Lower back pain of unknown origin and your c section or hernia repair scar; is there a connection?
Lower back pain is a common problem with many causes. One of the more common causes may be related to a scar that is a residual from a surgical procedure.
There is now growing evidence suggesting that abdominal scars can cause chronic back pain, knee problems, and even upper back pain. The International Fascial Congress which meets every two years is filled with the brightest minds in the field of fascia and fascial therapy. Many papers have already been published on this growing problem and at each symposium, more papers are presented that are either about to be published or have been published already.
Scars that are symptomatic are known as active scars, meaning they are actively causing symptoms or mechanical malfunctions.
Many women have discovered that after they had a C-section, they had difficulty straightening up while the incision heals. Scars heal differently on everyone due to genetics, body mechanics, the quality of the incision and the persons activity level. A minor scar on the outside may hide marked problems underneath it. You may discover the problem a few months post c sections if your back suddenly locks up on while bending over a changing table. Others may have different episodes of back, knee, hip or neck pain months or years later.
Many men who have had hernia repairs have had a similar experience as the mesh that was used to fix the problem develops its own scarring which is part of the healing process. Others may have had bowel or other types of surgery, suffering years later from back problems that may have resulted in their having back surgery or another surgery to their upper back or shoulder, without realizing that the area of the symptom may be related to abdominal scarring. There is no shortage of practitioners advertising their services to resolve problems caused by active scars.
Surgeons have recognized for years that scar formation can be dangerous, especially in the abdominal mesentery, since it can cause problems with the bowel and other organs. There is also growing evidence that many scars can affect the way we walk and move because they are attached not only to organs but to the muscles that help us walk and move. Attempts at surgical scar removal often result in more scarring and other potential problems that may include infections, and previously infected areas often have more scarring as a result.
There is a growing database of surgical procedures that are being developed to prevent scarring by using minimally invasive surgeries, especially when it comes to the abdomen, where scars can have long term effects on your mobility, your gait and the health of your internal organs that reside in the mesentery. For example, gall bladders are routinely taken out arthroscopically, using tiny incisions. Hysterectomies can now be done through the vagina rather than making a bikini cut with an incision that is similar to those who had a c section. Some surgeries are done through the umbilicus to avoid weakening the abdominal region.
Proactive evaluation of healing scars 6-10 weeks after the procedure as well as early intervention with a trained myofascial therapist can prevent many of the chronic problems related to surgical scarring. Scars, when they are young, are easy to work with and have not fully set. In the abdominal cavity, active scars can be evaluated by hand by your doctor and if treated early by a trained therapist, may prevent many of the chronic and costly manifestations of the secondary back, neck and even shoulder problems may be avoided entirely.
While there are more published reports on the phenomena now than ever before, few physicians concern themselves with healing scars, unless their patient is complaining of pain, discomfort or experiencing infection. This must change.
Our office has treated hundreds of these types of cases, and a holistic active evaluation with a thorough history can determine whether your back problem is scar-related. We are currently working on publishing on our own paper on treating C-section scars and we offer screening procedures for doctors to learn so they can easily diagnose these problems before they become chronic.
Chiropractors who are trained in myofascial release treatments such as Active Release Techniques, as well as other methods, should be the provider of choice because of their holistic evaluation skills, their use of myofascial treatment, manipulation of the joints and exercise regimens that can help more chronic abdominal scar problems that are affecting patients back and the way the move resolve or improve. Our experience suggests that early intervention is most likely to resolve active scars since they are still forming months after the closure of the wound. Because of the malleable character of new scars, treatment can often be performed to resolve many potential problems in a few visits, since the forming adhesion can be eliminated easily in uncomplicated cases.