Overview Causes Symptoms Treatment
What is c-section pain?
Chronic pelvic or intercourse pain can occur in the months or even years after a Cesarean Section (C-section). This is a major surgery that cuts through several layers of sensitive pelvic tissue. The pain is often caused by adhesions, the powerful internal bonds that form when the body heals from the surgical procedure. Corrective surgery can cause more adhesions, exacerbating the problem.
Common Related Conditions
Causes of c-section pain
C-section surgery accounts for roughly a third of all live births in the USA. C-section pain refers to discomfort, sensitivity, or ongoing pain experienced after a Cesarean delivery. While some level of pain is expected during the normal healing period, C-section pain can also become chronic when tissues heal with excessive scar tissue or adhesions. This pain may occur at the incision site or deeper in the pelvis and abdomen, and can present as soreness, pulling, burning, sharp pains, or a feeling of tightness or restriction. In some cases, adhesions formed after surgery can limit organ mobility, cause pelvic or abdominal pain, or contribute to issues such as painful intercourse, digestive discomfort, or secondary infertility.
C-section is a major invasive surgery that requires cutting through several layers of tissue, including the skin, subcutaneous fat, fascia, muscle (rectus abdominis), the peritoneum, uterus, and finally the amniotic sac. The surgeon first makes an incision through the abdominal wall, separating the tissues to reach the uterus, where another incision is made to deliver the baby. We find scarring from a C-section is a major cause of pain and secondary infertility as powerful post-surgical adhesions form on the uterus and within the delicate tissues of the female reproductive system. In some cases, C-section scarring has caused life-threatening small bowel obstruction, when the intestine becomes narrowed or blocked by post-surgical adhesions.
Symptoms of c-section pain
- Pain, tenderness, or sensitivity at or around the incision site
- A pulling, tugging, or tight sensation in the lower abdomen
- Burning or sharp pains along the scar
- Numbness or altered sensation around the incision
- Pain that increases with movement, stretching, or exercise
- Deep pelvic or abdominal pain due to internal scar tissue (adhesions)
- Pain during intercourse
- Digestive discomfort, such as bloating or constipation, if adhesions affect nearby organs
- Difficulty standing fully upright or feeling “restricted” in the lower abdomen
Treatment for c-section pain
When patients who have undergone C-sections come to us with pain, dysfunction, or infertility, our physical therapists evaluate the uterus and pelvic and abdominal structures for areas of tension or restricted mobility. They pay particular attention to the areas around and deep to the incisions. Considering the tendency of some adhesions to spread over time, they then examine the entire body for areas of pain, tension, and decreased mobility. They examine the whole pelvis and abdomen during evaluation and treatment. The “hands-on” techniques we provide have been shown in peer-reviewed medical journals to reduce adhesions, decrease pain, and improve soft tissue mobility, without the risks of surgery or drugs.
Other Treatment Options (Surgery, Drugs)
While lysis (destruction) of adhesions can be effective, the surgical cutting or burning of living tissue has some major drawbacks:
- It carries risks from anesthesia and infection
- Despite the best skills of the finest surgeon, the body creates more abdominal adhesions as it heals from the surgery designed to remove them.
A mammoth, multi-decade study in Digestive Surgery showed that more than 90% of patients develop adhesions after open abdominal surgery (e.g., C-section) and 55% to 100% of women develop adhesions following pelvic surgery. Another large study reported that 35% of all open abdominal or pelvic surgery patients were readmitted to the hospital more than twice to treat post-surgical adhesions during the 10 years after their original surgery. Thus, abdominal surgery itself has been implicated as a major cause of adhesion formation. Many patients become trapped in a cycle of surgery-adhesions-surgery with no end in sight. Clear Passage® ends that cycle of repeat surgeries for many patients.
Condition Specific Disclaimer:
Clear Passage® Therapy provides specialized manual physical therapy designed to address adhesions and improve mobility in the pelvic and abdominal areas. While this therapy has been very successful at reducing or eliminating pain after a C-section, therapy cannot guarantee pain relief or specific medical outcomes. While we are highly skilled and experienced physical therapists. We advise all patients to consult their physician to rule out underlying medical conditions.
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