Saturday, January 5, 2013

Scars, Adhesions and Referred Pain


We all have physical scar tissue. This healing process is so inherent to our daily lives that we take it for granted. We see the scars form, they happen naturally—so what is the big deal? Scar tissue is the body's way of repairing damaged tissues. Scar tissue shortens muscle tissue, which shows up as immobility, irritability and pain syndrome. Trigger points can be embedded in or around this scar tissue.

Trigger points create a type of muscle stiffness and are the result of tiny contraction knots in muscle and tissues where an area of the body is injured or overworked. Trigger points are something traditional doctors ignore and could be some thing overlooked in your case maybe for years. It is important to be knowledge empowered. If you have pain it is healthier to eliminate the cause of the pain. Many pain management techniques focus on masking pain rather than healing the body or helping the body heal itself naturally.

The healing process and scar formation can be initiated by something a simple as bumping into a corner of a table. We walk away, ignore the pain and go on with our daily lives. Most of the time this is not a problem—but some times this healing process triggers scar that if left unaddressed over time will result in pain and physical limitation.

When tissues in the body are interrupted by injury or impact, scar tissue forms as part of the healing process. Scar tissue helps mend together the separated tissues. Adhesions are scar tissues that form internally. Scar tissue is a dense fibrous connective tissue that forms over and/or around a healed wound or cut and is the body's way of repairing damaged tissues or of protecting surrounding tissues from foreign bodies.

We are familiar with acne scars, scars from cuts and scrapes, surgery. Internal adhesions form from procedures such as caesarian and hysterectomy surgery. There are also bone scars, as well as scars that form around breast implants and surgical mesh. Sometimes adhesions are present at birth. One example of excessive internal formation of scar tissue is a common complication that occurs in breast augmentation patients, known as capsular contracture. Keloids and hypertrophic scars are examples of excessive scar tissue formation, which happens externally.

Adhesion is the word used to describe bands of fibrous tissue that grows to connect internal organs. Adhesions can connect the loops of the intestines to each other, to nearby organs or to the wall of the abdomen. They can pull sections of the intestines out of place, which may block food from passing through the intestine. They cause symptoms such as crampy abdominal pain, vomiting, bloating, an inability to pass gas and constipation.
Some adhesions go away by themselves. Surgery can remove adhesions, however surgery can increase the risk of more adhesions. People who have experienced multiple back surgeries tend to have more adhesions, which can create the pain they were hoping to escape. Bony scar tissue, called a callus, will form on bone after a fracture.

While the degree of scar formation varies from person to person, there are some distinguishing characteristics: Becomes hard and non-pliable, Bands of fibers on or below the surface, Skin tightens or shortens, when crossing a joint, this contracture may limit range of motion, comprise function or cause deformity. Long-term effects the body’s formation of scar tissue can set the stage for future problems.
Since scars and adhesions are composed primarily of collagen, the scar tissue’s fibrosity prohibits adequate circulation, collagenous tissue creates physical limitations, and the lack of blood flow and lymph drainage occurring in scar tissue makes it vulnerable to dysfunction. The scar’s surrounding structures may resulting abnormal stress by nerve impingement, pain, numbness, limited range of motion and flexibility, postural misalignment, muscle atrophy, tissue hypoxia, and an increased potential for future injury. Some professionals and body workers believe that scar tissue is the root of a majority of physical imbalances and recommend addressing scar tissue early in its development to minimize secondary scar tissue issues.
When working with the scar it is important to be aware of the healing stage of the scar. Immediately after a wound heals, the scar is immature. The scar typically appears red and is painful, itchy or sensitive as nerve endings heal. Exercise, massage and heat application will have the greatest positive effect on an immature scar.
A mature scar tissue production, depending on the size and depth of the wound, will cease 3 to 18 months following wound healing. To reduce scar tissue in a mature scar a more disciplined, vigorous approach is necessary is needed to be effective.
Scar tissue is not a permanent fixture in the body. After the healing has taken place, the scar needs to be remodeled so it can tolerate the stress and forces that the body

Typically, adhesions show no symptoms and go undiagnosed. Most commonly, adhesions cause pain by pulling nerves, either within an organ tied down by an adhesion or within the adhesion itself. Signs and symptoms of adhesions are associated with the problems they cause rather than from the adhesion directly.
                Adhesions above the liver may cause pain with deep breathing.
                Intestinal adhesions may cause pain due to obstruction during exercise or when stretching.
                Adhesions involving the vagina or uterus may cause pain during intercourse.
                Pericardial adhesions may cause chest pain.
                It is important to note that not all pain is caused by adhesions and not all adhesions cause pain.
                Small bowel obstruction (intestinal blockage) due to adhesions is a surgical emergency.

It is very possible work with your own adhesions and scars. But I recommend that you consult with a physician, physical therapist, massage therapist or Rolfer to create an action plan. Some adhesions are life threatening especially in the abdomen. If you have had any kind of surgery I highly recommend ongoing massage is an excellent treatment and preventative for dealing with scar related trigger point pain.
Massage therapy can be performed during the initial immature stages but a gentle approach is needed. Body workers can improve scar tissue through specific techniques: Lymph Drainage, Myofascial Release, Deep Transverse Friction, Stretching, and Heat Application. Massage should never be preformed on an open lesion. Some do it your self-techniques for working with external scar tissue include:
Tip #1:  Rub Vitamin E oil on the scar. Vitamin E oil is considered an extremely efficient way of detoxifying skin scars and makes skin softer as well as lessening discolorations or scarring. As soon as the skin discolorations are slackened off to lessen the skin scars use vitamin E oil. Rub it on the parts of the skin with scars in a gradual spherical movement. Allow the vitamin E oil to go through the skin before putting on hot towel or cloth above the scarred area. This process will help slacken off the skin all the more and as well as extricate the dead cells and tissues. When the towel has cooled cleanse away the oil.
Tip #2:  Use baking soda for facial scars. Baking soda is an alkaline material, which is detoxifying and rids contamination from your body. Baking soda raises off dead skin cells permitting pores to be rinsed and dirt free lessening scars or even eradicate them. It is simple to use baking soda--blend a tablespoon of baking soda and a teaspoon of water then thoroughly mix them until it turns into paste consistency. Put the mixture on top of the scar and let it stay there for about two minutes before washing it off with clean water.
Tip #3:  Use citrus juice compress for skin scars. Citrus juices include elevated amounts of vitamin C that is useful in combating free radicals as well as for detoxify dangerous infection from your body. Lemon juice has the ability to eradicate dead and blemished skin cells to reduce and detoxify scarred skin. Immerse a washcloth in a concentrated lemon juice and place onto the skin for about 10-15 minutes or until the lemon juice had dried.
There are a number of home remedies and natural products marketed to prevent the formation of scars and to minimize the appearance of old scars. People are often interested in preventing are hypertrophic scars. They're red and raised and can be painful or cause limited movement in the affected area (called contractures). Hypertrophic scars usually diminish somewhat over time.  Home remedies used for preventing hypertrophic scars Include:
1) Vitamin E--Vitamin E, or tocopherol, is a fat-soluble antioxidant. It's found in capsule or liquid form at drugstores, grocery stores, health food stores, and online. The oil is typically applied to the affected area. Vitamin E has been shown to penetrate layers of the skin and reduce the formation of free radicals that can interfere with healing. Vitamin E also influences the production of collagen, a structural protein partially responsible for the strength and elasticity of skin.
2) Onion Extract--Onion, or Allium cepa, is an ingredient in one of the most popular scar gels found in drugstores. Onion extract has been found to have anti-inflammatory and antibacterial properties and regulate the formation of collagen.
3) Topical Honey--Honey has been used as a dressing for burns and wounds for centuries. Honey had antibacterial and anti-inflammatory properties and could stimulate the growth of new tissue.  Honey is more promising as a wound dressing for skin ulcers and burns, there isn't enough evidence to suggest that it can help with hypertrophic scars.
Other home remedies often used for scars, include aloe vera, gotu kola, vitamin C, and zinc.





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