Why Does My Rectum Hurt When I Sit? (Men)
Rectal pain with sitting is something many men experience but rarely talk about. It can be uncomfortable, distracting, and even concerning—especially when medical tests come back “normal.” While men often assume rectal pain must be related to hemorrhoids or the prostate, the cause is frequently muscular, postural, or nerve-related, particularly involving the pelvic floor.
Understanding how sitting posture and muscle function affect the pelvis can make a significant difference in both symptoms and recovery.
How Rectal Pain With Sitting Commonly Feels
Men describe rectal pain in a variety of ways. Some notice a deep ache or pressure inside the rectum, while others describe a burning or sharp sensation that worsens the longer they sit. A very common description is the feeling of sitting on a golf ball or something stuck internally. In many cases, the pain improves when standing, walking, or lying down, which is an important clue that muscles and nerves are involved rather than surface-level irritation.
The Role of the Pelvic Floor
The pelvic floor is a group of muscles that sit at the base of the pelvis and surround the rectum and anus. These muscles play a major role in bowel control, urinary function, sexual performance, and pelvic stability. When the pelvic floor becomes chronically tight or overactive, it can create constant internal pressure and irritation.
Sitting increases load through these muscles. If they are already tense, compressed, or poorly coordinated, sitting can trigger pain or make existing discomfort much worse. This is especially common in men who spend long hours sitting for work, driving, or gaming.
How Posture Contributes to Rectal Pain
Posture is one of the most overlooked contributors to rectal pain with sitting. Slouched sitting, a tucked pelvis, or excessive pressure through the tailbone changes how force is distributed through the pelvic floor. Instead of weight being shared through the hips and spine, the pelvic floor and rectum absorb more pressure than they’re designed to handle.
Poor posture also affects breathing mechanics. When the diaphragm doesn’t move well, the pelvic floor often stays in a guarded or contracted state. Over time, this constant tension can lead to pain, reduced circulation, and nerve sensitivity in the rectal area.
Even men who consider themselves active can develop posture-related pelvic pain if most of their day is spent seated without movement breaks.
Nerve Irritation and Sitting
The pudendal nerve supplies sensation to the rectum, perineum, and genitals. This nerve passes through muscles and connective tissue in the pelvis, making it vulnerable to compression when muscles are tight or posture is poor. Prolonged sitting, especially on firm surfaces, can irritate this nerve and produce burning, stabbing, or electric-like pain in the rectum.
Men often notice that symptoms worsen the longer they sit and improve quickly once they stand or change positions.
Prostatitis, CPPS, and Rectal Pain
Men diagnosed with chronic prostatitis or chronic pelvic pain syndrome frequently experience rectal pain with sitting. In many of these cases, there is no infection present. Instead, pelvic floor muscle tension, poor coordination, and nervous system sensitization are driving symptoms.
This is why antibiotics often fail to resolve pain and why pelvic floor physical therapy has become a key part of treatment for these conditions.
Tailbone and Pelvic Connections
The pelvic floor muscles attach directly to the tailbone. A past fall, sports injury, or even years of poor sitting posture can affect how the tailbone moves. When the tailbone is irritated or restricted, it can refer pain into the rectum, especially when leaning back while sitting.
Because of this close connection, tailbone issues are commonly mistaken for rectal or prostate problems.
Why Symptoms Persist or Get Worse Over Time
When rectal pain continues without treatment, the body often responds by increasing muscle tension as a protective strategy. Unfortunately, this makes symptoms more persistent. Sitting tolerance decreases, pain lasts longer, and even low-pressure activities can become uncomfortable.
Avoiding sitting, clenching muscles, or constantly shifting posture can reinforce the cycle if the underlying issue isn’t addressed.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy addresses the underlying causes of rectal pain rather than masking symptoms. Treatment focuses on restoring normal muscle tone and coordination, improving posture and sitting mechanics, reducing nerve irritation, and calming the nervous system.
Therapy may include hands-on techniques to release overactive muscles, postural retraining, breathing work, and exercises that improve how the core, hips, and pelvic floor work together during sitting and movement.
When to Seek Help
If rectal pain with sitting lasts more than a few weeks, worsens over time, or occurs alongside urinary, bowel, or sexual symptoms, it’s a strong sign that the pelvic floor should be evaluated. Men are often told that nothing is wrong because imaging and tests look normal, but muscle and nerve dysfunction does not show up on standard scans.
Rectal pain is not something men need to accept as normal or permanent. With the right approach, sitting comfortably again is very achievable. Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.