What could be causing rectal pain and pressure and how is it treated?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Rectal pain and pressure are common symptoms that may stem from conditions such as hypertensive anal cushions (swollen tissue inside the anal canal) or anal hypertonia (excessive tension in the anal sphincter muscles). Other potential causes include hemorrhoids, anal fissures, abscesses, or pelvic floor dysfunction. Treatment depends on the underlying cause and may involve topical medications, muscle relaxants, sitz baths, minimally invasive procedures, or physical therapy.

Because rectal pain can point to many different conditions—some minor, others requiring prompt care—identifying the likely cause early is key to finding relief. Take a free, instant, online symptom check to better understand your symptoms and confidently navigate your next steps.

Reviewed for medical accuracy: 07/15/2026

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Explanation

Rectal pain and pressure can arise from several conditions. One potential cause is hypertensive anal cushions, which means that the tissue in the anal area is under high pressure. This can lead to discomfort and pain during bowel movements. Another cause can be anal hypertonia, where the muscles in the anal area are too tight, which can also result in pain, especially when there are fissures or tears.

Causes:

Hypertensive Anal Cushions: This condition involves increased pressure in the anal cushions, which can lead to pain.
Anal Hypertonia: This is when the muscles are too tight, often associated with fissures or tears.

Treatment:

Medical Procedures: Depending on the specific cause, treatments may include procedures to relieve pressure or tension in the anal area.
Therapies: Treatments can also involve therapies aimed at relaxing the muscles or addressing any underlying issues.

If you're experiencing rectal pain and pressure, use our free symptom checker to help identify potential causes, and consult with a healthcare provider to determine the exact diagnosis and appropriate treatment.

(References)

Sun WM, Read NW, & Shorthouse AJ. (1990). Hypertensive anal cushions as a cause of the high .... The British journal of surgery, 2340400.
Salzano A, Carbone M, Rossi E, De Rosa A, Muto M, Amodio F, et al. (1999). [Defecography and treatment of essential anal pain]. La Radiologia medica, 10566296.
Gibbons CP, & Read NW. (1986). Anal hypertonia in fissures: cause or effect?. The British journal of surgery, 3719268.

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