I will make a more complete post later on with everything I did, but had to share this first.
Background: I have had a fissure for a year. For those last 2 months I was bedridden with debilitating muscle spasms. Couldn't sit or stand for about 6 hours after bm, every time.
Physical Therapy: my first pelvic floor physical therapy session was 1 week ago. At this appointment, the PT did a massage of the tense muscles inside my rectum. Was a little painful, but tolerable (I've definitely been through worse, with the fissure and spasms).
I am not exaggerating when I say THE VERY NEXT DAY I had practically no pain, either during bm or afterwards! This was the first time I could sit after a bm in over 2 months. I was shocked, and honestly still feel like it's too good to be true.
Of course every person is different, it only been a week, and I can't promise this will work for everyone but please, give physical therapy (with a therapist specialized in the pelvic floor!!) a try. It is relatively non-invasive (aside from of course them sticking a finger up there), quick, and most importantly can be so effective. I'm scheduled to go back to PT once a week.
Other tips: I should also say that though the physical therapy was the most helpful, I've also done other things to help me get to this point. (Including: finding the right amount of daily fiber supplement for my body, 64oz water/day, a glass of warm prune juice every day, 2xdaily miralax, a diet of mostly fruits/vegetables/whole grains, diltiazem-lidocaine perscribed ointment for the rectal region applied before and after a bm, a warm sitz bath after every bm and heating pad for other pain flares, & as-needed tylenol & ibuprofen)