Scar Tissue in Neck and Back

Adhesions are a type of scar tissue that forms when collagen (a type of connective tissue) adheres to its surrounding structures. Scar tissue and adhesions usually form after a period of immobilization or after some type of tissue injury. They can form after surgery or trauma as the tissue heals.

Man in red shorts holding his back on either side of a surgery scar
pastorscott / Getty Images

How Scar Tissue Forms

When the body is injured, scar tissue can form as part of the multi-stage wound-healing process. Scar tissue and other substances help mend injured tissue.

Adhesions are analogous to a scar that forms when you scrape your skin, except that it is found internally in the body.

Internal adhesions aren't usually visible through the skin and they often are too deep for you to feel. They can cause pain due to inflammation and pressure on nearby structures.

Scar Tissue Following Back Surgery

Scar tissue formation is a normal part of the healing process after back surgery.

People who have had multiple back surgeries tend to have more adhesions. Every time there are incisions, the structures around the spine will heal, and this increases the likelihood of adhesion formation.

Minimally invasive spine surgery is a technique in which a very small incision is made through the skin. Adhesions can form with minimally invasive procedures or with more extensive back surgery.


If you have pain due to adhesions, you can get relief with a number of different approaches.

Most of the time, working with a doctor and/or physical therapist to manage the pain with exercises and mild pain medications will help.

Seeing a sports massage therapist who does a technique called cross-fiber friction technique can be helpful, too. Cross-fiber friction massage helps align the collagen fibers in the correct way so that the tissue heals with proper alignment. It also brings more blood to the area for healing.

But a cross-friction fiber massage is not your typical massage. It's more like work than relaxation. Among other techniques, in a cross-fiber friction massage, the therapist uses a few fingers transversely across the scar tissue. The action is a bit like sawing.

When it's done properly, this method can help speed healing in the short run and give you back full use of your affected joints in the long term.

Sometimes, however, symptoms from adhesions can be so severe that the adhesions need to be surgically removed. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bijlard E, Uiterwaal L, Kouwenberg CA, Mureau MA, Hovius SE, Huygen FJ. A systematic review on the prevalence, etiology, and pathophysiology of intrinsic pain in dermal scar tissue. Pain Physician. 2017;20(2):1-13.

  2. Kim J, Sung DJ, Lee J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical applicationJ Exerc Rehabil. 2017;13(1):12–22. doi:10.12965/jer.1732824.412

  3. Warpenburg MJ. Deep friction massage in treatment of radiation-induced fibrosis: rehabilitative care for breast cancer survivorsIntegr Med (Encinitas). 2014;13(5):32–36.

  4. Lee F, Jamison DE, Hurley RW, Cohen SP. Epidural lysis of adhesionsKorean J Pain. 2014;27(1):3–15.

Additional Reading
  • Cross Friction Massage. Physiopedia Website. 
  • Kisner and Colby Therapeutic Exercise, Foundations and Techniques, 4th ed. F.A. Davis Company. 2002. Philadelphia.

  • Lodish, Berk, Zipursky, Matsudaira, Baltimore, Darnell. Molecular Cell Biology. Fourth Edition. W. H. FREEMAN. 2000. New York.

  • Moore, K., Dalley, A. Clinically Oriented Anatomy. Fifth Edition. Lippincott, Williams & Wilkins. 2006. Baltimore.

  • Mosby's Medical Dictionary. 7th edition. 2006. Mosby Elsevier. St. Louis, Mo.

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.