Adhesions & pelvic pain

Written by sarah dewitt ince
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Adhesions & pelvic pain
("24 de febrero" is Copyrighted by Flickr user: Daquella manera (Daniel Lobo) under the Creative Commons Attribution license.)

Adhesions formed as scar tissue develops from a serious injury or major surgery. Adhesions in the pelvic region are common with women who have had a C-section. The scar tissue can even become worse with each repeat caesarean section. Other types of abdominal surgeries on other organs can also cause pelvic pain in men and women. Every person heals differently and some people may have deep scar tissue causing lifelong pelvic pain.

Adhesions & pelvic pain
("24 de febrero" is Copyrighted by Flickr user: Daquella manera (Daniel Lobo) under the Creative Commons Attribution license.)

What Are Adhesions?

Adhesions are internal scars hidden inside the tissues. According to the International Adhesions Society, pelvic pain comes from the pulling caused by traction on nerves, tissues, and tendons. Some nerve endings can become trapped from being cut, which causes an adhesion to develop.

C-sections are a common cause of pelvic adhesions. The caesarean section rate in the United States is around 30 per cent. Other causes are from surgeries to treat pelvic inflammatory disease, hernia surgeries, or other types of abdominal surgery.


There is only one type of adhesion, but some adhesions are thicker and more severe than others. The more painful adhesions involve more nerves that may become intertwined causing pain from simple movements. However, there are several different types of pain caused from adhesions. For instance the pain can be described as a pins-and-needles feeling, stabbing, numbing, soreness, or a dull ache.


The effects of pelvic pain from adhesions can be severe, especially for women. The constant pain from adhesions will continually remind her of what she went through in the C-section. For some women the pain can be severe and debilitating, especially for women have undergone multiple surgeries to have several children.

Vaginal birth after C-section can reduce the effects that multiple surgeries can have on the body. However, not all doctors are in support of VBAC. The options really need to be looked at more carefully because so many women are suffering the painful physical effects of repeated surgeries. Severe adhesions can cause a person to have difficulty exercising or even working. Adhesions can also lead to bowl obstruction and other complications such as endometriosis. Another effect is infertility.


In some cases, physical therapy and massage methods are used to help free up tissues in the underlying structures. Laser surgery is also helpful for some people, but more surgery can lead to more problems for some people.

Expert Insight

Dr. Hugo Gonzalez says that the trends of surgery are increasing the risk of problems with adhesions. Forty-six per cent of women who had a second C-section suffered with pelvic adhesions. Women who had a fourth or a fifth caesarean section had an 83 per cent incidence of pelvic adhesions.

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