Hi.. Welcome to HEALTHCARE MAGIC.. So sorry to hear about your problem and will try my level best to solve it to the best of my knowledge and experience.. As per your explanation and query Hemorrhoids also known as Piles in general terms are inflamed and swollen veins that are formed when there is continuous irritation of the veins present in the rectum area and inflammation can lead to pain and bleeding during bowel evacuation.. In your case it seems to be extremely inflamed and as it is thrombosed it is further worsening the condition.. Consult a Proctologist and get evaluated and a clinical evaluation and anoscopy can be done for diagnosis.. -Application of steroid and numbing ointment that you are already doing in the form of sheild cream.... -You can also apply anovate cream as it contains steroid along with Phenylephrine that is a blood vessl constrictor and will help in reducing inflammation.. -Sitz bath that is sitting in warm water tub especially after bowels.... -Do cool compresses to reduce inflammation and pain.. -High fibre diet along with laxatives like Polyethylene glycol and stool softeners like Docusate to maintain proper bowels.. -Avoid spicy food and drink plenty of water.. -In case of no improvement with medical treatment you can be advised surgical procedures like Rubber band ligation, sclerotherapy or Hemorrhoidectomy that is surgical removal of the hemorrhoids.. Hope this information helps.. Thanks and regards. Dr.Honey Nandwani Arora.