OK here's what I know ...
Painful - yes, yes, yes. Relief available yes but please check with your doctor first. There is a cream called Nupricanal that is better than the over-the-counter stuff but you must ask for it from the Pharmacist - they can dispense it without a prescription but you must ask for it. If that doesn't work ask your doctor for prescription grade Anusol. My husband suffered with it and both of these creams worked for him.
Best wishes for speedy relief.