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Thursday, February 4, 2010

Scar tissue adhesions and female pain

Today I woke up with another killer lower backache. At first I attributed it to the crappy pillow-top mattress we have. But then as the day wore on I noticed I was getting almost cramping, like a period. I just had my period, I thought, and realized that it must be mid-cycle.

I then remembered that I had been experiencing back pain and more strange feelings 'down there' on a more frequent basis, almost cyclically. I've had two c-sections and thought, Do I have adhesion pain?

It's not severe, but annoying. It certainly wasn't enough to cause me infertility (at least after my first section) because I got pregnant twice more very easily. My doctor supposedly cleaned up scar tissue during my last surgery, but of course more would have formed after I healed up. Every now and then I get twinges that are almost like round ligament pains, and am starting to wonder just what the heck is going on.

Knowing little about adhesions and 'female pain,' I did some research. I was shocked to learn that among women surveyed for a particular study, between 55 and 100 percent of women had adhesions. Apparently they're pretty common after pelvic reproductive surgery, but not as many women experience complications from them.

Basically what happens is that when you heal, your scar tissue can literally grow into other organs around that space that are not normally connected. The worst-case scenario could mean infertility and even bowel obstruction, because the scar tissue has formed around the bowel tissue and literally cut it off. Other problems that are probably a total pain in the ass to live with include pain during urination and sex, and just pelvic pain in general. Unfortunately a lot of the treatment for c-section adhesions often means opening you up again to see what's going on, which just creates more scar tissue. And from what little I've read about it, it's often hard to get someone to take your pain seriously - often difficult to diagnose, it's estimated that around 33 percent of women will have it during their lifetime, and up to 20% already do.

As far as pain from c-sections go, the one website made a vague reference to 'an ounce of prevention being a pound of cure,' since they cited that nearly half of all women develop adhesions after their first c-section. That figure rises dramatically (to 75%) after a woman's third section. What are they saying? They don't exactly make it clear, but let's hope that it's 'if you can avoid having a section in the first place, it can help prevent this problem.' (Since this website is created by the Women's Health and Urology Department of Johnson & Johnson, I'm guessing that is the reason for their vagueness. Who knows.)

A patient referenced on the website said that while her first c-section went quickly, her second was much longer because her doctor had trouble removing the baby through the excess scar tissue. She added,
“If I had known about adhesions, I would have talked to my doctor about what can be done to reduce my risk for getting them.”
My fear is that her doctor never told her the risks, which is his responsibility as a physician. Looking back, my doctor never mentioned them either, only until I brought it up while preparing to have a VBAC with my second child. As expected, he totally downplayed the risks, in my opinion. (Avoiding a possibly unnecessary c-section in the first place would have even further reduced that risk, but I guess that's a moot point.)

And much to my amusement, one of their suggestions was that your risk of adhesions could be lowered if your doctor 'took great care during surgery.' Well, let's hope they all do that!


Ethel said...

And I know the best non-invasive treatment for scarring is deep tissue massage. It reduced the scarring on my mother's de-gloved and then skin grafted arm so that it's relatively soft and not like rawhide. But this meant for her painful massage each day by my father for years to get to the point where the skin was relatively normal. They didn't come up with this on their own, it was recommended by the surgeons and physical therapists.

I suppose you could get Rolfing done on your abdomen, but the thing is about the deep tissue massage is that the adhesions feel like bee stings when they break up and worse. Essentially it does the job without surgery but with a great deal of effort and often pain during the process. Just a thought on an alternative to surgery or living with the pain.

Outrider said...

Adhesions after abdominal surgery are very common in humans and (you've probably never thought about this) in horses.

Not all adhesions cause pain or impede function, but adhesions are my first concern when I'm presented with a horse (I'm an equine veterinarian) with abdominal pain and a history of abdominal surgery, especially small intestinal surgery.

Sometimes surgery is necessary (e.g., bowel obstruction) but elective surgery to break down adhesions can result in more adhesions. Laparoscopic surgery usually results in fewer adhesions vs. laparotomy (open surgery, like a C/S).

Talk to your physician or NP. Keep in mind that surgeons like to fix problems with surgery.

The Deranged Housewife said...

Outrider, you bring up an interesting point - that animals in these situations are often treated more 'gently' than their human counterparts! I have been thinking about animals in labor and how their instincts and behaviors kick in for a reason. Why should they not in humans? (rhetorical question, I suppose)

Ethel, I do remember something about massage used to break up the scar tissue, and also that it could be painful. While thankfully my problem isn't that serious, they are annoying and just make me wonder, if nothing else. And sadly, as Outrider mentioned, one cure to the problem creates more problems, ultimately! Seems bass ackwards to me. LOL

Thanks for your comments! Ethel, it's great to see you here! :D

Outrider said...

>>animals in these situations are often treated more 'gently' than their human counterparts!>>

Well, this isn't an entirely analogous situation. 2nd stage labor in a horse lasting longer than 20-30 minutes is generally fatal for the foal; not so in humans (obviously). When a C/S is indicated in a horse, the foal is almost certainly dead so it's really a salvage surgery for the mare. When the foal is dead we prefer fetotomy when possible because it's safer for the mare (yup, that means cutting up the foal and removing it in pieces... not something we usually do in humans, even when the baby is dead and it would be safer for the mother).

Re: adhesions - horses obviously can't tell us when they have occasional, short-lived mild to moderate pain caused by post-op adhesions. We discover adhesions during emergency abdominal surgery (usually done for severe pain, i.e., horse blowing through pain meds every minute or two... I'm not kidding) or last-resort exploratory abdominal surgery investigating chronic bouts of pain.

Nonetheless, adhesions are adhesions, regardless of species. Sometimes abdominal surgery is necessary, and lifesaving. No abdominal surgery should be performed without good reason because there are real and serious consequences, even when the surgeon is skilled and the patient is stable.

The Deranged Housewife said...

Thanks for your insight. I'd like to make a separate posts about the differences between human and animal labor but don't know much, if anything, about animals. Perhaps we could chat sometime?

Ashlynn said...

The Wurn Technique® is a hands-on physical therapy that breaks the powerful bonds of adhesions without surgery.

Highly skilled therapists use their hands to discover and treat restrictions throughout the body.

You can learn more at

Wendy said...

I had 2 c-sections a year apart. About 6 months after the second section I started having little, very painful tinge in the scar area when I moved the wrong way, or sneezed hard, anything that pulls the abdomen area.(I would like to state I have a very high tolerance for pain so anything that brings me to my knees is something major). Then over the past couple of years the pain became more frequent and now it is everyday and about once every couple of months the pain is so terrible I can hardly stand up straight or move. I have recently learned about adhesions post c-sections. I have wondered if this is the problem. I don't like the idea of surgery but even on a good day my entire abdomen can not be touched. What to do?

Kristy said...

Hi Wendy, I hope that this reaches you. I have had 3 csections, 1995 due to breech position, 2004 & then 2006. In January of 2012 I began noticing major pain on my left side. It went on for several months, worsening each cycle. I began having severe headaches as well & couldn't really function until I had popped a few excederines. I am like you and have been blessed with an extremely high pain tolerance. My husband made me go in to see his urologist. I have had kidney stones and assumed that was the root of my abdominal pain. The CT scan came back with clear kidneys & the Dr proceeded to tell me about how sometimes you pull muscles (YEAH LIKE THEY ARE SORE FOR 5 MONTHS STRAIGHT). Anyways a few days later after the radiologist had written up the report on my CT Scan, the urologist sent me to my ob. I had a growth attached to my left ovary. My OB said that it appeared to be a cyst from the ultrasound he did. If it was a cyst it would probably go away within a cycle. I knew it had already been 5 cycles & it was affecting my ability to function. After careful consideration we chose to do laproscopy to remove the cyst. When the Dr got in there he found it was actually scar tissue from the csections. It was wrapped around my left ovary, there was no way to salvage that ovary so I lost it. The scar tissue was removed 6 years after my last csection. So to answer your question I believe your pain is probably caused by adhesions. Especially if it is ongoing. Go get it checked out. I wouldn't want it to be attached to anything life threatening.

Anonymous said...

I too have been suffering with this problem since a c sect on my first baby.i was complaining to my GP for months n they were just totally clueless.i have felt so alone with my pain over d past 6 months n nothing makes it a result my lower back is totally fecked n have sciatica in my leg.i am a single mother n my baby is only getting heavier.i have attended physio for a few months now but don't seem to be improving.d thoughts that this is it for me is absolutely soul destroying as I am only 30 n enjoyed a high level of fitness pre im lucky to walk 5 mins without experiencing pain.i am at my wits end,I can't believe that so many other woman R also experiencing this,n yet doctors seem to know very little about it.d thoughts of going under d knife again is not even worth thinking about,n then there's no guarantee that it won't actually make matters worse!!!I would love to have more children in d future but am terrified that I will be faces with d same problems again.

Unknown said...

Adhenical is a successful cure for this. This medicine is made from herbal constituents those are highly effective for curing the problem. This medicine has no side effects; hence it is highly recommended and should be started as the Abdominal Adhesions get diagnosed. It is available at Herbal Care Products.

Unknown said...

The treatment of this issue is another surgery after which this problem occurs. There are less chances of getting cured again because 94 percent people fell again into this problem. The medicine for this problem is adhenical that is made by herbal constituents. It can be ordered by Herbal Care Products. It does not have any kind of ingredient which is harmful for health. It does not have any kind of side effects hence it is largely used by many of the Lysis of Adhesions.

Anonymous said...

Wendy, I can relate to your pain. A friend of mine who lived with adhesion pain for years, recommended that I take Doctor's Best Serrapeptase. It worked!! You can get it on amazon. Take 3-6 capsules on an empty stomach first thing each morning. Once you're experiencing relief, you can take them on an as needed basis. I hope this helps you! Dawn

Magsmiller said...

Kristi!! Your experience is exactly what I am going through! Two C sections, pain started a year ago with my first period and it is only on the right side. All scans showed no kidney stones. Finally went to my gyn and he thinks the pain is likely caused by adhesions from my c section. I also had a tubal during my second. I might lose my right ovary if he sees something. My surgery is Aug 4.

Margla Clerk said...

Abdominal adhesions are groups of fibrous tissue that can frame between stomach tissues and organs. Herbs Solutions By Nature are offering natural herbs such as Sedeton for Abdominal Adhesions Herbal Treatment, Sedeton an herbal supplement made out of 100% natural ingredients that are acquired from bona fide herb retailers.

Anonymous said...

I have major scar tissue on my stomach down to my abdomen from NEC surgery as a preemie. 28 years later, I'm having LOTS of issues with bowels and lower abdominal pain. My scar tissue hurts to the touch, and I have a general discomfort feeling inside. Have had many x-rays, a few CT scans, a colonoscopy, endoscopies, pelvic ultrasounds, transvaginal ultrasounds... all anyone tells me is I have constipation. Upon seeing a physical therapist recently for pelvic floor dysfunction, she thinks I definitely have lots of adhesions. Just deep scar tissue that may be all over the place. My gyno this morning heard me out about my pain (it's consistent, it can last all day, sometimes I'll have a week of no pain only for it to return) and cautioned against surgery because it could create more problems. It's a bummer, and I've gotten so much health anxiety over all this. I'm convinced I'm dying, that no doctors are listening to me. I've been prescribed Celexa and have been on that for 3 weeks in the hopes that one day soon, it'll help calm me down over all this. But going through life with chronic pain is exhausting. It's exhausting when doctors dismiss you or don't know how to help you. Anyway, thought I'd throw my thoughts in here. It's rough.

Middlouv said...

I have a lump about an inch in diameter on my left side, directly above my c section scar from 5 years ago. I noticed it 4 months ago, but I'm overweight so it could have been there longer. It only bothers me during my period, along with a burning pain on my actual scar. I'm worried because the lump doesn't go away inbetween cycles and hurts to the touch, but I've only had one really bad month as far as pain goes. I have my yearly physical in a couple months, but should I go in earlier? I had an ultrasound on my liver a year ago so I'm not sure if anything would have shown up anywhere? Thanks for the help