Acute and chronic pain of the scar following caesarean section, visceral pain, and the possible benefits of physiotherapy

Czech version

Authors: Marika Bajerová ^1,2; L. Hruban ^3,4
Authors‘ workplace: Rehabilitační klinika LF MU a FN Brno ¹; Katedra fyzioterapie a rehabilitace LF MU a FN Brno ²; Klinika gynekologie, porodnictví a neonatologie LF MU a FN Brno ³; Ústav zdravotních věd, LF MU, Brno ⁴
Published in: Ceska Gynekol 2026; 91(3): 232-238
Category:
doi: https://doi.org/10.48095/cccg2026232

Overview

Caesarean section (CS) is one of the most common obstetric surgeries, and the number of CS births has been increasing worldwide. Acute wound pain following a caesarean section can affect the postnatal recovery process, has an impact on the mother‘s mobility, on the mother-child bonding process, on the quality of breastfeeding, and increases the risk of developing postnatal depression. Chronic pain following CS is related to pain in the scar area (neuropathic pain) and to postoperative intra-abdominal adhesions (visceral pain). Chronic scar and abdominal pain following a caesarean delivery adversely affects a woman‘s routine daily activities, her psychological state, and motor functions. According to available studies, persistent chronic post-operative pain in the scar area is reported by 10% of women 12 months after caesarean section delivery. Intra-abdominal adhesions are the most common long-term complication associated with caesarean sections and their occurrence is reported in the literature as 24–46% after the first caesarean section and up to 59% after repeated caesarean sections. Currently, there are no unified standards for physiotherapeutic treatment of scars and management of adhesions following a caesarean section delivery. Although scar therapy is generally considered to be effective (aesthetic effect on scar remodeling, reduction in pain intensity, increased elasticity and flexibility of the scar), there is little scientific data in the literature to support this claim. Only a few studies have been published that demonstrate the benefit of physiotherapy in affecting the occurrence of symptoms related to the development of early postoperative adhesions, and studies that deal with approaches leading to the prevention of postoperative adhesions. With regard to the increasing trend of CS births worldwide and in the Czech Republic, and the related rising incidence of acute and chronic post-birth complications caused by CS scarring, it is necessary to create a standardized physiotherapy program focused on the recovery of mothers after a CS birth, including scar care procedures according to evidence-based medicine.

Keywords:

chronic pain – Physiotherapy – scar – caesarean section – acute pain – Pfannenstiel incision – adhesions

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