Scar tissue in the back can result from significant or repetitive injury to the spinal structures or back muscles. Scarring is a normal part of the healing process and typically strengthens the area against future damage. However, abnormal or excessive scarring can actually cause pain and might even make the affected region more susceptible to further injury in the future.
There are several reasons why scar tissue may be symptomatic. If scarring forms on nerves, neurological dysfunction or chronic pain may develop. If scarring forms on soft tissues, such as muscle, tendon, ligament or fascia, interaction with other structures may cause friction and pain. If scarring forms on bone surfaces or joints, mechanical pain may be elicited when the affected area is mobilized.
One of the typical reasons for problematic scarring to result is spinal surgery. Invasive techniques will leave damage, some of which may be permanent. This is one of the main reasons I always caution patients to learn the risks of surgery before acquiescing. Read more about scar tissue from back surgery.
Damage to the spinal structures, such as the vertebrae, muscles and intervertebral discs is possible from any significant trauma. The spinal structures are very durable, but can still be damaged and some injuries might leave lasting scar tissue.
Scarring is rarely a problem in bone, since these structures are not flexible. A weakness caused by improper healing might leave that vertebrae open to additional future injury.
If the scar forms within a joint, however, pain may be produced upon movement. This is often diagnosed as mechanical back pain.
Disc scarring can result from a bulge or herniation and might facilitate further degeneration of the disc structure in the future. Some scarring on the disc can be beneficial, as it may seal with annulus fibrosus against leaks of potentially irritating proteins in cases of ruptured discs or intact discs with annular tears. In fact, some surgical procedures are designed to create purposeful scarring for this very purpose.
Muscular scar tissue can affect the back muscles themselves or the tendons, fascia and ligaments in the affected region. Muscular scarring is common from repetitive strain injury and can build-up over time. Scarring in the back muscles can cause a reduction in functionality and range of motion. Scar tissue might encourage future injury at the same site, but this is not always the case.
Scar tissue is often blamed for pain, but is rarely the culprit for serious dorsopathy symptoms. Proper back pain rehabilitation of any muscular injury will go a long way to prevent problematic scarring from occurring in damaged soft tissues.
Scar tissue is another very common scapegoat condition blamed for a host of otherwise idiopathic pain complaints. While it is possible that scar tissue can cause pain and functional impairment, this is the gross exception to the rule, not an everyday event. The most common cases of troublesome scar tissue occur in patients with multiple serious injuries to a particular body part, including athletes and people with repetitive motion jobs.
If you suspect that scar tissue might be playing a role in your pain, consult with a physical therapist who might be able to assist you in working through the condition and returning to full functionality.
Just remember, not all pain which is blamed on scar tissue actually exists from a previous injury. Anatomical sites of previous damage are common locations for psychosomatic back pain to begin, since the syndrome will be very convincing and easily explained.