Doctor reveals how to get rid of ‘lightning bum’ - and when to worry about it

Whether it happens to you most weeks or once in a blue moon, it's simply a fact that a whole bunch of us have experienced a case of 'lightning bum'.

It's pretty much what it says on the tin - a sort of shooty pain you get in your bum sometimes, which is not exactly a pleasant sensation, and is often common amongst women.

Now, the medical name for the bizarre health phenomenon is actually 'proctalgia fugax', which is a sudden, stabbing rectal pain that comes out of nowhere, lasts seconds to minutes, then fully settles.

There’s no visible injury during episodes, as it’s a brief spasm of the anal sphincter or pelvic floor. It can be startling and even wake you at night, but once it passes, you feel entirely normal.

But how on earth do you get rid of it, and when should you be worried over it?

Anyone who's ever experienced 'lightning bum', listen up! (Peter Dazeley / Getty Images)

Why does it happen?

Sharing her insights on 'lightning bum', Ann Jarris, Medical Director at Response Ready, explained: "It happens when the internal anal sphincter or pelvic floor muscles go into spasm, often with a brief 'misfire' of the pudendal nerve.

"Stress, anxiety, constipation or straining, trapped gas, bowel movements, sex, menstruation, and even cold exposure can trigger an episode.

"It is also more common if you have IBS, haemorrhoids, or an anal fissure, which sensitise local nerves and keep muscles on higher alert. Night-time autonomic shifts can make the sphincter more prone to spasm, which is why it often strikes in bed."

Is it a red flag for another health issue?

The board‑certified emergency physician with decades of frontline A&E and remote, high‑risk experience, noted that brief, infrequent episodes in an otherwise well person are not a red flag and don’t usually signal another disease.

However, she added: "Be concerned if pain becomes constant or keeps returning for longer than about 20–30 minutes, or if it comes with fever, perianal swelling, new rectal bleeding, discharge or pus, weight loss, or a persistent change in bowel habit.

"It can coexist with haemorrhoids, fissures, IBS, endometriosis, or pelvic floor dysfunction, but those conditions bring their own clues on history and examination.

"From an emergency medicine standpoint, seek urgent care for severe pain with fever, inability to pass stool, spreading redness, or uncontrolled bleeding."

The medical name for the bizarre health phenomenon is actually 'proctalgia fugax' (Gratsias Adhi Hermawan / Getty Images)

When do you need to be worried about it?

According to Dr Tony Banerjee of HarleyDoc, in the vast majority of people, it is harmless and not a sign of a serious medical problem.

Jarris adds: "Occasional episodes, a few times a year that end within minutes, are usually nothing to worry about. Escalate to your GP if the attacks last beyond 20–30 minutes, are happening weekly or more, wake you repeatedly at night, or start affecting work, sleep, or sex.

"Seek assessment sooner if you’re over 50 with new rectal pain, have a personal or family history of bowel disease, are pregnant, or are immunocompromised. If you live or work far from medical care, plan in advance how you’ll access urgent evaluation if red flags appear to avoid delays."

Dr Banerjee also assures that the symptom 'does not indicate cancer, infection or structural disease'.

He echoed: "If attacks become regular, are increasingly severe, or start disrupting sleep or daily life, it’s worth a clinical review. Sometimes pelvic floor dysfunction, chronic constipation or nerve irritation are driving the pattern."

In terms of practical management advice, the expert advised:

• Heat (e.g., a warm bath or heat pad) can relax the muscles.
• Changing position, stretching, or gentle pressure over the perineum may provide quick relief.
• Avoid prolonged constipation - fibre, hydration, and regular bowel habits reduce triggers.
• If symptoms occur during high-stress periods, pelvic floor physiotherapy or relaxation techniques can help break the cycle.
• People with recurrent episodes should also ensure no underlying pelvic floor disorders are present, particularly if they have gynaecological symptoms.