by Eric Winder, DC 

 Photo from Shutterstock, attributed to Peakstock

The miracle of modern joint surgeries cannot be understated. The ability to restore a knee, stabilize the spine or replace a worn-out hip just keeps improving with each year. These surgeries can help individuals become more mobile and productive, enjoying their lives to the fullest. However, there are still some cases when pain still persists or increases after surgery, even if the procedure itself went perfectly.  

There are many possible reasons for this, and one of the most common is also quite treatable. It involves restrictions in the fibrous connective found throughout our bodies. This tissue, called fascia, contains nerve endings for position sense which affects muscular balance, joint alignment and perception of injury. Treating restrictions in fascia can often reduce or even eliminate unexpected pain after joint surgery. 

There are usually two reasons that fascia becomes restricted in a surgery area and causes pain. The first is a pre-existing injury, where the fascia has become stiffened by trauma that occurred before the surgical procedure. For example, someone might experience stiffening in the fascia of their knee and thigh as a result of slipping and falling on ice. Years later, this might lead to persistent pain after a knee surgery.  

The second reason for pain-causing restriction can be the operation itself, through no fault of the surgeon. The scar tissue that forms from the surgical incisions can sometimes cause distortion or stiffening of the fascia in the surgery area. This is more likely to occur if there is problem with healing such as intense swelling, infection or putting stress on the joint too soon.  In addition, procedures where sawing, drilling or chiseling the bone are required can sometimes stiffen the dense fascia that covers the bones. 

The case of a patient, whom I will refer to as Debbie, illustrates the possibility of relief from post-surgical pain by treating fascia restriction. Her spinal fusion surgery cured intense pain and numbness that ran from her left hip down to her toes, and she was grateful to be able to walk again. However, low back pain that she had also experienced before the surgery intensified after the operation. She was unable to ride in a car for more than 15 minutes, couldn’t do yardwork, and struggled to perform typical housework and cooking.  

Debbie tried various courses of physical therapy—pain management with injections and opioid medications and even acupuncture—all with minimal improvement. When she came to our office, an examination showed intense restriction of fascia around her entire pelvis, likely the result of falling from a horse 12 years prior.   

There was also intense stiffening of the fascia in the lumbar spine, particularly in the surgery area. She felt cautiously optimistic to hear there might be a reason for her mysterious and debilitating pain and agreed to receive the series of treatments I advised, in which gentle fascia release therapy would restore pliability and health to her fascia. 

Since the amount of Debbie’s restrictions was greater than we normally see, it took five treatments before she had a consistent decrease in pain. After two months of treatment her pain had decreased by 90 percent. She still has some mild pain and stiffness when she first wakes in the morning, but it is easily worked out with a little stretching and exercise. She now can easily do her daily tasks, has resumed work in her garden and recently drove to visit a relative in Georgia without experiencing any pain flares.  

It can be a relief to know that unexpected pain after surgery often has a treatable cause.  For those who find themselves with unexplained pain after a surgical procedure, I recommend consulting with a practitioner skilled in assessing and treating restriction of the fascia. This could be the difference between continuous suffering versus a restored quality of life. 

Dr. Eric Winder, DC, has 24 years in practice with a focus on pain relief and restoration of alignment and motion. He uses fascia release therapies, without forceful manipulation. For more information, visit GentleBay.com.