Out of 1.27 million C-sections are performed in US, 76000 to 229000 cases are reported of chronic pain following C-section. This pain can lead to a number of problems including changes in bowel or bladder habits, pain with urination or bowel movements, pain with functional activities like sitting, walking, lifting, it can cause pain with sexual activity.
There can be number of reasons for this chronic pain. It can be due to-
scar tissue from C-section scar, infections and keloid formations increase chances of scar pain or restrictions in mobility and cause delayed healing of scar tissue.
There can also be abdominal adhesions causing chronic abdominal pain. It is estimated that 93% of abdominal surgeries result in abdominal adhesions. These chronic adhesions can also cause referred pain along with local pain meaning your C-section scar can be causing your low back pain or pelvic pain or hip pain depending on the direction and location of adhesions.
There can be nerve dysfunction/ injury or an autonomic response after the surgery which can be leading to debilitating pain which is burning or sharp
I have seen patients with varying degrees of adhesions and pain where some patients just feel some movement restrictions from the scar tissue whereas others are not able to sit or let any clothes touch their abdominal area due to pain. These limitations can interfere greatly with caring of the newborn and many a times can be the reason for post partum depression.
A lot of patients unfortunately don’t have enough resources to deal with these pain and other post-partum symptoms. Especially if the symptoms are mild in nature, they are most often neglected as “part of pregnancy/childbirth”.
Manual therapy by skilled abdomino-pelvic health specialist has been shown to be the best treatment for all of the above pain, symptoms. Remember that your pain can be arising from a number of things, it might not only be the C-section scar and so the best approach would be to look at the history, pain pattern and whole body mechanics to treat the source.
Laser has also been shown effective for improving scar tissue mobility and cosmetic appearance of the scar.
Silicone Gel has been prescribed for improving scar appearance and pain. Stay tuned for my next blog where I cover the safety, benefits and side effects of silicone gel for C-section and other scars based on the most current evidence.
It is a common practice in European countries to be assessed by pelvic health physical therapist after vaginal delivery or C-section where all women are assess for their over musculoskeletal health and problems like back pain, pelvic pain, incontinence, constipation, diastasis recti etc. I encourage all patients that I see during pregnancy to come for an evaluation after they are cleared by their obgyn usually after 4-6 weeks after delivery. It would be a disservice to leave women to heal on their own after their body has undergone such a huge change and lot a of times a major abdominal surgery as well!
