• Alena Kobesova, Craig E Morris, Karel Lewit, and Marcela Safarova.
• Second Medical Faculty, Rehabilitation Clinic, University Hospital Motol, Charles University, Prague, Czech Republic. alena.kobesova@lfmotol.cuni.cz
• J Manipulative Physiol Ther. 2007 Mar 1; 30 (3): 234-8.

ObjectiveThis 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.Clinical FeaturesA 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.Interventions And OutcomesManual 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.ConclusionsAssessment and treatment of "active" scar tissue may comprise an important component of the management of locomotor dysfunction and associated pain syndromes.

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