Adhesion pain is chronic discomfort resulting from the body’s internal healing response, which forms scar tissue in unintended locations. This internal scarring, known as adhesions, causes symptoms ranging from mild aches to severe, debilitating pain. The subjective experience varies widely based on the location and severity of the scar tissue. This article describes the physical reality of adhesion pain.
What Adhesions Are and How They Form
Adhesions are bands of fibrous scar tissue that develop between organs or tissues that are normally separate, causing them to stick together. The formation of these internal scars is a natural part of the body’s repair mechanism following trauma to an internal surface. This healing response is most often triggered by abdominal or pelvic surgery, but it can also occur after infection, inflammation (such as from endometriosis or pelvic inflammatory disease), or radiation treatment.
The scar tissue can appear as thin, web-like sheets or as thick, dense, fibrous bands. Adhesions tether internal organs, such as the intestines, uterus, or bladder, to each other or to the abdominal wall. This tethering restricts the normal, fluid movement of these organs, which typically slide freely against one another. The physical restriction and the pulling on sensitive tissues and nerve endings generate the sensation of pain.
The Specific Sensations of Adhesion Pain
The subjective experience of adhesion pain often manifests as sensations that change depending on movement and internal function. One common feeling is a persistent pulling or tugging sensation, which occurs when the movement of an organ stretches the scar tissue to which it is attached.
Adhesion pain can also present as a sharp, stabbing discomfort, particularly during sudden motions or when the scar tissue is stretched quickly. This sharp pain is often brief but intense, reflecting irritation or compression of nerve endings caught within the fibrous bands. The baseline experience for many is a dull, chronic ache or discomfort that remains constant, representing the ongoing tension created by the immobile scar tissue.
When adhesions affect the gastrointestinal tract, the sensation may be described as cramping or colicky pain. This intense, intermittent pain is caused by the increased muscle contractions of the bowel attempting to push contents through a segment narrowed or kinked by the scar tissue. The pain is often localized but can sometimes radiate outward, making the exact source difficult to pinpoint.
Where Adhesion Pain is Most Often Felt
Adhesion pain is most frequently reported in the abdominal and pelvic regions, as these are the most common sites for scar tissue formation. In the abdomen, the pain may be felt in specific quadrants, often correlating with the site of a prior surgery, such as an appendectomy or a C-section incision. The discomfort can be generalized or vague, sometimes described as a deep ache across the lower abdomen.
Pelvic adhesion pain is common for individuals who have undergone gynecological procedures or who have conditions like endometriosis. This pain is felt deep within the pelvis, sometimes involving organs like the uterus, ovaries, or bladder.
The pain pattern is typically chronic, lasting for months or years after the initial trigger. It can also be intermittent or cyclical, often worsening at specific times of the month for women due to hormonal changes. The intensity may fluctuate daily, sometimes increasing in the afternoon or evening as physical activity accumulates.
Daily Activities That Exacerbate Adhesion Pain
The pain caused by adhesions is frequently triggered or intensified by movements and internal bodily functions that stretch the tethered organs and tissues. Actions that involve significant stretching or compression of the torso, such as bending over, twisting the body, or lifting heavy objects, are common instigators of increased discomfort. Physical exertion, including exercise, can aggravate the pain by placing tension on the restricted area.
Internal functions that cause organs to expand or contract can also acutely worsen adhesion pain. For instance, digestion can increase discomfort, as the bowel attempts to move food and waste through segments restricted by scar tissue. Bowel movements and urination may become painful due to the movement and filling of the intestines and bladder, which pulls on the adhering bands. Intercourse can also be a painful trigger if the adhesions involve the pelvic organs, causing movement that stretches the internal scar tissue.