Internal scarring and tissue restriction can significantly impact quality of life, leading to chronic pain and reduced mobility. Adhesions are a common source of this internal discomfort, causing tissues to feel stuck or bound. Seeking relief often involves a combination of non-surgical, physical, and professional medical interventions to restore natural movement and pliability.
Understanding How Adhesions Form
Adhesions are bands of scar tissue that form between internal organs or tissues that are not normally connected. These fibrous connections can range from thin sheets to thick, ropelike bands of collagen. They develop as a natural consequence of the body’s repair mechanism responding to inflammation and tissue disturbance.
The most frequent trigger for internal adhesions is surgical procedures; up to 93% of people undergoing abdominal or pelvic surgery develop some degree of post-operative scarring. Any form of trauma, infection, or injury, including orthopedic incidents, can also initiate this healing response. The inflammatory process causes a fibrin matrix to form between damaged surfaces, which matures into permanent fibrous tissue, connecting structures meant to glide independently. While many adhesions remain silent, they can cause symptoms like chronic discomfort, restricted movement, and internal complications, such as small bowel obstruction or infertility, when they tether organs.
Non-Surgical Methods for Adhesion Release
Physical therapy and specialized manual techniques are the first line of defense for mechanically addressing soft tissue adhesions. These non-surgical methods aim to physically stretch and mobilize the affected tissues, encouraging the scar tissue to lengthen and align in a more functional pattern. Treatment often starts with gentle, hands-on approaches, which are effective for superficial scar tissue and surrounding fascial restrictions.
Myofascial release applies sustained, gentle pressure to the connective tissue (fascia) to encourage elongation and release tension. This hands-on approach helps restore the natural slide and glide between muscle layers and organs bound by scar tissue. Another common technique is scar mobilization, which involves applying direct pressure to the scar and moving the tissue in various directions, such as circular or cross-friction motions. This mechanical manipulation remodels the collagen fibers within the adhesion, increasing tissue pliability and reducing the tethering effect.
Cross-friction massage is a more aggressive form of manual therapy that uses deep, perpendicular strokes across the fibrous band to break down collagen cross-links. Practitioners also utilize Instrument-Assisted Soft Tissue Mobilization (IASTM), which employs specialized tools to mobilize restricted fascia and scar tissue. Targeted stretching and movement exercises are incorporated into a physical therapy plan to maintain the length and mobility achieved during manual treatment sessions. Seeking a qualified physical therapist or specialized bodyworker who understands scar tissue pathology is important for safe and appropriate application.
Professional Medical Procedures and Adhesiolysis
When non-surgical approaches are insufficient, medical doctors may recommend professional procedures to address symptomatic adhesions. The most direct intervention is adhesiolysis, the surgical removal or breakdown of the fibrous bands. This procedure is typically reserved for cases involving chronic, debilitating pain or life-threatening complications, such as small bowel obstruction.
Adhesiolysis can be performed using two main surgical approaches: traditional open surgery (laparotomy) or minimally invasive laparoscopic surgery. Laparoscopic adhesiolysis is often preferred because it involves smaller incisions, leading to a shorter hospital stay, reduced post-operative pain, and a quicker return to daily activities. The surgeon uses a slender tube equipped with a camera (laparoscope) to visualize the internal area and specialized instruments to carefully cut or burn the adhesions.
While surgery can provide immediate relief, it carries the risk of causing new adhesions to form as the body heals from the surgical trauma. Studies suggest that a significant percentage of patients who undergo adhesiolysis may develop new or recurrent adhesions. For chronic pain related to adhesions, other professional options include targeted injections, such as a celiac plexus nerve block or epidural steroid injections. These interventions deliver local anesthetics or anti-inflammatory medication near the affected nerves to manage pain signals and reduce localized inflammation, treating the symptoms rather than physically eliminating the adhesion.
Preventing Adhesion Formation and Recurrence
A proactive approach is the best strategy for minimizing the formation of adhesions and preventing their recurrence. Early mobilization is an effective step, encouraging injured tissues to move and glide against one another after an injury or surgery. Following a structured movement protocol, often guided by a physical therapist, helps align new collagen fibers and prevents them from forming permanent, restrictive bonds.
In a surgical setting, medical strategies are employed to reduce post-operative scarring. Surgeons use meticulous techniques, such as gentle tissue handling and optimal control of bleeding, to minimize tissue trauma. Emerging strategies involve the use of barrier films or gels, such as those made from hyaluronate carboxymethylcellulose, placed between susceptible organs during the procedure. These temporary barriers physically separate the healing surfaces for a few days, allowing the initial repair phase to occur without the tissues sticking together. Maintaining consistent movement and adequate hydration further supports tissue pliability and health.