I can add more since I recently finished recovering from one of the worst kinds... the 3rd version.

As jmpherso mentioned, you have a couple types. None of which require surgery, but the last one, the external thrombose hemorrhoid is so fucking painful that you're going to wish you can get surgery, like asap. Here's my experience with it:

I'm a pooper. Pooping is great. I've had hemorrhoid before so I'm pretty good with the technique: don't strain, just let it happen. I remember one day being particularly in a hurry and I thought 'hey, I haven't had a hemorrhoid in a while.. I'm sure I could strain a little bit to get this out quicker.'

Nope. Fucking nope.

I didn't notice it right away. I do sit on my ass a lot, either on my laptop at home, or on my laptop at work, I sit a fucking lot. Later that night I noticed a little pain, kind of felt like tugging or pinching near my asshole. Wtf?

I muster up all my courage, dignity (which, by the way, whatever amount I had at the beginning would very rapidly disappear), and head to the bathroom. I make like a porn star, find a mirror, turn my buttocks to it, bend over, and well, let's just say it looked like one of those entrances to a cave with a huge boulder outside preventing entrance.

Welcome to the world of an external thrombose hemorrhoid. After inspecting the damage, I thought 'oh well, won't be too bad.'

Go back to my laptop, launch up dota 2, get into a game, nice.

10 minutes into that game I just feel.... pain. I can't describe it. Wait, yes I can. Imagine you have a vein in your butthole. The skin around it is kind of elastic, but it has nerve sensors so obviously you can feel it if you were to poke it. Okay, now imagine that because of a blockage, your vein is inflamed. I'm talking the size of a grape. And since it's down there where your uncle used to touch you, it's constantly rubbing against your cheeks, the hair down there poking it, and the fact that it feels like at the base of it it's being twisted like the final step of tying a balloon.

I'm a 25/m. I quit my game, went to my bed, and laid on my back, legs spread, feet against the wall. I could have cried that day. I mean, I would have, but I was in so much pain that I don't know if I could have mustered it.

I realize now I'm talking at great fucking lengths about the story of my external thrombose hemorrhoid. If there's interest in me continuing this absolutely gross and horrific story, let me know. I haven't even gotten to the blood clot hamburger that came out, or the blood that squirted like a ketchup bottle every time I farted.

Holy shit this was gross.