rectal Pain
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
The pain is deep in your rectum. It may be a dull ache that builds with sitting, a sudden sharp spasm that wakes you at night, or a burning that will not settle. Your colonoscopy was normal and there is no hemorrhoid or fissure to blame. Most rectal pain with normal exams comes from the muscles and nerves around the rectum.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Rectal Pain
Rectal pain has many possible sources, and your physician should always check for hemorrhoids, fissures, abscess, inflammatory bowel disease and other disease first.
When those are clear, three muscle and nerve patterns explain most rectal pain. Levator ani syndrome causes a dull, lasting ache or pressure that builds with sitting. Proctalgia fugax causes sudden, sharp, cramping episodes lasting seconds to minutes, often at night. Pudendal nerve irritation causes burning or electric pain that worsens with sitting. Tailbone problems and trigger points in nearby muscles can also refer pain to the rectum.
Dr. Gordon identifies which pattern you have and treats the muscles and nerves involved, coordinating with your colorectal specialist.
Rectal Pain at a Glance
Also called
Proctalgia, anorectal pain
Causes to rule out
Hemorrhoids, fissures, abscess, IBD, rectal disease
Common muscle and nerve patterns
Levator ani syndrome, proctalgia fugax, pudendal nerve irritation
Common aggravators
Sitting, bowel movements, stress, sex
Main drivers
Pelvic floor tension and spasm, trigger points, nerve irritation, tailbone problems
The Gap in Care
What Tests Check, and What They Can Miss
Rectal pain is usually evaluated with colonoscopy and anal exam. When they are normal, Dr. Gordon assesses the pelvic floor and nerves.
What routine testing is looking for
- Hemorrhoids and fissures
- Abscess or fistula
- Inflammatory bowel disease
- Rectal disease on colonoscopy
What often keeps symptoms going
- Levator ani tension and trigger points
- Sudden spasms of the pelvic floor
- Pudendal nerve irritation
- Tailbone problems that refer to the rectum
- Stress-related pelvic floor tension
These are assessed with a pelvic floor and nerve exam.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Dull, lasting ache
Deep aching or pressure lasting 30 minutes or more.
Sudden sharp spasms
Brief, intense cramping episodes, often at night.
Burning
Burning pain that suggests nerve involvement.
Worse with sitting
Pain building while seated.
Pain with bowel movements
Discomfort during or after going.
Tailbone pain
Pain spreading to the tailbone.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Levator ani tension
Tension and trigger points produce a dull, lasting ache.
Pelvic floor spasm
Sudden spasms produce the sharp episodes of proctalgia fugax.
Pudendal nerve irritation
Nerve irritation produces burning or electric pain with sitting.
Tailbone and nearby muscles
Coccyx problems and nearby trigger points refer pain to the rectum.
Your First Visit
How Dr. Gordon Evaluates Rectal Pain
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your colonoscopy, anal exam and GI history.
Tailbone and nerve assessment
Assessment of the tailbone, sacrum and pudendal nerve path.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Pattern review
Dr. Gordon reviews timing, duration and triggers to identify which pattern you have.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Blood in the stool or black, tarry stools
- A lasting change in bowel habits, especially after age 45
- Unexplained weight loss
- Severe abdominal pain with fever or vomiting
- Fever with a painful lump or swelling near the anus
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for rectal pain, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases the levator ani, coccygeus and surrounding pelvic floor muscles that produce rectal pain. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along the pudendal and sacral nerve pathways to calm nerve irritation.
See servicesBetween visits
Sitting Plan & Team Coordination
Sitting, bowel and stress guidance, coordinated with your colorectal specialist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Of all the doctors I have met with Doctor G.has been the most kind, caring, empathetic and patient. I feel like most doctors don't listen but Dr. G took the time to make sure I was heard."
DRIGO music, Google Review
Rectal Pain Questions
Answers About Rectal Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Sudden, brief, intense rectal cramping, often at night, from pelvic floor spasm.
It causes a dull, lasting ache rather than brief spasms.
Yes. Burning or electric rectal pain with sitting suggests pudendal involvement.
No. The pelvic floor is examined and treated from the outside. When the deep pelvic floor needs needling, the needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Many people improve within six to ten sessions.
Yes. Stress commonly triggers pelvic floor spasm.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For rectal pain, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the internal pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped, and nothing internal is done without your clear consent. You can pause or stop at any time.
Yes. Rectal pain can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Rectal Pain
Book a full evaluation with Dr. Gordon and find out which muscles or nerves are behind your pain.
Early morning, evening and weekend appointments available. Free on-site parking.
Further Reading
Rectal Pain With Normal Tests: Levator Ani Syndrome
From the blog: A deep rectal ache with a normal colonoscopy can come from the levator ani muscle. How GI doctors define levator ani syndrome, and where muscle care fits.
Keep Reading