After surgery or injury, scar tissue can form six to twelve weeks after the tissue has been damaged. After a period of pain due to inflammation directly after surgery, the pain will seem to subside. However, after a few weeks, scar tissue begins to form. While this scar tissue is not of the same quality as the healthy tissue it is replacing, it does its best to act as a protective barrier. Scar tissue is suspected to be the “potential” cause of this pain in the leg and back after back surgery; however, scar tissue does not have any nerve endings. Because of this, scar tissue itself is not the cause of the actual pain.
Actual Cause of Back and Leg Pain
The actual cause of the pain is the binding or tethering of the lumbar nerve root that is formed by the scar tissue. Radiating pain can occur anywhere down the spine if scar tissue forms from a bulging disc, herniated disc, surgery, or other injury. This pain can occur when the scar that is adhered to the nerve is stretched.
How Scar Tissue on a Nerve Root Causes Pain
The pain caused by a nerve root adhesion will generally occur when a repetitive movement reaches a specific end range of the adhesion. The pain will generally subside when the movement is back within the end range of the adhesion. Therefore, the pain will be felt once a person stretches beyond the adhesions limits. However, the limits of the adhesion could be severely limited causing pain more often.
Eliminating Nerve Root Scar Tissue Pain
The best way to eliminate this pain is to stretch the scar tissue. This will expand the fibrosis, which will progressively and carefully stretch the adhesion beyond the limited end range. Stretching the scar tissue is important because the limiting range of motion within this segment can affect the spinal segments next to the area, which will cause a restriction in these other segments. These neighboring segments are more susceptible for injury if range of motion is not expanded.
Nerve root adhesions should only be stretched once the derangement is healed. It is important to use proper precautions or re-injury could be a result.
Stretching Scar Tissue
Flexibility is limited because of scar tissue; therefore, pressure on the nerve can cause the pain. Stretching will help to break up the fibers, which will create flexibility. Stretching can also help to prevent excess scarring around the nerve root.
For lower back surgery, a simple ankle pumping while stretching the hamstring can help to keep the nerve mobile. Another form of exercise that can help to stretch the nerve root scar tissue is stretching the arms. Be sure to start with minimal motions and gradually increase motion.
A physical therapist can help with developing a stretching program that will be moderate enough. It is very important that a patient does not overdo the stretching or he/she will risk re-injury.
