Abstract
The levator syndrome consists of the symptoms of pain, pressure or discomfort in the region of the rectum, sacrum, and coccyx. The patients often have gluteal discomfort and high rectal distress. Sitting may aggravate the disorder. Tenderness upon motion of the coccyx is not an important part of this syndrome. Therefore, the term “coccygodynia” should not be used. The syndrome affects women more frequently than men, and occurs most often in the fourth, fifth and sixth decades of life. Although the symptoms are at times vague, the diagnosis is easily made by those who suspect its presence. Tenderness of the levators is always present and most often unilateral and on the left. Its etiology is unclear. In a significant proportion of patients concomitant anorectal disease such as fissure and hemorrhoids is present. Massage with or without diathermy, hot sitz baths, and muscle relaxants such as diazepam have proven to provide effective treatment, and the recurrence rate after therapy is low.
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