Hey everybody, soooooo I recently went to see my CRS in VA and she gave me some nitro ointment and lidocaine to take home, this was almost a week ago. I've noticed that my stools are softer, poo's more regular and no new bleeding and just the weird itchy feeling (like a scab) that almost feels like it's healing up sooo cool great! BUT everytime, every movement I'm still having that damn excruciating pain for hours afterwards..where sitz baths, ibuprofen, nitro, NOTHINGGGGG helps   I honestly thought that all these signs of healing would mean less pain! Crazy thinking right? Anyone else have this happen? Where all signs point to healing but that pain isn't lessening AT ALL!??!?! I'm sorry guys, I'm just so frustrated because you would think with all these improvements and especially no new tearing (no blood for 2-3 weeks) that the pain would have at least lessened up some. Thanks guys!! 

Hang in there! When I started with nifedipine it took 10 days to kick in. Days 8 and 9 were the worst pain. And I had not had any bleeding for about two weeks but I still had horrible pain. I found applying the ointment to the internal sphincter helped me more than putting it on the outside even though it was painful to do that. I hope that the ointment starts working soon for you!

Thanks darkeyes! She told me to put it about a half an inch inside opposed to outside which hurts so bad but I'm trying to push through it. I really hope it does start working soon as this is just horrible. Right when I start thinking I'm making progress, this happens..UGHHH.. Trying to hang in there though :-/

Half an inch is a good recommendation. I thought my doctor was crazy that she wanted me to put the medication inside when I was in so much pain. It hurt so much at first to put the ointment in. One day I just gave up and cried. But then I started again, I was so desperate to get better. I found that soaking in the tub for 20 minutes first and then putting in the medication made it a little easier. I used my smallest finger. I lubricated my finger (Vaseline) and put the medication on it. I tried finer cots but they were too painful. Once the medication started working, it was less painful to apply it. The discomfort of applying the medication has gotten so much better over time.
During my worst days, I put a heating pad on my bottom (over my pajamas) and that helped a little. I had to be sure I did not get it too hot. I also used a lidocaine ointment from the doctor. I just put it on the outside. It helped a little bit. And I took extra soaks in the tub. But nothing was as good as when that ointment started working. I wish they had something topical that worked more quickly!

The same thing is happening to me.. I had a lot of great signs for healing, and then suddenly my BMs were just as painful as before... but no blood. It's really weird. I have been using nitro for a few months now..

Well, make sure you have had a good physical and know what it is you're dealing with.  No one has mentioned steroid cream.  Both mainstream and naturopaths recommended it for me to decrease inflammation of the scar tissue.  I was not confident about this until they both advised it.  Once I gave it the ol' college try--meaning getting it up inside a bit and onto the AF scar tissue several times a day..I think it led the way to healing for me.  I was reluctant and said, but put it right on an open wound?  But they said, yes, put it right on the edges of your fissure, two to three times per day (I recall).  I think the steroid cream helped a lot in addition to the anti-spasm creams (nifedipine, ditilazem).  You only use it for a week or so but I think it was important.  Don't be too shy about putting these creams up inside.  Your poos are bigger than your fingers...aren't they?  It takes a little getting used to but it's totally doable.  I kept my index fingernail really short and just 'went for it.'  Then, I decided to use gloves. Then I cut the fingers off the gloves (like finger cots) to use one at a time.  It's not that bad.  You just lie on your left side, breathe, relax, and stick the ointment up in.  Others on this site have talked about devices you can use if this is too unpleasant.  I think the pain was MUCH more unpleasant than applying the ointments.  Best of luck to you!