I’m on week 5.5 (roughly) of my fissure, day 20 of using Rectiv twice daily. I don’t seem to have much sharp pain lately, even when having a BM. It’s more of a dull ache that can come and go, and sometimes jabs of achey pain. I went to the bathroom 4 times yesterday thanks to Miralax, so I’m a bit more sore today - hoping I won't have even a single BM today! Apparently taking even half a cap every single day is too much for my body, so I’ll be switching to every other day and cross my fingers.
Anyway, it seems like a lot of people online say that sharp pain means an acute fissure, while more of an ache indicates a chronic fissure. Is that true? I thought it would be a good thing if the sharp, "passing glass shards" pain subsided, but I'm no longer positive.

Hi crimeofpassion
It sounds to me that your rectiv (nitro g) is working as you say the sharp pain-that may be associated with the spasm are occurring less.
The dull ache we can get just from the fissure itself, I dont think it necessarily means yours is chronic vs acute. I hear over 6 weeks for anal fissures means chronic.
Here: "Most anal fissures  heal with home treatment after a few days or weeks (acute anal fissures). If you have an anal fissure that has not healed after 6 weeks, it is considered a long-term problem (chronic)."
webmd.com/digestive-disorders/tc/anal-fissure-topic-overview
other web sites gave the same figures too
So you may be right at the verge. Please do not be to stressed though as it looks as though your headed in the right direction of healing.
HTH GL

Yeah. My CRS said he doesn't consider a fissure chronic until after 8 weeks, so I'm trying not to flip out. And I haven't been using the Rectiv for that long. I believe the minimum is 3 weeks, but frankly I'll probably use it until the tube is gone.
Anyone know if it's possible to be healed but still experience pain? Or can you only be healed if you have absolutely zero pain?

Hi Crime,
As Butt says, if your pain has changed from sharp to dull, I would also agree that your Recto is doing what it should in calming down those spasms. This is exactly what happened to me once I got on the Diltiziam Cream. The pain reduced immensely from the knife-stabs to dull throbs. The cream will not heal the fissure but relax the sphincter to the extent that it allows blood flow back into the area and thus promotes healing of the wound. For me 7 weeks of using the cream evidently allowed the fissure to heal to an extent that it was no longer incredibly painful when I stopped using it and with all the careful measures and dietary/ toilet habit changes, it just got better & better & healed more & more. I did continue to experience some spasms afterwards but these manifested as very dull pain with a feeling of pressure in my bottom (like trapped gas) which was really frustrating and annoying but once this passed and the spasms stopped, my healing got even better. "Healed" means no pain at all and to the extent that you will feel pretty much normal most of the time again, but you may still continue to experience the occasional twinging or discomfort when passing a BM, but this is more due to the scar tissue formation in that area and it all settling down. My fissure was chronic and took a long time to heal completely and although most of the time, I feel normal again with no pain at all, I still get occasional discomfort/ twinging pre BM, when the stool exerts some pressure on the scar tissue and now & again a minor discomfort during the process but nothing major at all. My CRS advised me this is totally normal because once that area has suffered trauma, it will never quite be the same again.
Hopefully, yours does not become as chronic as mine and recovery much quicker! Wishing you all the very best :) 

crimeofpassion, I agree that going from sharp to dull is sign of healing, as I go back to my journey of healing I remember how the pain, spams and discomfort gradually changed as the fissure was healing, now, it will be times that you may get some set backs, but usually is not as bad as when the fissure is fresh and is you keep track of what you are doing to keep the fissure happy you can always fix any changes that may cause and increase in discomfort.
I am happy that you are doing better. 

I appreciated Ever's description of the various pains/sensations.  I'm on month (let me think...) 6-months from the original onset and four months from the terrible retear (back to square one minus some), so I am definitely 'chronic.'  I'm amazed at how my daily pain levels vary, slowly going down but there will be days of renewed sharper pain (e.g., up to 6, easy)  and the ever annoying unpredictable 'butt cramps.'  However, pain during passage of BM's has slowly improved.  Along with the ointments, daily (usually more than one) sitz baths and using a heating pad at night, I think, have helped both provide comfort and encourage blood flow to the area. I walk for exercise (and blood flow) about five days per week (earlier it was too painful to walk and occasionally this contributed to retears, I believe).   It takes a lot of time and constant care but at least my pain ratings are going down.  Having the support of fellow AF warriors on this website has been crucial for surviving it mentally (thanks to the founders and all you participants!!).  

Hi crimeofpassion,
I am healing and my pain has also been dull and varies sometimes. It's definitely NOT at the level it was when I first developed mine in December last year where I wanted to jump off the nearest bridge during Christmas. That was excruciating pain that developed after having BMs (not during, as I've never had pain during BMs other than slight weird twinges or aches). The pain I get now is more of an ache that varies in intensity and comes and goes (especially with stress, which is hard for me to control, unfortunately, as I'm a very anxious person) after BMs. Some days I feel almost normal, while other days I get minor to moderate pain that will last a couple of days, then disappear. It's definitely worse before and during menstruation, though. Hormones really mess a woman up and the pain threshold is lower during the time. Water retention and cramps don't help, either, as well as the digestive issues that can occur.
Unfortunately, this is just a very slow process, especially when healing naturally (I can't have surgery for financial reasons at the moment and would like to try everything I possibly can to avoid it, anyway). As others have said, the skin will remain tender for some time and doesn't gain back its full strength until a year or more, from what I recall others have said on here (correct me if I'm wrong). Diltiazem, drinking lots of water throughout the day, eating healthy and avoiding foods that cause me digestive issues, and trying my best to relax have helped me tremendously. You just have to keep up the routine, which can be difficult at times, especially when you're feeling a lot better.
I also notice I feel a lot better in warm weather. Anyone notice this? I definitely felt worse during the colder months. Maybe cold weather makes the area tighter or the pain more noticeable? I'm not sure. I hate cold weather because of that. Maybe I'm just more sensitive to it?
I wish you all the best for quick healing!

@luka, how deep do you apply Diltiazem? also how long have you been applying it, ive been using it about 3 weeks now, things are slightly looser but i dont feel any big healing going on.

crimeofpassion
u ?

Anyone know if it's possible to be healed but still experience pain?

As ETO suggest, you want to shoot for being pain-free as pain is generally associated with inflammation, a sign of healing.
I said it before and will continue to say, I am amazed how smooth and pain-free I am down there after years of tears and re-tears and recurr's along with tags and what seemed a close call to getting a fistula. Best feeling in the world nowadays is the occasional hard BM comes out totally painfree and ZERO discomfort.
Time will tell though crimeofpassion, just keep stringing together months and months of no retears setbacks recurr's and you too will be amazed at how the body can heal itself (I do so know that's what your trying to do and it can get soo frustrating, but please stay strong).   sticktoitiveness.
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Wow marg6043, I did not know you were doing so well, great news.
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Yeah luka, I think Cabin Fever played a role as many of my fish seemed to spawn during the winter months. Just not a lot of movement (mind body and soul) going on among other things.
Take care guys, I'm pulling for you.

splinterboy2013 - I've been applying Diltiazem for about six months now, on and off in the past couple of months. I'm still trying to wean myself off of it. I don't have any bad reactions to it and it seems to help, so I keep applying it when I really need it (when I have noticeable spasms/pain). I apply it with a finger cot on my pinky finger inside (just up to the first knuckle... about 2mm). As long as you get it inside a little bit, it will do its job at relaxing the internal sphincter muscle.