I recently began seeing a new client. She came to me because of chronic low back pain that has been ongoing for the last 8 years. Upon getting started with The Healthy Back Program, she reported several abdominal surgeries including: 1 appendectomy, 1 C-section, and 1 hysterectomy. All her imaging shows only minimal arthritic changes in her spine.

“How can that be possible? I struggle with such pain, yet the imaging showed nothing! Am I going crazy?”

“No” was my reply. I went on to discuss with her the many possibilities for her back issues. The one that seemed to make the most sense was the concept of scar tissue, and how it can create or add to low back pain. Especially as she had several abdominal surgeries.

The confusing aspect about this type of back pain… It can make us feel crazy. Or it can make us think we are hypochondriacs. This is because there is no way to see it on imaging. Thus, often times folks feel like they are at the whim of the entire universe when it comes to low back pain.

Let’s review the process of scar tissue development. During any injury/surgical process, there will be inflammation. With inflammation people experience the typical symptoms of redness, heat, swelling and pain. This is normally short-lived during the initial stages of healing.

Once the body starts to repair the injury/surgical area, it begins using a building protein call fibrin. Fibrin is mostly found on the inside of blood vessels, and is what helps form a clot to stop bleeding.  It basically acts like duct tape to help hold and support the wound via scar tissue.

The problem begins when the body fails to shut down the inflammatory process even after the wound is healed. This can cause a damaging pattern of chronic inflammation.

Unfortunately, the body doesn’t know the difference between new inflammation or old. It continues to do what it is supposed to – deposit fibrin in the inflamed area. This leads to a buildup of scar tissue.

With continual scar tissue buildup, the area can begin to have restricted blood flow, decrease organ functioning, and other issues of chronic inflammation.

We know the build of scar tissue can lead to the formation of adhesions or connections between the scar tissue and surrounding organ or structures. We often see this in abdominal surgery.

Excess scar tissue can cause restriction and pain during movement. Over time, these adhesions can result in significant lost mobility and increased pain.  

Additionally, scar tissue formation can trap or press on a nerve, or cause irritation due to nearby adhesions. This is also common from back surgery.  

The key to lasting back pain relief is managing the inflammation, preserving movement, and getting myofascial bodywork to help break up the scar tissue and keep things moving.

Once scar tissue has developed, pain pills may temporarily dull the pain but they won’t remove the scar tissue or its cause.

Another way based on diet and supplements is to consider the a class of enzymes called proteolytic enzymes. These not only function as digestive enzymes, but also support a healthy immune system, promote healing of tissues, and encourage muscle recovery. There is a school of thought that they may also potentially help breakdown scar tissue and decrease inflammation throughout the body.

Since I’m a huge fan of less is more when it comes to supplements and medications, why not eat your proteolytic enzymes? You can get them from papaya and pineapple (the two of the best sources of proteolytic enzymes). Other foods that are high in proteolytic enzymes include:

  • Ginger
  • Kiwi
  • Sauerkraut
  • Yogurt
  • Kefir
  • Miso

Finally, it is possible to have surgery to remove the excess scar tissue. However, every time the body gets cut into, it creates its own scar tissue! Thus, often times a no-win situation.

As 85% of chronic low back pain patients have no known cause for their pain, maybe it’s because there is a missing piece of the puzzle. But knowing the cause is only part of the battle.

The rest is up to us at home, on a daily basis… Diet, movement/exercise, inflammation minimization, and stress management. And if you feel you would like to start tackling your chronic back pain through a shift in health, consider a tried and true method!

Your coach and friend,

Director of The Healthy Back Program
“You are the only person that is 100% invested in your health and its outcomes!” ~ Andrea