All my anal pain started after delivering my daughter; I got a fissure healed within months but the pain remained. I still have pain with bowel movements; the burning is the worst in the evening. I'm seeing a pelvic floor physical therapist that does internal work; massaging the muscles, tissues vaginally or rectally. I've had Botox to the pelvic floor muscles and it did relieve some pain but the burning sitting pain still persists. Yesterday I had internal work done rectally, afterwards I was aching but today I had less burning sitting pain. I will continue to do dilation to mobilize the tissue...
Check out this website for more information;
http://www.pelvicpainrehab.com/