Old Surgical Scar at the Ankle Causing Referred Sciatica-Like Pain Treated With a Scar-Fascial Release Technique

A surgical scar with adhesions to the underlying fascia and periosteum caused radiating pain to different parts of the scar. Abdominal pain is a common complication of surgical scars, but surgical scar associated with extremity pain is rare. A 75-year-old man had a gait disturbance due to right sciatica-like pain from the thigh to the lower leg for >10 years. He also had mild ankle pain due to osteoarthrosis. The medical history was significant for an ankle injury diagnosed as a sprain and intra-articular small fracture, for which he underwent resection of the bone fragment from the anterior aspect 14 years ago. The surgical scar was adherent to the underlying fascia. The surgical scar was shown to be involved in sciatica-like pain. For the adhesive scar, the scar-fascial release technique was performed by stretching in the direction of the palpated restriction. The sciatica-like pain and gait disturbance resolved one month after the procedure, while the ankle pain remained mild. The current case is a rare case of an adhesive ankle scar causing sciatica-like pain and gait disturbance. The sciatica-like pain involving the proximal lower extremity caused by the ankle scar supports the myofascial meridian concept.