Scar tissue massage after back surgery can be very beneficial to patients. Whether you’ve had a laminectomy, discectomy (microdiscectomy), spinal fusion, vertebroplasty or kyphoplasty, scar tissue is an evitable part of recovery. In fact, scar tissue after back surgery is a normal part of healing. As your incision site and wound heal, scar tissue will naturally form as your body produces collagen fibres to close the affected area. Generally, scar tissue (when remodelled properly) is not an issue.
However, in rare cases after back surgery, scar tissue can become painful. For instance, after a discectomy (or other back surgeries) scar tissue can form around the lumbar nerve root. When the scar tissue binds to nerve roots in the back with fibrous adhesions, this can be painful. The formation of scar tissue in and around the nerve roots after surgery is called “epidural fibrosis”.
Scar tissue doesn’t have to be permanent. During healing, remodelling (through exercise, massage and icing) is key to promote elasticity, strength and movement. To avoid “bad” scar tissue from forming, you’ve got to work that scar!
Read on as we break-down scar tissue 101 and share how to break up scar tissue, PLUS (as promised) the when, why & how of scar tissue massage after back surgery. But first:
Can Scar Tissue in My Back Be Painful?
Generally, scar tissue itself is not painful nor does it cause pain. The symptoms of built-up scar tissue (like tightness, muscle weakness, numbness) are where most issues lie. In saying this, in very rare cases after back surgery, epidural fibrosis can occur. To recap, epidural fibrosis is when scar tissue binds to nerve roots in your spine. This can be painful. When it comes to epidural fibrosis, pain is relieved after surgery, but then around the 6 to 12 week mark pain starts to creep back in.
Fact: Continued pain (back, leg, thigh, foot) after a spinal decompression surgery is much more likely to be caused by nerve damage, misdiagnosis, further disc herniation etc., than from scarring (scar tissue build up) around the nerve. Read “What Pain Can I Expect After Back Surgery?” to learn more about pain after back surgery.
Scar Tissue After Back Surgery 101
There are actually 3 phases of scar formation and healing: inflammatory, proliferation, and the remodelling. During the inflammatory phase, blood clotting starts and the incision looks red and inflamed. A few days after surgery, the proliferation phase begins where new tissue (collagen fibres) form to close the wound. The third stage, is where the scar tissue forms, and the area feels textured. This phase lasts for several weeks and months after surgery. It’s during the remodelling phase that you should begin to work your scar tissue. You should not massage scar tissue until your incision has completely healed (at least two or more weeks out from surgery).
Exercise and movement after back surgery is the absolute key to reducing scar tissue build-up, avoiding complications associated with scar tissue (epidural fibrosis), and for increasing healing, mobility, reducing tightness & more.
Why Scar Tissue Massage?
Scar tissue massage breaks down tough scar tissue, helps to remodel it, adds elasticity, and promotes area healing. Scar tissue massage is something that is most effective within two years of surgery.
Here’s why you should massage your spine scar tissue:
- Decrease scar tissue build-up. Excess scar tissue can make muscles stiff and weaker, making movement limited (and even causing deformity or corrective surgery).
- Helps improve blood flow, which boosts healing.
- Helps to drain the area, cutting down swelling.
- Helps with feelings of numbness, tingling and soreness, rebuilding feeling and sensitivity to the area.
- Increases range of motion by working out your constricted tissue.
- May help to reduce the physical appearance and proliferation of your scar.
When is It Safe to Scar Tissue Massage?
Massaging scar tissue is most effective in the first 2 years while the scar is still forming and healing.
Always ask your care team about massaging your incision site. As a fixed rule, you should not massage your incision site until it is fully healed. This usually means after the two week mark. Prematurely massaging your scar and area tissue can cause your newly formed incision to open (possibly leading to infection and other complications). There is differing opinions on when to get a professional massage after back surgery, so consult your care team.
Your scar is NOT ready for tissue massage if:
- Your surgery was less than 2 weeks ago
- The area is raised and scabbed
- The area has draininess
- The area hurts to touch
How to Massage Your Scar
There are a lot of benefits to showing your scar some love and performing scar tissue massage. Before massaging the area, it’s a good idea to talk to your care team. Depending on the area and the size of your scar on your back, it may be difficult to massage yourself. Registered massage therapists in your area can perform scar tissue massage, as well as addressing other areas of your body affected by your back issue.
Here’s are techniques to massage your scar tissue at home once you’ve received the go-ahead (or your at least 2 weeks into recovery):
Getting Started: Aim to massage your scar for 10-15 minutes a day (2-3 times a day for 5 mins at a time). Use a scent-free Vitamin E lotion/ oil to your scar area. Vitamin E is proven to help build collagen and massaging with lotion lubricates the skin, cutting down friction.
- Using the pad of your thumb or finger, firmly massage in a circular motion. You want to press firmly. (Test: if when you add pressure to the area your fingernails turn white, this is the ideal firmness). Then, go up the scar clockwise, working your way up and around your scar slowly. Then, massage counterclockwise around your scar. The amount of pressure should not be painful. This motion helps drain excess fluid from the area.
- Next, stretch the skin apart around your scar, and repeat your massaging with a firm circular motion using your thumb or finger.
- Next, maintaining pressure, slowly slide your finger up the scar. Change direction by slowly sliding down.
- Next, using a method called “cross friction massage”, apply pressure with your finger to massage your scar in a direction that’s perpendicular to your scar line. This helps with remodelling and alingining collagen fibres.
Repeat these different techniques until you’ve massaged for about 5 mins. Do this 2-3 times per day (a total of 10-15 minutes of massage per day).
When you’re recovering from back surgery, there’s a lot of things you should monitor. There’s also a lot of things you should be actively doing to ensure a safe and full recovery. Learn more about recovering from back surgery (tips, tricks & warning signs to watch out for).
Want guidance as you recover? PeerWell has the leading smartphone PreHab & ReHab program for at-home spine surgery recovery. That’s right, we’ll send you a daily plan to accelerate your recovery by ensuring you’re doing all the right things!