Does anyone have an anal fissure but their sphincter doesn't seem very tight. I feel like that is my case, but why then am I not healing?

Hello restoremybody,
I have an AF and my sphincter doesn't feel tight at all - it never did. However, when using Diltiazem/Nifedipine, I clearly feel how more relaxed it gets. A super relaxed sphincter, for me, feels more like I just had a BM and things are still a bit "dilated" (with no pain). I actually don't love the sensation - I prefer the "normal" feeling. However, I understand that this part of the healing and these medicines really helped me feel much better - to the point where i haven't felt pain in 1 week.
Have you seen a CRS? S/he may prescribe something to make your sphincter more relaxed than normal to speed up the healing.

I have been using diltiazam. And since using it internally where fissures are (my crs told me i could just put it outside) i can visually see my stool being more normal size than it has been since the fissure. It used to be like a pencil from fissure and miralax, but now looks more like quarter size. I do still ache after I go too.- is this from muscle spasm or just beacuse of the pulling apart of fissure-the ache seems to be the whole area- like i pulled it too far apart but a quarter in diameter is not too far.

Restore, these could be the so-called "spasms". For me, they never really felt like real spasms, but more like a feeling of a "tight pain" - hard to explain, but similar to what you mention. Yeah, quarter diameter doesn't feel too far, but fissures HURT - so any little stretching can cause this pain.
The healing is quite slow. For the first few days, Diltiazem helped a little but things really got better slowly. I'm now using it for 5 weeks (I switched to Nifedipine after 3 weeks since Diltiazem had some side effects for me, although it worked quite well) and I feel absolutely no pain anymore, before, during or after a bowel movement.
My doctor said I almost healed 2 weeks ago ( I was still feeling a bit of pain then), so this means basically that this thing really heals slowly. If you are seeing improvement, it probably means that the medicine IS working. And if it is working, you have a good shot at it working all the way!
wrt of the inside/outside discussion, I apply it outside. It works inside too, but I hurt myself a couple of times by using it inside. I've been all-outside for 3 weeks now and feeling great. Let's see what the CRS says this Thursday...

THanks for the info. I've heard so many conflicting advice on putting it inside/outside. I have been using this for about 2 months though :( THought this bease would be gone a long time ago. ABout a month ago my CRS said 90% give it another month. But I still in same place i was last month. (3 months before that he said- give it 6 weeks). Feels like going backward. I also feel some irritation while I walk or bend still- do you ever feel that?

Do you have a Chronic anal fissure but the sphincter isn't tight? What are the options in this case other than creams?