by Eric Winder, DC  

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 us stay mobile and productive, enjoying our lives. However, there are still some cases in which pain persists or increases after surgery—even if the procedure went perfectly.   

There are many possible reasons this can happen, and one of the most common is also quite treatable. It involves restrictions in the fibrous connective called fascia, located throughout our bodies. Fascia contains nerve endings for position sense, which allow for muscular balance, joint alignment, and feeling the pain of injury. Restricted fascia can affect these nerves, causing misalignment, joint instability, muscular imbalance, and pain. But treating fascia restrictions can often significantly reduce, or even eliminate, unexpected pain after joint surgery. 

There are generally two reasons why fascia becomes restricted enough to cause pain.  The first is a pre-existing injury, in which the fascia has stiffened due to trauma that occurred before the surgical procedure. For example, someone might experience stiffening in the fascia of their knee and thigh after slipping and falling on ice. Then, years later, this might lead to persistent pain after a knee surgery.   

The second reason for a fascia restriction is the surgery itself, through no fault of the surgeon. The scar tissue that forms from surgical incisions can sometimes cause distortion or stiffening of the fascia in a surgery area. This is more likely to occur if there was a problem with healing such as intense swelling, infection, or putting stress on the joint too soon. In addition, procedures that require sawing, drilling, or chiseling the bone can sometimes cause stiffening of the dense fascia that covers these 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 an intense pain and numbness that had run from her left hip down to her toes, and she was grateful to be able to walk again. However, lower back pain that she had also experienced before the surgery became worse after her procedure.  She was unable to ride in a car for more than 15 minutes, could not perform yard work, and had little ability to do household chores or cooking. Worst of all, the pain was steadily worsening. 

Debbie tried two different 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 initial examination showed intense restriction of fascia around her entire pelvis that had likely been the result of falling from a horse 12 years prior.   

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

The amount of fascia restriction in Debbie’s spine area was greater than we normally see, but she still began to experience relief after just a few treatments. After two months of treatment, her pain had decreased by 90 percent. She still has some mild pain and stiffness when she first wakes up in the morning, but it is easily worked out with a few stretching exercises.   

Now, she can easily perform her daily tasks, is able to work in her garden once again, and recently drove to visit a relative in Georgia without any flare-ups of her old pain. She is more than pleased with these transformative results. 

It can be relieving 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.  It could mean the difference between persistent suffering versus a restored quality of life.  

Dr. Eric Winder has 26 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.