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Scar tissue
Relief for C-section pain tested in new study

03/02/17
By Ryan Lessard news@hippopress.com



 Women who have been suffering chronic pain in the scar tissue left by cesarean sections are finding relief in massage, and a local physical therapist is looking for more patients to participate in a study that will scientifically measure the effectiveness of those massage techniques.

Jennifer Wasserman, an assistant professor in Franklin Pierce University’s Doctor of Physical Therapy program and a Ph.D. student, received a $10,000 grant to study the techniques’ effectiveness. 
A couple years ago Wasserman and a group of students published the results of a small study on two women that measured and documented the pain relief the patients experienced after a few treatment sessions using what Wasserman called scar release techniques and myofascial release techniques, both forms of deep tissue massage. 
Now Wasserman is working on her dissertation and, seeing a dearth of research on the topic, she has set out to do the nation’s first full-scale, multi-site, controlled clinical trial of these techniques on C-section scar tissue. The Women’s Health Section of the American Physical Therapy Association awarded the grant.
“They only give out one research grant a year, so I was honored to get it,” Wasserman said.
Besides Manchester, clinics in Washington, D.C., and Seattle, Washington, will also be participating. Wasserman needs between 30 and 36 women who have pain from C-sections they received at least three months ago and up to several years ago.
She has about 27 patients so far. 
Patients will need to come to a total of seven half-hour sessions over the course of four months, but the grant allows Wasserman to give participating patients a $50 stipend upon completion. And there’s a good chance their pain will be relieved. 
“Intuitively, we know this works. There’s actually been nothing published,” Wasserman said.
Wasserman didn’t want to deny anybody treatment, so instead of using a control group with a placebo, she is measuring patients’ pain upon their first visit and then waiting a month before testing again and starting treatment.
“That way, we can use them as their own controls to show, if they get nothing, what happens,” Wasserman said.
The scar pain is often caused by something called tissue adhesions. After abdominal surgery, it’s not uncommon for an organ to stick other organs or connective tissue it’s not accustomed to sticking to, and that lack of mobility causes pain when the patient moves. Untreated, that pain can last decades. The massage techniques are designed to dislodge some of the glued-together tissue and provide more flexibility. 
Surgeons are already aware of the problem and have changed some of their techniques to better avoid scar tissue pain. Talcum powder from latex gloves that gets into the body has caused adhesions, so they’ve stopped using gloves with talcum powder. And there are some gel substances that can be applied to help prevent them while surgeons are sewing up.
Wasserman said 1.3 million C-sections are performed every year in the U.S. and studies have shown that 7 to 18 percent result in chronic scar pain. That’s between 91,000 and 234,000 new cases each year.
Wasserman’s motives are twofold: She wants to have published science that measures the relative effectiveness of two kinds of massage techniques, and she also wants to help women who have been living with this pain, sometimes for years.
“Most of the people that are coming in ... are saying they never knew there was anything that could be done,” Wasserman said.
If you have C-section pain and would like to participate in the study, you can contact Wasserman at csectionresearch@franklinpierce.edu or 731-5327. 





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