What are Adhesions?
Scar-like adhesions may require various types of treatments, from medical to chiropractic and massage. Internal body parts are normally slippery, and this is because they need to be able to move around each other easily. Adhesions are tissues which are “scar-like”, and they form between two surfaces, leading the two surfaces to stick to each other. Surgery, injury, or inflammation, can cause these adhesions, and they can occur almost anywhere in the body.
Where Do Adhesions Develop
Some of the more common places where adhesions develop would be the abdomen, pelvis, eyes, and joints, such as the shoulder joint. Arthritis in the area or overuse of the joints can also cause the adhesions which develop in the joints. The problem comes when the adhesion is able to pull a body part out of position so that it is unable to move as well. This creates problems with range-of-motion as the area becomes stiff.
While laparoscopic surgery reduces the risk of post-surgical adhesions, typical medical situations that can cause this problem are appendicitis, endometriosis, cancer, infections, and radiation. When tendons, joints, or ligaments have been beset by these scar-like tissues, they become painful and harder to move. Abdominal adhesions can cause symptoms of constipation, nausea, bloating, and cramps. Some patients may have long-term or chronic pelvic adhesions and pain. Surgery may be considered an option to separate this sticking together. However, it also increases the risk for the occurrence of further scarring and adhesions in the long run. Left untreated, eye adhesions can become glaucoma, intestinal ones can turn into bowel obstruction, and pelvic adhesions can lead to infertility, for example. The patient needs to seek some sort of medical attention before the adhesions are allowed to be of great detriment to major and important areas of the body.1
One type of common adhesion, adhesive capsulitis, is also known as “frozen shoulder”. In this condition, the connective tissue in the area around the shoulder has become inflamed and experiences restricted motion. This leads to chronic pain. Recovery from frozen shoulder is slow, and the pain worsens during the night and in times of cold weather. Even performing actions of restricted movement is difficult. And the experience of a sudden onset of tremendous pain may result from small bumps or jostles to the shoulder. Frozen shoulder can last any length of time from months to years. Its original triggers may be physical trauma, or possibly an autoimmune problem, wherein the body mistakenly attacks healthy tissue. The joint also lacks fluid in adhesive capsulitis. As a result of pain and sleeping difficulties, depression, back, and neck problems may occur as well.
The types of people who are at the most risk of getting frozen shoulder are those who also have diabetes, thyroid disease, and connective tissue disorders, or those who have had a stroke, or lung and heart disease. Adhesive capsulitis can also happen after physical trauma accidents. It is a rarer occurrence in individuals who are under the age of 40. Traditional treatments may range from physical and occupational therapy to pain relievers and anti-inflammatory medications, such as analgesics and NSAIDs, or even surgery. Other treatment options include chiropractic, massage therapy, and manipulation under anesthesia (MUA). With proper treatment, there is a chance that the frozen shoulder can resolve itself and, over time, most people regain their shoulder motion with up to about 90% of their previous range.2
Fascia are connective tissue within the body, and they may become “entangled”, leading to “impingement”, which can impact the movement of the muscles, nerves, and blood circulation. Massage therapy can help relieve myofascial adhesions and knots, which are also called trigger points. It is believed that the action which is most essential to breaking down adhesions is movement. Patients can benefit from muscles being warmed, as well as friction, vibration, and compression performed on the area of the adhesion. Other treatments include traction, proper stretching, and range-of-motion movements.3
Chiropractors can also employ many of these techniques as well. Patients complaining of numbness, tingling, and pain may be suffering from adhesions. Active Release Technique (ART) may benefit these patients. ART is a specialized soft tissue therapy that is not the same as regular massage; it has been specifically designed with the correction of adhesions and scar tissue in mind.4 Other chiropractors may employ the Graston technique or Sound Assisted Soft Tissue Mobilization (SASTM) to treat patients. This therapy does not require the patients to move as it applies and uses specialized instruments with gentle pressure strokes. SASTM is considered less painful than ART, both for the patient and the practitioner. Chiropractors could also recommend exercises for their patients to try at home in order to keep up treatment even outside of the office.5