Friday, June 29, 2012

Why massage techniques to remove adhesions are all rubbish

Deep tissue massage therapy ( the Wurm  technique) to break soft tissue adhesions has been aggressively marketed under different names ( for example , clear passage therapy ). They claim  that as a result of applying deep pressure through the abdominal wall, it’s possible for the therapist to selectively remove the patient's adhesions , thus allowing  the pelvic organs to start functioning normally – and that this will reduce pain and restore fertility.

This is rubbish. And to  understand why, let’s look at some basic anatomy and physiology , as to why this can't possibly work. Adhesions are scar tissue , and are made of soft fibrous bands. Because of an insult to the tissues (for example , an infection), the walls of the fallopian tubes get stuck to adjoining structures ( such as bowel) Adhesions are made of soft tissue - which is exactly the same as tissue the fallopian tubes and bowels are made of . If someone tries to apply deep massage through the abdominal wall in order to remove these adhesions , simple common sense will tell you that there is no way that anyone could do it so selectively. It’s not possible to guide the massage in such a way that it would tear only the scar tissue, and not affect the normal tissue. ( Surgeons can do this, but only under vision, using a laser !)

If deep tissue massage was really effective in breaking and thus removing the adhesions, a lot of patients would end up with holes in their bowels ! Fortunately , the technique is completely ineffective , and no one can remove adhesions, no matter how deep the massage they apply.

Talk to any surgeon you know as to how he removes adhesions. In order to do so, he has to go through the abdominal wall, so he can see them. In the past, this was done by opening the belly; and today, this can be done by using a laparoscope. He then needs to use a laser or scissors to break the adhesions, in order to free the tissues and restore normal pelvic anatomy. This can be quite a challenging task , even for a skilled surgeon – and often takes a lot of time, skill and experience to do so safely ( without tearing the bowel), even though he is doing it under vision.

The trouble is that most people are so reluctant to undergo surgery today , that they are quite happy to clutch at straws which offer nonsurgical alternatives. Unfortunately , a lot of these techniques prey on the patient’s ignorance . Simply because patients don't know any better, it’s very easy to take them for a ride. they are marketed very clever.  These are often  very expensive techniques ( someone has to pay for the slick marketing !) which are completely ineffective.

So, why do some patients believe they have improved as a result of this therapy ? Making an accurate diagnosis of adhesions is extremely difficult – and it’s not possible to do this on an x-ray or an ultrasound scan - you need to either open the abdomen or do a laparoscopy to make a reliable diagnosis, Now, since most of the patients do not have a visual proven diagnosis , it’s very convenient to label everyone with chronic pelvic pain as having adhesions – and blaming the adhesions for their pain, without ever
proving or disproving the diagnosis . Now, since pain is perceived in the brain , any intervention - sometimes , just a kind word ! - can help to relieve this pain. This is why a lot of patients who believe ( or have been fooled into doing so) that they have pain because of adhesions, will improve , thanks to the therapy, not because the treatment itself works ! They feel better, not because their adhesions have melted, but simply because someone has been nice and kind to them , and actually laid their hands on them ! The placebo effect can be very powerful, and  this is something which patients need to understand !

What about those infertile couples who claim  they conceive after taking Clear Passage Therapy ? Usually, their correct diagnosis is unexplained infertility – and many patients with this diagnosis do get pregnant , even when nothing is done for them ! If it really were so simple to remove adhesions nonsurgically, most surgeons would be very happy to stop cutting up patients to open their abdomens,  and start doing this deep tissue massage themselves !


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16 comments:

  1. Anonymous3:34 PM

    Hi Aniruddha! I agree that these techniques can't possibly break or dissolve adhesions as claimed, but don't you think that they can stretch the tissues indiscriminately: fallopian tubes, bowel tissue, adhesions? Tissues tend to loosen and stretch when put under heavy strain repetitively.

    But this would mean that no one needs to go to a special adhesion-dissolving massage therapist, they could achieve the same results by pulling at their abdomen as hard as they can. It can't hurt, then why not? Agree?

    ReplyDelete
    Replies
    1. "Stretch" tissue as in, *deform*, like plastic? How could anyone from outside of the body, through layers of skin and adipose tissue, with our nubby fingers, make such changes?

      Delete
  2. Yes, they may not hurt - but they do create false hope, which can be harmful.

    Also, they end up wasting the patient's time because the patient does not seek the right medical care ( since she is deluded into believing that she is "treating" herself).

    ReplyDelete
  3. I found this article very interesting. I agree that knowledge and common sense will tell you differently than what they sell, however, it can be mentally improving and so make the strain feel less of a burden.

    ReplyDelete
    Replies
    1. False hope can be expensive !

      Delete
  4. Great post! There is some really helpful information here. Keep up the good work!

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  5. Dear Dr. Malpani, 4 weeks ago I had a laparoscopic oophorectomy/large cyst removal. A few days ago some pain came back in the exact area where I experienced pain directly after surgery. I massaged the area with my fingertips and moderate pressure for 20 minutes. That night the pain woke me up and I felt I needed to cough, so I held the sore area with my hand so it wouldn't hurt worse, and when I coughed I felt a pop. From that moment on I have been completely pain free. Please tell me what you think may have happened.

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  6. I have been to clear passage therapy and paid dearly for a deep tissue massage, no more, no less. Yes they are nice people and make you feel right at home but from the first day I knew it was a hype. Nothing they said made any logical sense and I have had better massages at the spa. $6,000.00 down the drain. You are correct. My adhesions are still there and so are the blocked tubes.

    ReplyDelete
    Replies
    1. I am so sorry you wasted your money.
      You would have been much better off investing it in an IVF cycle !

      Delete
  7. I went to clear passage too few months back, to the HQ for treatment thinking of that is where the founder and pioneer therapists located but it was a total false impression. Another issue is if anyone that thinking of signing up a 20hours of treatment, you wont get that number. The actual "hands on treatment" hours probably only 15hours (if you are lucky) or lesser. This Wurn technique might suit some but not everyone, it just too costly to trial and error. Please research more, make a wise decision. If you still want to proceed with this technique, do ensure you have very much in excess in your saving in case it doesnt worked for you, you still can manage to obtain other therapy or treatment to treat your health condition. I have more to share if any of the reader wish to collate further info. Goodluck!

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  8. I did get Medical help for my fibroid, adhesions, and blocked tubes (which he caused by cutting to deep in my D& C 10 yes ago). He was completely useless. He left the fibroid in after laproscopy claiming he could tell which kind it was. He told me to either deal with the pain or get a hysterectomy ( I have no kids yet by the way). So I turned to alternatives. Nothing expensive. No scams. Just herabal medicines and teas so far. Serraeptase diminished the pain after 2 weeks of use. I also use fresh ginger, tumeric, cinnamon, and camomille tea ( Works wonders for pain and inflammation). My follow up left my Dr. scratching his head at how my fibroid had shrunk. Of course he took credit and claimed it must have been the laproscopy although I explained that I was treating myself since he gave me no other alternatives. Yes there are lots of scammers out there reying on desperate women but there are real solutions and real hope too. So don't count alternative medicine out.

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  9. I really liked reading your comment! It’s so true as well!! A LOT can be said for alternative medicine.

    ReplyDelete
  10. For the main part of this, yes, it is untrue. You cannot magically make adhesions disappear through deep tissue massage HOWEVER, I got a full diagnosis of adhesions 2 years ago. The pain has steadily got worse to the point I am hardly able to walk and rely on a wheelchair as the adhesions spread through my abdomen like a plague. I have adhesions sticking part of the bowel to the abdominal wall as well as a hernia just above my belly button from previous operations which has several loops of small intestine stuck to the abdominal wall by adhesions. I recently (2 months ago) started getting DTM whilst in the hot hydrotherapy pool. It is designed to stretch the adhesions which then helps your insides to settle back down into a more natural position. Since starting that we have found out that a nerve that runs through the abdominal muscles and down the left leg has been damaged by the adhesions which is preventing me from being able to walk however, the DTM in hot water has greatly helped with how much pain I am in!! I have gone from having to take 50+ pills per day to half of that. I get the DTM 3 times per week, every week.
    So, in a nutshell, DTM absolutely CANNOT make adhesions magically disappear however, it CAN help with pain levels if done correctly.

    ReplyDelete
  11. Anonymous12:56 AM

    Western medicine "fixes" all manner of disease and disorder with cutting and drugs but there is an problem. The doctor says he can correct or repair the adhesions with surgical intervention, but every time the abdominal wall is cut, even small incisions, (lap) more adhesions and scar tissue will form, as that is the part of the healing process. So, outcomes are generally poor. The surgeon, however, gets paid every time they perform so they will always want you to get more.

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  12. Anonymous9:49 PM

    I had no idea about adhesions until just a few months ago. I have been getting shots for "damaged nerves"from surgery. I had a C-section, which gave me endometriosis, which led to a hysterectomy. Three years later I was in the ER with bowel obstruction. . .three MONTHS after that, they removed part of my colon. . The pain has been NON STOP since then. That was 7 years ago. . Someone gave me info on DTM and now, I don't know what to do. I have no where to turn. I am a completely different person than I once was. I feel helpless.

    ReplyDelete
  13. Dear Anonymous- Having been through an appendectomy, two c-sections, tubal ligation, two major spine reconstructions (done front and back from low c-section scar to just under sternum on front & from my bum to between shoulder blades on back), removal of tumor on left ovary along with ovary & Fallopian tube (Waited a week in hospital w/intense pain of twisted tube and tumor for the surgery to be done laparoscopically but woke up with an 8 inch scar...great.), so I truly and COMPLETELY understand being a different person than you once were [and feels like one you don’t even know!] AND being helpless, hopeless and lost.
    While I am still not completely “back”, my heart goes out to you HUGE and want you to know that while physically, you may be different from your earlier self, inside it’s still you in all your glory!
    First, trust yourself again. Don’t let ANYONE or ANYTHING push you to making decisions quickly or uninformed. Do the research yourself, knowing that you will find extreme opinions (like the OP “Dr.” here!) on both sides of any option you look at. But, as Mulder would say, “The truth is out there!” �� �� And it’s almost always on the spectrum between those two extremes. But you will find it!
    While I hope you don’t write this off as some religious piece of garbage, I believe with all my heart that regardless of whatever relationship or non-relationship you have with God today, if you sincerely ask Him to direct your steps and allow yourself quiet times to listen (on the inside), then as you research and talk to others about what will work best for you, you will know the direction to go. If you rush and try something that doesn’t work, it’s not the end of the world! It’s just another step towards your finish line and a life you love and enjoy!
    Praying all the best for you, ALWAYS!
    Melanie

    PS If you’re anywhere close to Seattle, let’s get together! If you’d like to talk, drop me a line!
    mloudon2@gmail.com

    ReplyDelete

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