Most hemorrhoids that are painful and not accompanied by blood in the stool are the result of external hemorrhoids. External hemorrhoids are more painful when there is a local thrombosis or local infection with edema. If a local thrombus forms, it is called a thrombosed external hemorrhoid. In clinical practice, the main treatment is surgery, either thrombectomy or thrombosed external hemorrhoid removal. If the hemorrhoid is locally infected with edema, it is called inflammatory external hemorrhoid, which is mainly treated clinically by conservative treatment, you can use potassium permanganate solution with water at a ratio of 1:5000 by mass to take a sitz bath against inflammation, and topical application of Ma Yinglong hemorrhoid cream. If the hemorrhoid symptoms are still not controlled by conservative treatment with medication, surgical treatment needs to be considered. There is also the possibility of anal fissures, which are generally characterized by anal pain accompanied by bleeding as the main symptom. So when patients experience painful hemorrhoids, they should go to the hospital in time to clarify the type of hemorrhoids and then take the appropriate treatment measures.