Randomized, controlled clinical trials of treatments for chronic anal pain

Author, yearDiagnosisInterventionComparator(s)Main findings
Eckardt et al 199610 N = 16 (crossover)Proctalgia fugaxInhaled salbutamolPlaceboSalbutamol shortened duration of severe pain vs placebo (P = .019); effect most marked in patients having prolonged attacks
Abbott et al 200611 N = 60Pelvic floor myofascial painBotulinum toxin A; pelvic floor injectionPlacebo: saline injectionSignificant reductions in dyspareunia and pelvic floor pressure with both botulinum toxin and placebo
Dessie et al 201912 N = 59Myofascia pelvic painBotulinum toxin A; pelvic floor injectionPlacebo: saline injectionNo significant clinical effect
Rao et al 200913 N = 10a (crossover)Levator ani syndromeBotulinum toxin A; transanal injectionPlaceboNo effect of either botulinum toxin or placebo
Chiarioni et al 201014 N = 157Levator ani syndromeBiofeedbackEGS; levator muscle massage12-month results
Pain days: 14.7 (baseline)
3.3 (biofeedback) vs 8.9 (EGS) and 13.3 (massage)
Pain intensity: 6.8 (baseline)
1.8 (biofeedback) vs 4.7 (EGS) and 6.0 (massage)
Adequate relief: 87% (biofeedback) vs 45% (EGS) and 22% (massage)
Zoorob et al 201515 N = 29Levator ani syndromeSteroid injections in levator ani trigger pointsPelvic floor physiotherapyBoth groups improved equally (60% achieved 50% reduction in symptoms)
  • a Only 7 had complete data.

  • EGS = electrogalvanic stimulation