Adhesions and Pain

Adhesions, like scar tissue, are one of the byproducts of the injury process and the body's attempt at regeneration of the injured body structures towards full functioning. Adhesions are a sticky residue that is left over after the swelling, caused by injury, is reabsorbed by the body. When a body part becomes injured, swelling builds up around the joints. The contents of the substance includes water, materials to prevent infections, and substances designed to close off cavities that were created as the result of injury. Once the injury becomes close to healed, the swelling fluid is reabsorbed by the body. In some cases, though, not all of the swelling is reabsorbed by the body, and there is a left over sticky substance that becomes attached to soft tissue structures involved in movement. This leftover materials, called adhesions, reduces flexibility of structures such as the ligaments and tendons, and can even begin to bond certain structures to others that were not meant to be bonded together. Conditions that may result in the buildup of these adhesions in the connective tissues of our body may include complications from surgery, osteoarthritis, and soft tissue tears. These adhesions may cause pain when they restrict the movements of the joints and soft tissues, and when they reduce the flexibility of the tendons and ligaments. Adhesions are difficult to treat and diagnose.



The swelling that becomes built up, in response to a musculoskeletal injury, is reabsorbed by the body, in the majority of injuries. Some conditions that may involve an incomplete re-absorption of the contents of swelling fluid include poor circulation and chronic muscle tension. In these conditions the fluid may not fully dissipate, and the leftover materials are a sticky substance that becomes "adhered" to ; hence the term adhesion.

Some doctors think that adhesions are the reason that many people continue to experience pain as a result of herniated discs and why many back surgeries don't succeed. Typically, bulging discs and herniated discs often resolve themselves, at least in terms of the patient's experience of pain. bulging discs, unless the outer envelop is torn, can eventually resume their original shape, within a couple of days. In some instances, though, bulging discs can turn into herniated discs, and the expelled nucleus that occurs as a result can press into the nerve root. When this happens, the resulting pain caused by the condition may be very painful or even crippling. Nevertheless, the condition caused by the degenerated disc will resolve itself with time, as the disc either reseals itself, or the fluid in the disc diminishes to the point that the whole disc flattens out, and the spine fuses together to become more stable. When the spine does fuse and stabilize itself, the back pain will typically go away. This process could take weeks of months.

While the nerve root is being compressed and these degenerative changes are taking place, there is swelling and inflammation around these affected structures. The leftover adhesions caused by the swelling may linger even after the herniated disc has healed within a period of 9 months. Some doctors think that it may take up to several years for adhesions to completely break down and lose their attachment joints and soft tissues.

Treatment for adhesions. A hands on type of manipulative therapy called the Wurn technique has been develop to break the bonds of the adhesions to the joints and soft tissues, in order to increase mobility and decrease pain.