title: Twenty-year-old pathogenic "active" postsurgical scar: a case study of a patient with persistent right lower quadrant pain.
abstract: OBJECTIVE
  This case study describes a patient with persistent right lower quadrant and low back pain who experienced relief after manual mobilization techniques of an old appendectomy scar.
  
  
  METHODS
  A 53-year-old man with pain in the right lower quadrant of the abdomen and low back had previously failed several trials of multimodal treatments. He had an irritated old appendectomy scar in the right lower quadrant. Degenerative disk findings were also noted in the upper lumbar spine.
  
  
  RESULTS
  Manual mobilization of the superficial and deep layers of the scar tissue was applied. The patient experienced an immediate pain reduction after the first treatment. Nine treatments in total were administered to the patient.
  
  
  CONCLUSIONS
  Assessment and treatment of "active" scar tissue may comprise an important component of the management of locomotor dysfunction and associated pain syndromes.
authors.affiliation: Second Medical Faculty, Rehabilitation Clinic, University Hospital Motol, Charles University, Prague, Czech Republic. alena.kobesova@lfmotol.cuni.cz
authors.forename: Alena
authors.initials: A
authors.lastname: Kobesova
authors.forename: Craig E
authors.initials: CE
authors.lastname: Morris
authors.forename: Karel
authors.initials: K
authors.lastname: Lewit
authors.forename: Marcela
authors.initials: M
authors.lastname: Safarova
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000628:therapy; D000328:Adult; D002921:Cicatrix / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011183:Postoperative Complications