I made my entry into this world via an emergency Cesarean section (C-section), and more and more women are opting for planned C-sections for various reasons. However, currently I don't feel enough 'hands on' treatment is offered to improve the healing of the scar tissue itself. I think physiotherapists do a great job with the core stability advice, postural advice and pelvic floor strengthening, but currently there is not enough treatment of the actual scar and surrounding scar tissue (the scar tissue is much more widespread than the scar you see on the surface of the skin). Restrictions in the scar (adhesions) can cause a lot of pain, restricted movement, digestive issues and potential problems with further pregnancies. Doctors aren't well equipped with solutions and tend to give the same old 'Just give it time to heal' advice to most women.

As the scar begins to heal after surgery and the stitches have been removed, collagen fibres are created at the site of the wound. This leads to adhesions being formed, which in the beginning is important to bind the wound together, but as these collagen fibres are less elastic than the tissue that was there previously, they can cause problems in the long term. It takes around 9 months to a year for the scar to complete the healing process and during this time the fibres that have been produced loose some of their elasticity. This can lead to the scar feeling like it is tightening over time.

I recently had a client come to see me 11 months after giving birth via emergency C-section. She was still having significant pain in her scar area and since returning to work following her maternity leave, was now having issues being able to sit at her desk for more than a few minutes, without having to get up and walk around. Her employer luckily sent her for some private physio, which is how she ended up in my office. She had received the regular physiotherapy advice through outpatient NHS services, but this did nothing to reduce the pain she was in, though she did feel her core stability improved from the exercises she was given. So, I had to take a different approach, we first tried some scar massage to break down some of the scar tissue fibres, but this was to painful for my client to tolerate. I needed something less hands on. In came the 'Acupuncture' suggestion. She looked at me and said 'I'm willing to try anything to help the pain but I'm scared of needles' . Sigh.....

I thought I might be able to convince her so I replied 'How about if you can't see them and I'll give you a magazine to read?' I didn't expect it to work but she surprisingly she agreed. So she lay on the bed and covered her face with a towel. Right, now to the acupuncture, I used very small acupuncture needles and started to insert them into her scar. They were quite difficult initially to insert due to thickness of the scar tissue. Due to the fact that she was still quite numb around the scar area she didn't feel a thing pain wise but could feel a slight pushing sensation as the needle went in. During the first session I was only able to get in around 6 needles, due to the thickness of the scar tissue. They were left in for around 15-20 mins and then removed. She sat up smiling and said she felt a bit silly for covering her face, I smiled and said its common the first time for people to be scared and most people envision it to be much worse than it is.

A week later she was back for her next appointment. I wasn't really expecting much change after just one session, but she bounded in my office a week later like a new woman. I asked her how she felt and she replied 'the scar feels totally different, its softer and doesn't look as red as before'. She agreed to more acupuncture and this time I didn't have to cover her face, she actually wanted to watch what I was doing! One needle phobic cured! This time I was able to get more needles in and the scar didn't feel as hard as previous, the difference from the previous week was noticeable for sure. She continued coming in for weekly acupuncture for around 6 weeks. I'm glad to say each time the scar looked smaller, softer and was she was in less pain, enabling my client to complete her job as normal and do heavier household chores which she was unable to do previously due to her pain, even lifting her son became no issue. She even said she would consider having another child now that she knew how to get rid of the pain afterwards if it re-occurred!

Now lets talk about how it works. I am basically using the needles to break up the scar tissues fibres that have formed in order to heal the wound from surgery. The needles also help to stimulate blood supply to the area and help to release areas of trapped fluid. If there are areas of the scar that are more tender than others, focus on these areas.

So if you yourself have a problem C-section scar, why not look into trying some acupuncture, or recommend it to your friends if you know they are having some issues. Leave a comment below with your experiences!

Have a great week guys!

Helen

Acupuncture: The Treatment of Cesarean Scars