A couple of things:
1. There was a recent study that showed biofeedback was superior to electrogalvanic stimulation and massage (physical therapy) for the treatment of Levator Ani Syndrome (LAS). In fact, 87% of participants reported "adequate relief" with biofeedback (as compared to 45% for EGS, and 22% for massage).
Here is the link to the study:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847007/Personally, I would HIGHLY recommend biofeedback. Obviously, if you continue to strain or push to have a bowel movement, it will be very difficult or impossible for your fissure to fully heal.
2. I would ONLY go to a nurse or specialist who is highly trained in administering biofeedback. In fact, the nurse I went to (in South Carolina) says that people fly in from all over the country to see her because it is so difficult to find someone who is properly trained in biofeedback. Each session costs about $450 (without insurance) and lasts about an hour to an hour and a half. Some people only need a couple of sessions. In the study cited above, each participant went for 9 sessions. I was able to achieve lasting results in 4 sessions. To be perfectly honest, I was very skeptical about biofeedack when my CRS first mentioned it to me, but I have been amazed at the results (I no longer strain AT ALL to have a bowel movement).
3. No, I did not have a fissure when I first went for biofeedback; however, if you do have a fissure, the nurse can place the strobes on the outside of the anus (as opposed to inside the anus) and achieve the same results. You definitely would NOT want to insert the strobe if you have a fissure. The end of the strobe is at least 1/2" wide.
4. After using Miralax daily (a lifesaver for me!) and Nifedipine for 6 weeks, my CRS says he thinks my fissure is finally gone. I am still experiencing some pain and discomfort following a bowel movement, but my CRS thinks it's because I am still dealing with LAS.
5. While somewhat controversial in mainstream medicine, many people with LAS have reported success using the principle's in Dr. John Sarno's books to "cure" them of LAS. Sarno's theory is, in part, that the pain is an unconscious "distraction" to aid in the repression of deep unconscious emotional issues. Sarno believes that when patients think about what may be upsetting them in their unconscious, they can defeat their minds' strategy to repress these powerful emotions; when the symptoms are seen for what they are, the symptoms then serve no purpose, and they go away. Dr. Howard Schubiner has also done some seminal work on the subject, and has said that he believes LAS is a common manifestation of Mind Body syndrome. Here are some links for both of them (you can also find their books, along with lots of helpful reviews, on Amazon):
http://www.healingbackpain.com/http://www.unlearnyourpain.com/Both my CRS and my biofeedback nurse believe there is a connection between the emotions and LAS.
Of course, you should ALWAYS check with your doctor before beginning any treatment.
I hope this helps!