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 trauma.

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

How Scar Tissue Forms

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

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 can cause pain. Usually, the pain related to adhesions is not due to the adhesions themselves, but rather to effects they have on nearby structures, such as inflammation and pressure.

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 and healing of the structures around the spine, adhesions can form.

Minimally invasive spine surgery is a technique in which a very small incision is made through the skin, and there is usually less disruption of deeper structures than there is with open surgery. Minimally invasive spine surgery is associated with fewer adhesions than traditional 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 do the trick.

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. 

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4 Sources
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  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.