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An adhesion is essentially an internal scar. It is a band of tissue that forms between two points in response to injury. Adhesions are tough and fibrous and they can cause complications for the patient. Some adhesions cause no ill effects, while others may need to be treated with surgery or other means.
One of the most common reasons some might develop adhesions is as a result of surgery. After surgery, fibrin is deposited at the surgical site to help it heal. The body is supposed to break down the fibrin after healing is complete, but sometimes it persists, leading to an adhesion. The more surgeries someone has, the greater the risk of adhesions. Conditions in surgery can also influence adhesion formation. Research has shown, for example, that if tissues are allowed to dry out during surgery, deposition of fibrin increases.
Sometimes adhesions form without surgery. People with inflammatory diseases can incur internal injuries that cause adhesion formation and sports injuries sometimes result in adhesions, especially if they involve repeated variations on the same injury. Adhesions may cause no problems for a patient, but others restrict freedom of movement for joints or internal organs. Some can wrap around the bowels and cause obstructions, and others can lead to internal pain, such as pelvic pain. In cases where adhesions are causing pain or irritation, treatment must be considered.
Abdominal adhesions are among the most common type of adhesion and they are a common complication of abdominal surgery. Another example of an adhesion is frozen shoulder, a condition characterized by adhesions in the shoulder joint that make it difficult to move freely. Medical imaging studies can be used to look for adhesions if they are suspected. Once they are identified, a doctor can discuss treatment options with the patient and develop a plan that will address the adhesions and meet the needs of the patient.
One option for managing adhesions is surgery to remove them. However, the problem with this treatment option is that surgery increases the risk for more adhesions. Surgery is usually recommended in cases where the risks of leaving the adhesion in place outweigh the risks of the surgery. Sometimes, adhesions can be broken up with manipulative therapy, depending on their location and how extensive they are. Such therapy can include stretches and massage to loosen the adhesion and encourage it to break up. This must be done under the supervision of a physical therapist to avoid injury.