Scars matter. Very in-depth article but heres a summation.... surgery/burn/injury=brain is on over drive to heal + surrounding areas may not be getting as much attention from the brain = improper movement patterns resulting in pain. According to some lines of thought, an excess of neuroinflammatory stimuli and a release of neuropeptides (substance P and peptides that release calcitonin) can be observed, which prolong the production of growth factors and cytokines, generating an extracellular matrix in excess.30,31 The neuroinflammatory overstimulation is probably a result of a reflex arc at the medullary level, which comes from the injury (sensory nerves with nonmyelinated fibers of type C and delta fibers) and then returns as a neuroinflammatory signal, with a consequent excess activity of neuropeptides.34 Research has confirmed an increase of nerves in the region of scarring, particularly HSs, and an accumulation of neuropeptides.34 This means a scar can present daily stimuli, enabling us to understand the symptoms we are going to examine later in this article. What generates this inflammatory overstimulation? According to some textbooks, skin-rubbing stimulates a neurogenic inflammatory response,31 and a tight dress is enough to stimulate a neurogenic reflex arc. According to another current thought, this neuroinflammatory response is mainly caused by stimuli of anomalous tension originated in the injury.31,33 This process provokes a release of neuropeptides from cells native to the extracellular matrix (therefore, not only those belonging to the nerve endings), stimulating an inflammatory reflex arc.30,31,35With reference to this idea, the tension on the injury depends on the direction of the injury itself; for example, in a vertical or horizontal direction compared with the axis of the leg.36 In fact, in the case of a horizontal scar, there will be a tension three times greater.
Posted on: Tue, 28 Oct 2014 15:45:26 +0000
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