Guide to Services - women`s health

Transcription

Women’s Health
Table of Contents
The Wurn Technique® and Clear Passage Approach®……………………..3
Female Fertility
Fertility: Natural and Assisted (IVF, IUI)…………………………………..6
Blocked Fallopian Tubes ………………………………………………….10
Hydrosalpinx………………………………………………………………...12
Endometriosis: Pain, Infertility, Sexual Dysfunction………………........14
Menstrual Pain (Dysmenorrhea)………………………………………….18
Hormonal Problems: FSH, Premature Ovarian Failure, PCOS……….19
Trauma and Post-Surgical Problems Unique to Women………………....21
C-Section, Hysterectomy, Myomectomy………………………………...23
Episiotomy, Endometriosis, Mastectomy………...………………….......24
Abuse, Early Childhood Surgery………………………………………….25
Female Sexual Conditions
Intercourse Pain (Dyspareunia)…………………………………………..27
Decreased Desire, Lubrication, Orgasm…………………………….......28
FAQs ………………………………………………………………………………30
“Your work is a Godsend.”
Christiane Northrup, MD
- New York Times bestselling author of
Women’s Bodies, Women’s Wisdom
“A safe and effective alternative to surgery.”
- Jacques Moritz, MD, Columbia Medical School
“You have perfected a technique to treat
adhesions.”
- Leslie Mendoza Temple, MD, Northwestern Medical School
www.ClearPassage.com
Phone: 1-352-336-1433
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The Wurn Technique® and the Clear Passage Approach®
About this therapy
The Wurn Technique® (WT) is a unique hands-on physio/physical therapy method designed to
decrease adhesions – the internal scars that form naturally when the body heals. Once formed,
adhesions often remain in the body; they can cause significant pain or dysfunction later in life.
We first developed this therapy to treat our Director, physical therapist Belinda Wurn, when adhesions
from surgery and radiation therapy left her unable to work, move or breathe without debilitating pain.
Because surgery is a major cause of adhesions, she and her husband Larry, a massage therapist,
spent over 25 years studying adhesions and how to rid the body of their powerful grip – without
surgery.
Together, the Wurns took dozens of advanced courses, including study at a French medical school. A
year later, Belinda was able to return to a pain-free life. Deeply moved by the experience, the couple
decided to dedicate their lives to help others with debilitating or unexplained pain or dysfunction.
Combining the Wurn Technique with other skills they learned, they developed, tested and published
results on specific protocols that are effective for particular conditions. This expanded work is called
the Clear Passage Approach® (CPA).
Over the years, skilled physical and physiotherapists, doctors, scientists and medical researchers
joined their team, impressed by the results they saw in so many of their patients. Today, this network
of clinical locations stretches throughout North America and into the United Kingdom.
This hands-on therapy can often feel like a deep massage. It has been shown effective in numerous
medical journals, and is frequently used by patients and doctors as a replacement for surgery in
conditions related to adhesions – such as post-surgical pain, recurring bowel obstructions,
endometriosis, female infertility and menstrual pain. Their therapy has also been effective with
chronic or recurring headaches, neck and TMJ pain, some hormonal conditions and female sexual
problems.
The WT and CPA target adhesions in the body – from the most superficial to the deepest areas of the
body – from head to toe. The focus of the work is to detach and deform adhesions within and
between bodily structures, including organs, muscles, nerves and connective tissues. During a course
of therapy, the body appears to return to an earlier state of pain-free function – one that existed
before the adhesions formed.
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The structure of adhesions
Adhesions are composed of small but powerful collagen strands that form naturally to help injured
tissues heal. Resembling curtains, ropes, or balls of string, adhesions can occur after any trauma,
surgery, inflammation, infection – or radiation therapy. Adhesions can remain in the body long after
healing, binding tissues and organs that are intended to move freely. When this happens, pain and
dysfunction frequently occur. The WT is designed to deform and detach the bonds of these tiny but
powerful adhesions, and return the body to normal, pain-free function and mobility. This manual
therapy treatment offers results without the risks or side effects of surgery or drugs.
Our therapists treat the entire body with a focus on specific areas of pain or dysfunction. Sometimes,
therapy can feel like a deep stretch as we work to deform the adhesions causing your pain; other
times, the work can be very light, as it follows the subtle rhythm of the fluid that lubricates the dura –
the connective tissue sheath that surrounds the brain and spinal cord, at the very core of the body.
Depending on the diagnosis and treatment area, your therapist may work to improve motility – subtle
organ movements. At other times, she may ask you to flex certain muscles, or move in certain ways,
to improve the body’s mobility, symmetry or function.
We recognize that you have lived in your body your entire life and regard you as an expert in your
body, in many ways. Thus, we educate you about our work and encourage you to be as active a
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member of your treatment team as you like. We find that we get better results when you are included
in the team that is treating you. Thus, effective therapist-patient communication is key to maximizing
results and helping you achieve your goals.
Our therapists
We hand pick every therapist who works with us, based on their experience, skills and compassion.
In fact, our therapists average 26 years’ experience. Each must demonstrate proficiency in over 200
manual therapy techniques described in our 600-page Therapist Training Manual. Each therapist
must pass rigorous testing before she can be certified to treat our patients. The Clear Passage logo is
your assurance that you are being treated by therapists who have received the specialized training
required to provide this work.
During its decades of development, the Wurn Technique has helped thousands of men, women and
children achieve their goals and reclaim their lives. Some people use it as a stand-alone treatment –
others as an adjunct to their physician’s care.
Positive results of the Wurn Technique and Clear Passage Approach have been published in peerreviewed medical journals and accepted into the U.S. National Library of Medicine. Citations about
our work appear in WebMD’s Medscape General Medicine, Journal of Clinical Medicine, Alternative
Therapies in Health and Medicine, and the Journal of Endometriosis. Physicians and scientists from
our in-house research team and advisors from respected medical schools help us design studies and
guide us through ongoing scientific inquiries.
“You succeeded in breaking up adhesions that
blocked my tubes and in such a short amount of
time. The tests confirm this and I was able to
achieve a pregnancy all because of your
remarkable work.” - Chandra
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Fertility: Natural and Assisted (IVF, IUI)
Note: Since this Guide to Services was published, our infertility success rates have been updated per
a landmark 10-year study published in February 2015. Please visit our Success Rates webpage for
the most current data: http://www.clearpassage.com/resources/success-rates/
Treating female infertility and improving pregnancy rates
A woman’s pelvis and reproductive tract are subjected to numerous stresses and traumas throughout
life. The body’s natural response is to create adhesions as it begins the healing process. Surgery,
endometriosis, infection and abuse are primary causes of adhesion formation. Falls onto the back, hip
and tailbone can cause tiny adhesions to form in the muscles and organs of the pelvis, binding
delicate structures and decreasing fertility. Nearly half of all female infertility is the result of these
mechanical causes.1,2
Adhesions can form between and within
reproductive structures, causing infertility or pain.
A woman’s reproductive tract is open to the outside environment and is susceptible to infection,
inflammation and direct trauma. As a womb, its warm, moist environment also creates an ideal
environment for bacterial growth. The body’s reaction to any of these events is to lay down
collagenous cross-links, the powerful threads that are the building blocks of adhesions.
The hip joint is located beside the ovaries and fimbriae – the delicate flower-like structures of the
fallopian tube designed to grasp the ovum as it releases from the egg. A fall or bad misstep can
cause trauma to the hip, increasing the likelihood of adhesive bonds forming at the hip and the
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nearby ovary or fallopian tube. Adhesions can also form in the pelvis and neighboring structures
when a woman’s gait changes to compensate for a fall or a surgery.
The body’s first step in healing is to lay down adhesive strands called cross-links. These cross-links
can form at the vagina, uterus, cervix, ovaries or tubes. When they do, they can bind these delicate
structures like glue, decreasing their mobility and function, and sometimes causing pain.
The Wurn Technique® is designed to decrease the adhesions that cause pain and infertility. After
more than two decades of research and study, we have learned to locate adhesions based on patient
history and the tensions we feel in the body, and to detach or deform them non-surgically. When we
decrease adhesions, the reproductive organs become more mobile and able to function more
normally, as they were prior to surgery, trauma or infection. The body becomes more capable of
conceiving naturally – or via assisted reproductive techniques such as intrauterine insemination (IUI)
and in vitro fertilization (IVF).
Research and publications
In a two-part study published in WebMD’s peerreviewed journal, Medscape General Medicine, the
Wurn Technique achieved high pregnancy rates
(both natural and as a pre-IVF treatment) in women
diagnosed infertile.3 Our successes include women
diagnosed as infertile due to: totally blocked
fallopian tubes; endometriosis; primary, secondary
and unexplained infertility; and those with
adhesions from surgery, infection, inflammation or
trauma.
The two-part study examined both natural and IVF
pregnancy rates. Participants had been
experiencing long-standing infertility, having been
diagnosed infertile an average of five years. Some
study highlights and success rates are noted here;
for a complete overview of our treatment success
rates, please visit the Success Rates section of our
website
(http://www.clearpassage.com/resources/successrates/).
Women who had Clear Passage
therapy before IVF transfer had
significantly higher pregnancy rates
than the nationally reported average.
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Natural pregnancy rates and pain reduction
Natural pregnancy rates were 71% after receiving the Wurn Technique, and 64% of participants had
live births. All of the participants who reported pain before therapy (e.g., endometriosis, menstrual, or
intercourse pain) reported a decrease or elimination of their pain after receiving therapy.
Birth rates in the natural pregnancy group
Of the women who became pregnant in the natural fertility study, 90% delivered full-term babies.
Next, 40% of these women reported a second full-term pregnancy after their first live birth, suggesting
that the Wurn Technique has lasting effects.
Improved IVF pregnancy rates
We also measured results in women who underwent an IVF transfer after therapy. Study participants
who received our therapy prior to IVF increased their chances of an IVF pregnancy to 67% vs. the
national average of 41%. Seventy-nine percent of the participants who received therapy and became
pregnant via IVF had live births.3
The women in this “Therapy Before IVF” study were a challenging group. Before receiving the Wurn
Technique, they collectively underwent 54 intrauterine inseminations (IUIs) and 24 IVFs. Of these 78
attempts, only one procedure (an IVF) yielded a full-term pregnancy -- a 4% IVF birth rate for these
women, before therapy. After therapy, these same women underwent 14 IVF transfers and achieved
10 pregnancies with seven full-term deliveries. This equates to a post-therapy IVF pregnancy rate of
71% and a live birth rate of 50%, significantly higher than the 4% birth rate without therapy.3
IVF success in women over 40
The pre-IVF study noted a 57% clinical pregnancy rate among women 41 or older.3 For example, one
43-year-old study participant had four unsuccessful pre-treatment IVFs, then became pregnant and
had a live birth with her first post-treatment IVF. Another pre-IVF Clear Passage patient, a 48 year-old
woman, gave birth to twins after receiving our therapy and proceeding to IVF, using her own fresh
eggs. These are some of the many success stories that we love to hear and share.
How can the Wurn Technique increase pregnancy rates?
Diagnosis and treatment of intrauterine adhesions are integral to the optimization of fertility
outcomes.4,5 Adhesions that form on the inner walls of the uterus create a less hospitable surface for
implantation. They can cause spasm or inflammation in the uterus, complicating or preventing
pregnancy. Adhesions that form around the ovaries or within the fallopian tubes can prevent release
of the egg or restrict its transport to the uterus.
Tiny, even microscopic adhesions can restrict the ligaments that attach to the cervix and pull it
forward, backward or to either side. In addition to complicating the transfer process, we find that this
pull into the uterus can cause spasm and inflammation. The adhesions can restrict or close the
uterine opening, making an assisted transfer via IUI or IVF more difficult as the adhesions restrict the
opening of the cervix.
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Adhesive cross-links can form on or within the uterus or cervix,
decreasing the chance for implantation.
Some women have been diagnosed with cervical stenosis (narrowing) or fibrosis (excess collagen).
In most of our patients, we find this to be the result of adhesive cross-links attaching to muscle cells
within the cervix after a bladder or vaginal infection, abortion, D&C or other surgical procedure. When
we treat these conditions, positive changes are generally palpable to us and the physician, greatly
improving IUI and IVF transfer results.
“Clear Passage was exactly the alternative I was looking for as I
did not want to take fertility drugs. My body was telling me my
problem was with adhesions and I had no faith that Clomid and
other drugs would work. I am now pregnant after treatment!”
- Lisa
Our therapists apply the unique manual techniques we developed over two decades to treat adhered
tissues at the uterus, cervix, ovaries and fallopian tubes. When reproductive organs are released from
these tiny adhesive straitjackets, the organs move more freely and function more normally – as they
did before the adhesions developed. Patients have told us that “it feels like my body is going back in
time.” Freed from their adhesive bonds, the organs and support structures are able to move as they
were designed. This usually results in improved reproductive function and decreased pain.
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Opening Blocked Fallopian Tubes and Clearing Hydrosalpinx
Therapy and fallopian tubes
Fallopian tubes are among the smallest and most complex organs in the female body. They can
become blocked or compromised by adhesions or scarring after an infection, trauma, inflammation or
surgery.
We were initially surprised when our patients began reporting natural pregnancies despite heavily
damaged tubes, total blockage, hydrosalpinx (liquid within the tube) and clubbing of the fimbriae (the
delicate structures found at the end of each tube). We were also seeing natural pregnancies in
women with prior unsuccessful IVF and surgery to open their tubes. Most of our patients became
pregnant after we opened their blocked tubes, and several reported second (or more) natural
pregnancies and births with no further treatment.
A research gynecologist, Chief of Staff of our local hospital, encouraged us to conduct a study on this
phenomenon. The results were published in the peer-reviewed medical journal Alternative Therapies
in Health and Medicine6 and summarized in Contemporary
Ob/Gyn,7 the professional journal of U.S.-based
gynecologists.
According to the data, the Wurn Technique® achieved a
61% success rate opening blocked fallopian tubes in
women with totally blocked fallopian tubes, and most of
the successes reported natural full-term pregnancies. This
success rate is considered high, rivaling or exceeding
surgical success – without the inherent cost or risk of
surgery, such as formation of new adhesions.
Successes in the published study of opening blocked
fallopian tubes included women with:
• two totally blocked fallopian tubes
• one tube removed and the other blocked
• one or both tubes with hydrosalpinx (swollen, liquid
filled tubes)
• mid-tubal and distal blockage (a challenging area,
near the ovary)
Phone: 1-352-336-1433
One study shows that the Wurn
Technique opened tubes in most
women without surgery.6
10
The results of our therapy appear to last for years. One woman reported her second natural full-term
pregnancy more than seven years after we treated her and opened her only fallopian tube. A study in
the journal Human Reproduction showed that even with a minimally invasive surgery on proximally
blocked tubes (near the uterus, the simplest area to access), 81% of tubes closed again just six
months after surgery.8
By contrast, our non-surgical therapy opened tubes for 66% of the women whose blockage was by
the uterus (the same area as the surgical study). Furthermore, the risks from a 20-hour course of our
threapy are minimal, such as temporary soreness, while common side-effects are positive -decreased pain and increased sexual function (desire, lubrication, orgasm).9–11
Surgically opened tubes tend to close again, within six months.6
How can therapy open blocked fallopian tubes?
Fallopian tubes are so small that they can easily become blocked. Adhesive cross-links can form
around or within these delicate structures after infection, inflammation, trauma or surgery. Blocked
fallopian tubes prevent the sperm and egg from meeting, thus preventing pregnancy. Adhesions at
the far end of the tube can prevent the delicate finger-like fimbriae from grasping the egg once it is
released from the ovary. Scarred tubes that are partially blocked can decrease the easy transport of
sperm and egg, lowering the chance for conception and increasing the risk of an ectopic pregnancy
(implantation within the tube).
We developed our unique manual therapy over two decades to decrease adhesions and improve the
function of the tubes and surrounding organs. The Wurn Technique is non-surgical; we use our hands
to release the tubes from these restrictive adhesions. Surgical procedures such as IVF, GIFT and
other assisted reproductive techniques try to bypass blocked or scarred tubes for a single menstrual
cycle. Our goal is to restore a “clear passage” for an unobstructed pregnancy now and for years to
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come. It appears to make little difference whether the tubes have been blocked for a year or a
decade. The Wurn Technique has been shown in peer-reviewed studies to open blocked fallopian
tubes and improve function in most of the women who come to us with blocked or scarred tubes.6
Hydrosalpinx
Hydrosalpinx is a collection of fluid within the fallopian tube, often the result of infection or prior
surgery. Just as a knee might swell when it is injured, a hydrosalpinx causes fluid to pool in the
damaged tube, causing it to swell. Hydrosalpinx often indicates blockage at the far end of the tube.
As a result, the delicate flower-like fimbriae, designed to grasp the egg as it exits the ovary, may
become adhered or clubbed together, closing the tube completely.
Hydrosalpinx may form as the result of a prior infection in the pelvis, surgery or adhesions from any
number of causes.12 While some women with a hydrosalpinx display no symptoms, others report
significant pain.
Hydrosalpinx and infertility
Hydrosalpinx is a serious threat to fertility. It not only renders the tube ineffective, it can also decrease
the effectiveness of various infertility treatments such as IVF.12,13 Hydrosalpinx also increases the
likelihood of miscarriage. Moreover, a hydrosalpinx in one tube often affects the other, resulting in two
abnormal tubes.
Reproductive endocrinologists believe that fluid from an infected tube that spills into the uterus can be
toxic to embryos; thus, it decreases the chance for successful embryo implantation. For this reason,
fertility specialists often advise patients to have these tubes removed prior to undergoing IVF.
The liquid within a hydrosalpinx decreases the chance for implantation.
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Treating hydrosalpinx surgically
Until recently, surgery was the only known course of action for treating hydrosalpinx. With
neosalpingostomy, a surgeon cuts the hydrosalpinx, creating a new opening in the tube. Successful
results from this type of repair are typically obtained in younger women and women with small
hydrosalpinx. Surgical repair on these tiny structures does not have a high success rate; the tube
often closes again, enabling the hydrosalpinx to return.12–14
We were initially surprised when patients with hydrosalpinx reported natural full-term pregnancies
after therapy. When we reviewed the data, it became apparent that the previously blocked and
swollen tubes often regained normal function after our manual treatment, creating a free path for
conception to occur.
Our success rates treating hydrosalpinx are promising and are of interest to reproductive physicians
and surgeons. The American Society for Reproductive Medicine (ASRM) invited us to present a study
abstract (Fertility and Sterility, 2006)15 that examined our ability to open blocked fallopian tubes with
hydrosalpinx. The results showed success returning fertility to tubes blocked with hydrosalpinx,
followed by natural pregnancies and live births for some of the women.
“I couldn’t believe it – it was just my second cycle
after my treatment at Clear Passage and I was
pregnant! I went to see a midwife and she confirmed
my pregnancy with a blood test. I had no
complications with my pregnancy and I gave birth to a
beautiful full-term baby. I am so happy I decided to go
to Clear Passage. I could have gone through years of
invasive treatment. Instead, I went to them and
because of their hands, I got pregnant almost
instantly.” - Jacqueline
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Endometriosis: Pain, Infertility and Sexual Problems
What is endometriosis?
Endometriosis is a condition in which endometrial tissue that normally lines the uterus is found in
other areas of the body. The misplaced endometrial tissue often appears on or near the reproductive
organs, or within the pelvic or abdominal cavity. The endometrial implants respond to the menstrual
cycle as if they were in the uterus, swellong with each monthly cycle. But unlike menstrual fluid that
leaves the body every cycle, endometrial implants have no place to go. Their attachments to other
tissues and organs of the body may cause inflammation, pain and infertility.16–20
Adhesions can form on or within structures (right) or at the sites of endometrial implants (left). They
act like glue in the reproductive structures, causing pain or infertility.
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Why does endometriosis cause infertility?
Endometriosis can impact fertility in several ways. While overproduction of prostaglandin hormones
may contribute to infertility, most doctors agree that adhesions frequently form in areas of endometrial
implants. The glue-like combination of endometrial tissue and adhesions are major causes of infertility
for these women. Simply put, when delicate reproductive tissues become bound by endometrial
adhesions, they cannot move or function normally.18,21,22
Endometriosis can cause delicate reproductive organs to adhere to other structures or to each other.
On ovaries, it can restrict the release of the egg; on or within the tubes, it can impede transport of the
egg to the uterus. Adhesions on or within the uterus can cause spasm or create a less hospitable
surface for implantation. Women with endometriosis or adhesions can have significant pain with
ovulation or intercourse, decreasing the opportunity for natural conception. The pain may decrease
with anti-inflammatory drugs, and some physicians recommend hormones or oral contraception
medications to stop menstruation.19,23–25 While this helps some women, these products are not
suitable for women who want to become pregnant.
Why does endometriosis cause pain?
Doctors do not know the exact cause of endometriosis pain. Patients who have surgery to remove
endometriosis and adhesions frequently complain of recurring pain in the areas where the surgeon
cut or burned the tissue. It is unclear to physicians whether this pain is due to return of endometriosis
or from adhesions that form to help the body heal from the surgery.
As these strong adhesive bonds spread in the pelvis, abdomen or elsewhere, they can eventually
cause pain throughout the month. Some patients arrive at our clinic with pain when they move in
certain ways, have intercourse, stand straight or even breathe.
The pull of adhesions on endometrial implants may cause pain.
Our work appears to deform or detach these bonds, greatly decreasing pain.
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Clinical trials conducted at Clear Passage yielded insight into a major cause of endometrial pain. This
investigation began when patients reported significant pain relief after therapy. It became clear that
our therapy was significantly decreasing pain and improving fertility for many women with
endometriosis. Published studies and clinical trials examining our work support this data.10,11 After
20+ years of investigation, we believe that endometrial pain is due largely to adhesions. When the
tissue swells during each monthly cycle, endometrial adhesions pull on the delicate structures to
which they attach, causing pain. When we detach or decrease the adhesions, the pain relief is often
profound. Organs become free to move as they did years ago, before the onset of endometriosis.
Thus, natural function and fertility can return.
Endometriosis and its accompanying adhesions can become more extensive over time. As they cover
more areas, reproductive organs can become adhered. Organs that cannot move freely as they were
designed cannot function properly, thus impairing fertility.26,27
In general, 30-40% of patients with endometriosis are infertile – two to three times greater than the
infertility rate of the general population.28 Fertility appears to decrease due to the severity of
endometriosis. In a study from the Journal of Endometriosis, the overall pregnancy rate in patients
with mild, moderate and severe endometriosis was 53%, 25% and 0%, respectively.29 Our own
published study of infertile women, including those with a history of endometriosis, showed a 71%
success rate in natural clinical pregnancy therapy in women averaging five years of infertility
(unpublished results.)
Treatment options: drugs, surgery and the Wurn Technique®
As noted above, pharmaceuticals can decrease pain in some women by reducing inflammation, or
preventing ovulation or menstruation. Surgery can help reduce endometriosis and its accompanying
adhesions. But due to the recurrence of the endometriosis or post-surgical adhesions, pain can return
in the exact places where the surgery occurred. Over the years, we have treated many women who
have had multiple surgeries but still have pain or continue to struggle with infertility.
The Wurn Technique has shown positive results decreasing pain and increasing fertility in women
with endometriosis. Our focus on detaching the cross-links and reducing adhesions has returned
pain-free function and fertility for many women.10,11
Research and published data
We have published citations in the Journal of Endometriosis11 and presented our work treating
endometriosis pain to physicians at the American Society for Reproductive Medicine (ASRM.) In one
study,11 we examined pain levels at several times during the cycle:
•
•
•
•
ovulation
pre-menstruation
menstruation
intercourse
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Results after therapy showed statistically significant improvement at all times during the menstrual
cycle, with the greatest improvements at the typically most painful times – menstruation and sexual
intercourse. The following graph shows the percentages of women that reported reduction in pain
levels after treatment.
Most women who come to Clear Passage with endometriosis and infertility
report significant pain decreases; many have became mothers after therapy.
Endometriosis sexual function study
Physicians and scientists are intrigued by the pioneering nature of our work. The ASRM honored us
by soliciting our findings on improvements in sexual pain and function for women with endometriosis,
to be presented at its national meeting.11,30 Published results showed a significant improvement in all
six areas of sexual function (desire, arousal, lubrication, orgasm, satisfaction and pain). As we
understand, no other medical or pharmaceutical treatment has ever been shown to improve every
domain of female sexual function. The greatest improvement in sexual function was reduced
intercourse pain.
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Dysmenorrhea (menstrual pain)
Dysmenorrhea is a condition characterized by frequent and severe uterine cramping and pain
associated with menstruation. A study in Obstetrics and Gynecology reported the prevalence of
dysmenorrhea at 90% in reproductive age women;24,31–33 the condition disrupts daily activities and is
a leading cause of absenteeism from work and school.
Primary dysmenorrhea begins with a woman’s first menstrual cycle and may recur until menopause. It
can occur when there is no pelvic pathology. Secondary dysmenorrhea has a later onset and may
first appear after identifiable conditions such as surgery, endometriosis, inflammation (PID), infection
or trauma. Secondary dysmenorrhea has also been linked to mechanical causes inside or outside of
the uterus, such as adhesions or an intrauterine device (IUD).
Mechanical causes
Dysmenorrhea can be caused by spasm, endometriosis or adhesions affecting the ligaments, fascias,
or connective tissues that attach the uterus to surrounding pelvic structures. Women with secondary
dysmenorrhea may also experience pain due to mechanical factors, such as restricted mobility of the
reproductive and urogenital structures due to adhesions. Adhesions can form as the body reacts to
trauma, inflammation, infection, surgery or chronic spasm, and thus can cause and/or contribute to
dysmenorrhea. The Wurn Technique is designed to reduce or eliminate these adhesions, cross-link
by cross-link. It has been highly effective in decreasing pain and returning normal function for women
with dysmenorrhea.
“My pain decreased precipitously during my menstrual
cycle. In fact, I didn't even know I started my period
until I saw it!”
- Danielle, mother of two after attending Clear
Passage for treatment of endometriosis and infertility
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Improving Hormone Levels
High FSH, Premature Ovarian Failure, PCOS
When we first began treating female infertility with our manual therapy, we assumed that we could not
affect hormone levels. We knew we could help sperm meet egg by decreasing the mechanical blocks
to that process (adhesions, blocked fallopian tubes, cervical tightness and stenosis, endometriosis);
we had conducted the research and published the results. But treating those conditions was a far cry
from treating hormonal conditions such as high follicle-stimulating hormone (FSH) or polycystic
ovarian syndrome (PCOS). For this reason, we regularly discouraged women diagnosed with only
hormonal factors and no mechanical problems from coming for infertility treatment.
Our patients helped us realize that we could assist conditions we had never considered treating. A
woman who had been diagnosed menopausal became pregnant naturally, two months after therapy,
despite previously being refused IVF three times due to very high FSH levels. She had a successful
pregnancy and live birth, then a second natural pregnancy and birth two years later – all after a single
week of our therapy.
Naturally, this provoked our interest. At the urging of a research gynecologist, we began accepting
women diagnosed with high FSH for treatment. To create measurable data, we tracked changes in
FSH levels for these women, before and after therapy. Remarkably, these clinical trials have shown
some of our highest and most promising success rates, with natural pregnancies or measurable
hormonal improvement in well over 80% of the cases we treated.
Significantly elevated FSH levels indicate premature ovarian failure (POF). Primary ovarian failure
(POF) is characterized by increase in FSH, and a decrease in ovarian function with or without
changes in menstruation.34 We have successfully treated patients with this condition by lowering FSH
levels and increasing ovarian function, leading to successful conception. With POF, success appears
to depend upon the length of time the woman has experienced POF symptoms and elevated FSH
levels in the menopausal range.
How can therapy help hormone levels?
Reproductive activity depends on effective communication between the ovaries (in the pelvis) and the
pituitary and hypothalamus glands (in the head). The master gland of female reproduction (the
pituitary) rests within a hollowed area of the sphenoid bone in the center of the skull. It is surrounded
by fascia from the dura, a protective sheath that covers the brain and spinal cord, then attaches to the
sacrum in the pelvis. The Wurn Technique® uses protocols we developed to access and treat all of
these anatomical structures, without drugs.
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Reproductive structures in the pelvis must communicate
effectively with the pituitary gland deep within the brain.
When we combined treatment of the reproductive structures with treating the dura and cranial bones,
from the head to the sacrum, we saw dramatic improvements in hormone levels. The result was
numerous full-term pregnancies in women diagnosed infertile due to hormonal factors. Simply put,
when the structures are freed from collagenous bonds that form during a lifetime of healing events,
they appear to function as they did earlier in life. While these results are considered preliminary, we
are encouraged that most of the cases we treated showed positive effects on hormone levels.
"My husband and I had one child and had been trying for
nearly 2 years when we found Clear Passage. I was
having many pre-menopausal symptoms (hot flashes,
nightmares, night sweats, black menstrual bleed, fatigue
and pain during ovulation, menstruation and intercourse).
I became pregnant within 6 months of my treatment. And,
am now pregnant with my third post treatment baby!"
- Olivia
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Pain and Problems Due to Surgery or Trauma
C-Section, Hysterectomy, Myomectomy, Episiotomy, Endometriosis,
Mastectomy, Abuse, Early Childhood Surgery
Surgical recovery
In an ideal recovery, surgical adhesions and scars reattach sites that were cut and go no further. In
some cases, post-surgical adhesions spread beyond the surgeon’s initial focus. These additional
adhesions may bind together neighboring structures that are designed to move independently. When
that happens, post-surgical adhesions and scars can create pain or dysfunction that can confound
both patient and physician. We frequently treat patients who have undergone two or more surgeries
and who want to be freed from a spiraling cycle of surgery-adhesions-surgery, with no end in sight.
Many tell us that their quality of life decreases with each successive surgery.
Adhesions after surgery, repeat surgery
Adhesions that form after open surgery (laparotomy) are a major concern for patients and their
physicians. This problem was highlighted in a study from Lancet: The British Journal of Surgery which
reported that 35% of all open abdominal or pelvic surgery patients had to be re-admitted to the
hospital an average of twice more to treat post-surgical adhesions after their surgery. Many follow-up
surgeries (22%) occurred in the first year after surgery, and hospital readmissions continued steadily
over the next 10 years.35 Even modern, minimally invasive laparoscopic surgeries, such as those that
treat the delicate tissues of the female reproductive organs, can cause problems.36,37 The Geneva
Foundation for Medical Education and Research reports that “adhesion formation and reformation are
an unavoidable event in reproductive pelvic surgery in spite of the variable skills in microsurgery,
endoscopic or laser surgery.”
Adhesion surgery (lysis)
Simply put, despite the skills of the finest surgeon, adhesions tend to form as a natural byproduct of
tissue damage after surgery.38–40 When adhesions cause pain or dysfunction, physicians may
recommend a follow-up surgery called lysis to “clean out” the adhesions. Lysis involves cutting or
burning adhesions in the body under general anesthesia, via laparoscopy or laparotomy.
While lysis of adhesions can be effective, it has the same drawbacks as other surgeries:
•
•
•
•
risk of infection
risks from anesthesia
additional adhesion formation as the body heals from surgery
unintentional damage to other structures in the tightly packed anatomy
Until recently, surgical lysis was the only choice medical science offered to treat adhesions. Despite
elaborate efforts to reduce or prevent adhesions, their formation remains a frequent occurrence after
abdominal or pelvic surgery. Data provided by the Victorian Minister for Health (Canada) advises that
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“surgical removal of adhesions may be pointless, except to remedy serious problems like bowel
obstruction. In around 70 percent of cases, the operation to remove the original adhesions will cause
additional adhesions to form.41
Surgeries in women
Surgery is a primary cause of many of the women’s health conditions we treat, particularly chronic
pelvic pain.42–45 Between the remarkably complex anatomy and the variety of activities that occur in a
woman’s body, the pelvic organs and support structures may be subjected to trauma, infection and
inflammation throughout life. Bladder, yeast and vaginal infections, as well as endometriosis, are
common. Recurring menstrual and hormonal changes and reproductive processes are incredibly
complex. Any deviation, whether from a fall, inflammation, surgery or other cause, can create a host
of problems. The very act of having intercourse, for example, can introduce bacteria into the vagina,
cervix and uterus, causing infection or inflammation.
When tissues become injured, infected or inflamed, tiny but powerful collagen cross-links form as the
first step in the healing process. Like the tiny strands of a nylon rope, these fibers are the building
blocks of adhesions that form in injured areas. After the body heals, these internal strait-jackets
become part of the body, adhering structures together. When this happens, they can cause pain or
dysfunction, including difficulties with digestion, menstruation, sexual function or fertility.
Physicians may suggest surgery to diagnose or repair various pelvic conditions. After cutting through
several layers of superficial tissues, the surgeon can cut, burn, repair or remove structures that are
causing a problem. They may cut adhesions in areas that have become bound together to free them
from collagenous bonds. Most tend to avoid areas they could injure, such as the delicate tissues of
the bowels or reproductive structures. While surgeries can save or improve lives, the surgery to
diagnose or correct a problem often causes more adhesions to form.
Pelvic surgery is a major cause of glue-like adhesions.
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A review of surgical literature over several decades reported that over 90% of patients developed
adhesions after abdominal surgery, and 55% to 100% of women developed adhesions after pelvic
surgery.
Thus, surgery itself has been implicated as a major cause of adhesion formation. In fact, many
women who have undergone two or more pelvic surgeries often feel trapped in a cycle of surgeryadhesions-pain-surgery, with no end in sight.
Caesarian section (C-section) is a major surgery and the most common major surgery among
women in the United States. Complications such as a breech baby or a vaginal birth that is not
progressing are cited as the most common reasons for a C-section.46 During the procedure, the
surgeon cuts through several layers of pelvic tissues, then cuts the uterus open. The surgeon then
removes the newborn and re-stitches the various cut layers.
C-section is a major surgery in which the physician cuts through
the skin, muscles, fascia and abdominal wall to expose the uterus.
Following C-section, tiny strands of collagen rush to the sites that have been cut. There, they join to
form powerful adhesive bonds. The adhesions that form in the pelvis after this open surgery remain in
the body for life as a permanent byproduct of the procedure.
Surgery is a significant cause of adhesions, pelvic pain, digestive problems and secondary infertility in
our patients.47,48 According to a study in Birth (2008), nearly 20% of women who underwent C-section
surgery reported pain at the incision six months postpartum.49 Another study found that women who
underwent C-sections were more likely to experience bowel problems than women with vaginal
deliveries,50 presumably due to adhesion formation following the surgery.
Hysterectomy generally accesses the uterus in the same way as the C-section noted above. Instead
of cutting through the uterine wall, the surgeon will cut the uterine attachments and remove the entire
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organ (sometimes leaving the ovaries). Some women opt for a vaginal hysterectomy because it
leaves no visible scar. As noted earlier, surgery can create adhesions that cause recurring pain or
dysfunction, even long after the procedure.51 A study on the impact of open gynecological operations
found that 35% of all open pelvic surgery patients were readmitted to the hospital an average of two
times during the 10 years after their original surgery “for a problem potentially related to adhesions or
for further intra-abdominal surgery that could be complicated by adhesions.”41
Myomectomy, the surgical removal of uterine fibroids, can help relieve heavy menstrual bleeding
and pelvic pain, and improve a woman’s chances for successful pregnancy. Yet like other surgeries, it
can also leave painful adhesions and scarring. Moreover, myomectomy may clear present fibroids but
cannot stop new fibroids from developing later. Thus, repeat myomectomy is recommended for some
women.
Women who undergo myomectomy sometimes experience deep or superficial pain (or both) after the
procedure, as the body develops scars and adhesions to help the body heal from surgical repair.
Adhesions within the uterus can impair fertility by causing tightness or spasm, thus decreasing the
chances of successful implantation of a fertilized egg. Adhesions outside the uterus can cause
infertility by binding delicate reproductive structures such as the ovaries or fallopian tubes, impairing
their function.
Episiotomy refers to the physician cutting the back of the vaginal opening to ease childbirth. While
many women undergo episiotomy with no ill effects, some report intercourse or pelvic pain, sexual
dysfunction, or problems with elimination after an episiotomy. We find post-surgical adhesions to be a
major cause of these problems in many of our patients.
Diagnostic laparoscopy for pain and endometriosis: Physicians may suggest a diagnostic
laparoscopy to help find the cause of pelvic pain or infertility. This surgery uses a tiny camera inserted
into the abdomen to help surgeons view and treat internal structures. It can give them a direct view of
pelvic structures and may allow them to cut, burn, repair or remove problems such as adhesions.
Unfortunately, the surgery to view or treat problems can cause more adhesions to form. No matter
how skilled the surgeon, the body forms adhesions as the first step in tissue repair after surgery.
Simply put, the body must heal from the near-inevitable tissue damage that occurs with surgery.
Therefore, it is nearly impossible to perform surgery without causing adhesions.
Mastectomy is a lifesaving treatment for many women diagnosed with breast cancer. Yet, like other
surgeries, it can leave painful adhesions and scarring. Women who have undergone a mastectomy
may experience a variety of post-mastectomy symptoms. Pain may occur at the surgical scar,
throughout the chest wall, and into the shoulders, arms or neck. As adhesive straitjackets envelop the
area after this surgery, mild to severe tightness can occur at the surgical site, and throughout the
chest cavity and neighboring structures. While some pain is due to cut nerves, we find adhesion
formation to be a major cause of pain and tightness after mastectomy. Patients with a history of
breast augmentation or reduction may experience similar problems.
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Physical and sexual abuse can create emotional and physical scarring. Psychological counseling
can help victims come to grips with the conflicting emotions so often associated with abuse. However,
many also experience physical pain or dysfunction due to post-traumatic adhesion formation, long
after the abuse has ended. These palpable physical scars can exist in the body’s tissues for decades
after abuse has ended. If left untreated, they can last a lifetime. Our therapists are well-versed in
treating the physical scars associated with abuse. Please contact us for more information.
Genital mutilation or female circumcision is practiced in various countries and tribal regions. The
procedure involves partial or total excision of the external female genitals. It is often performed during
adolescence but may take place as early as infancy. Because the procedure is usually performed in a
non-sterile environment without anesthesia, it can cause massive adhesions due to infection and
healing. Many women experience a lifetime of chronic pain, dysfunction or infertility as a result.
Most victims of genital mutilation come to us with severe pelvic or intercourse pain. Many report
infertility, bladder problems, digestive problems or sexual dysfunction, such as decreased desire,
lubrication and orgasm. As we free the powerful adhesive bonds from this sensitive area, response is
generally excellent, with significant decreases in pain and improved sexual, bladder, digestive, and
reproductive function.
Early Surgery: We have helped many adults and teens who had major surgery in their infancy or
early youth. Children who undergo surgery at a young age tend to grow ‘around’ their scars. These
scars often remain as tightly bound areas while the rest of the body develops normally. We have
witnessed overwhelmingly positive results when we treat early surgical scars with our non-surgical
therapy.
Summary
The female pelvis contains a remarkable array of structures, responsible for myriad complex
processes. It is situated in an area of the body that is vulnerable to injury, accessible to objects from
the external environment and susceptible to infection. When structures in the pelvis heal, they can
become bound by adhesions. Composed of tiny but powerful strands, pelvic adhesions often bind
delicate tissues, causing pain and dysfunction.
Because of the complexities noted above, women are often subjected to surgery to diagnose
problems or to repair internal organs. Adhesions form naturally after most surgeries. As post-surgical
adhesions form, they may spread to neighboring structures. This can result in an uncomfortable
pulling sensation or pain that may begin weeks or months after surgery – or even years later.
Adhesion pain never seems to improve; it generally remains the same or worsens throughout life.
Adhesions can cause pain wherever they form. In the delicate folds of the bowels, they can also
create digestive problems such as diarrhea, constipation or irritable bowel syndrome. In severe
cases, these adhesions can cause bowel obstruction, a life-threatening condition. Adhesions affecting
the delicate tissues of the reproductive tract can block function, cause pain and decrease fertility.
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Medical treatment of adhesions – lysis surgery
Until recently, surgical lysis (destruction of adhesions) was the only choice medical science offered to
treat abdominal or pelvic adhesions. Lysis involves cutting or burning adhesions under general
anesthesia. While lysis may be effective, abdominal and pelvic surgeries have some major
drawbacks, such as:
•
•
•
the risks from anesthesia and infection,
the risk of damage from cutting/burning neighboring structures in the tightly packed abdominal
and pelvic anatomy, and
the body’s tendency to create more adhesions after surgery, often requiring repeat surgeries to
remove the adhesions.
The Wurn Technique: a non-surgical treatment for adhesions
The Wurn Technique® has been shown in peer-reviewed medical journals to reduce adhesions,
decrease pain, increase function and improve fertility without the risks of surgery or drugs. Our work
is designed to reduce adhesions, cross-link by cross-link. This mechanical process appears to be
effective even if the adhesions formed years or decades earlier. In addition, it does not appear to
matter whether the adhesions are attaching muscle, bone or organs. They may adhere areas as large
as the bones of the low back and pelvis, as small as the fallopian tubes, as deep as the pituitary
gland or as delicate as the vaginal walls. Wherever they appear, we have witnessed excellent
outcomes by treating the affected areas.
Our success is due in part to decades of palpatory skills and part is our in-depth study of each
patient’s history. In addition, we listen deeply to each of our patients to fully understand their goals.
We invite each patient to be a member of the treatment team in order to help her achieve success.
“I cannot say enough about the staff or the therapy. They
felt that the adhesions from the endometriosis and
surgeries were acting like glue in my pelvis, binding my
reproductive organs and causing me pain. Following my
therapy the endometriosis pain I had lived for over 10 years
completely disappeared. My body felt looser and somehow
more free when I walked and moved.” - Ava
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Female Sexual Conditions
Intercourse Pain, Decreased Desire, Lubrication, Orgasm
The female reproductive tract may be subjected to numerous traumas, infections, inflammations and
surgeries throughout life. A fall onto the tailbone, bladder or yeast infections, and even sitting for long
periods of time can all contribute to adhesion formation. Since the vagina is open to exposure from
the outside environment, it is prone to infection, inflammation and direct trauma. Its warm, moist
environment also creates an ideal environment for bacterial and fungal growth.
Some women absorb these repetitive traumas, infections and stresses without experiencing
symptoms or negative side effects. But some women experience significant, long-lasting symptoms.
Among these are dyspareunia (pain with intercourse), anorgasmia (the inability to have an orgasm or
reach a full orgasm) and decreased desire (libido). Others note decreases in arousal, lubrication and
satisfaction.
Dyspareunia, painful intercourse
Painful intercourse plagues millions of women worldwide.52–54 For some, pain occurs as a sharp,
specific pain at or near the opening of the vagina (introitus). Other patients speak of pain with deep
penetration. This is generally a broader or deeper pain; sometimes our patients say, “It feels like my
partner is hitting something.” Some women have a combination of the two types of pain, which may
be accompanied or followed by uterine cramping.
Clear Passage is world leader in developing an effective, non-surgical and drug-free therapy to treat
intercourse pain. We have published studies and citations in peer-reviewed medical journals and
have addressed large physician groups on our work in this area.9–11
Pain at the vaginal entrance
With pain or tightness at the vaginal opening, we find that adhesions have formed as a response to
prior inflammation, surgery, trauma or infection. As the body heals from these, tiny adhesions that are
often invisible to the naked eye develop. These micro-adhesions can form at the vaginal entrance, on
the surface of the labia or within the delicate tissues of the vagina. In any of these locations, they can
be stretched during penetration. When adhesions pull on nerves and pain-sensitive structures, they
can cause pain at the time when a woman should be experiencing great pleasure. Irritation and
adhesions can cause pelvic spasm that, in turn, causes more pain and dysfunction, perpetuating the
process.
Pain with deep penetration
We find numerous causes for this condition, including trauma such as a car accident or a fall onto the
buttock, hip, back or coccyx (tailbone) – often at an early age. Other causes include endometriosis,
pelvic surgery, inflammation or infection (vaginal, bladder, etc.) Physical or sexual abuse and
repetitive stresses, such as sitting for long periods of time, are also common causes of this pain. All of
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these factors can cause adhesions that spread to internal vaginal structures, causing pain with deep
penetration.
Intercourse pain can severely impact relationships. Our treatment has decreased pain, increased
sexual function and restored the pleasures of intimacy for many women. In doing so, we greatly
enrich their lives and those of their partners.
Orgasm, desire, arousal, lubrication
We first began to examine the Wurn Technique as a treatment for female sexual dysfunction after
patients reported dramatic increases in desire, lubrication and orgasm after therapy. Gynecologists
encouraged us to investigate further because female sexual dysfunction is so prevalent and no other
medical treatment has been shown to decrease intercourse pain for women while simultaneously
increasing sexual function.
Orgasms are a healthy part of a woman’s life. Yet when tiny micro-adhesions form on the delicate
walls of the vagina, they can diminish a woman’s ability to reach a complete orgasm or to have an
orgasm at all. We palpate tiny adhesions that act like a blanket on the vaginal walls, dulling sexual
response. We also note rope-like adhesions, which are often left from childhood falls and attach to
nearby structures. When we treat the affected areas, we often notice significant improvement in
sexual function, documented by studies on our work published in peer-reviewed medical journals.11
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Clear Passage therapists are professionally trained to treat this delicate and personal area of the
body. This is not sex therapy; our patients do not have orgasms during treatment. Yet, our manual
therapy has been shown to increase function and pleasure that has been dormant for years or
decades, once the patient returns home.
Many patients report their desire (libido) awakens suddenly and powerfully after therapy. Others have
reported long-lasting dramatic improvement of their lubrication and orgasm. Most report significant
pain relief after our therapy. These unusual and remarkable effects of therapy have become major,
life-changing or marriage-saving events, with positive outcomes generally lasting for years.
Research and publication
Since decreased sexual function affects nearly half of all U.S. women,55 we felt it important to conduct
a controlled study on women with sexual dysfunction or pain. Our first sexual function study was
published in WebMD’s peer-reviewed medical journal, Medscape General Medicine and is now part
of the U.S. Library of Medicine.9 Results showed a highly significant improvement in all six
measurable areas of female sexual dysfunction: desire (libido), arousal, lubrication, orgasm,
satisfaction and pain.
Published results9 showed that:
•
•
•
96% of participants had decreased pain with sexual intercourse, and more than half reported
better and/or more frequent orgasms;
78% reported increased desire (libido);
91% reported overall sexual function improvement
“After years of experiencing almost total loss of sexual
interest, I have had the pleasant and remarkable surprise of
renewed, intense sexual desire and response – and I am
over 40! After my first 12 hours of therapy at Clear Passage,
I am having sexual desire and responses unlike anything I’ve
ever experienced in my lifetime! My husband is really
smiling, but he is actually getting exhausted with my newfound libido! We are both so grateful!” – Dawn
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Frequently Asked Questions
What is Clear Passage?
We are a network of physio/physical therapy clinics. We use a unique manual therapy (the Wurn
Technique®) and protocol (the Clear Passage Approach®) to treat chronic pain and dysfunction,
including post-surgical pain, small bowel obstruction and female infertility. Our therapists receive
exclusive training, certification and licensing to provide the Wurn Technique. None of our treatments
involve drugs or surgery.
Patients come to Clear Passage locations from around the world and from all walks of life. Many have
conditions that have not resolved after traditional therapy, medications or surgery; some want to avoid
future surgery. A number of our patients are health care professionals. Our therapy has shown
positive results in published studies and is completely natural.
What is the Clear Passage Approach?
The Clear Passage Approach is a unique hands-on therapy, developed over 25+ years of study and
clinical research by Belinda Wurn, PT and Larry Wurn, LMT. Our focus is to deform the bonds that
attach collagenous cross-links, the building blocks of adhesions. The protocol includes over 200
individual techniques, including the Wurn Technique, designed to reduce and eliminate the adhesions
that form wherever the body heals. As a manual therapy, it works without the risks or side effects of
surgery or drugs. Studies on the effectiveness of this work, published in peer-reviewed medical
journals, show success treating conditions previously treated only by surgery or drugs.
Why is this therapy unique?
Every body heals differently after injury, surgery or trauma. Physical therapists certified in the Wurn
Technique are trained to evaluate and treat the entire body. This holistic view, coupled with extensive
patient history and feedback, helps us understand the physical forces preventing patients from
leading the life they envision. Our focus is to decrease the powerful adhesive pulls that cause pain or
dysfunction – no matter where they occur in the body.
Our therapy is different from other manual therapies for several reasons:
•
We have lived the experience. Our work was born in 1986 from the need to find a nonsurgical answer to treat debilitating pain in our founder, Belinda Wurn, PT.
•
Our background is broad; our focus is logical and methodical. We studied rigorously with
top manual physicians and physical therapists in the U.S. and abroad. From that strong
foundation, we worked hard to develop our own work, to effectively treat the adhesions
causing her pain and dysfunction. After Belinda was able to return to work, we continued to
refine our work to treat others with pain and dysfunction complaints.
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•
We test our work and publish our results. Independent physicians and scientists measure
the results of our therapy. Positive results of the Wurn Technique and Clear Passage
Approach have been published in peer-reviewed medical journals and accepted into the U.S.
National Library of Medicine. Citations about this work appear in WebMD’s Medscape General
Medicine, The Journal of Endometriosis, and Alternative Therapies in Health and Medicine.
Many health care providers call our work pioneering.
•
We rigorously train and test our therapists for knowledge and clinical skills. We base
their certification on strong manual and palpatory skills, and on test results after several weeks
of study and training. Each must demonstrate good understanding of the material in a 600
page Therapist Training Manual written by Belinda Wurn, PT and her training staff.
How can adhesions affect fertility?
Adhesions can block fallopian tubes, decrease function of the fimbriae or ovaries, or restrict the
cervix, creating a difficult passage for sperm. Tiny adhesions may cause uterine spasm, inflammation,
or otherwise decrease the uterine wall’s ability to allow implantation, causing a miscarriage after
fertilization. Ovarian adhesions can decrease hormonal function. We have high success rates treating
the above conditions in our patients.
What kinds of pain and dysfunction are caused by adhesions?
Adhesions can cause chronic, unexplained or recurring pain anywhere in the body. Frequent pain
complaints we treat include post-surgical pain; long-standing back, hip and neck pain; frequent
debilitating headaches; pelvic and abdominal pain or cramps; pain from endometriosis, menstruation,
ovulation or intercourse; full body or unusual pain patterns; head, neck and jaw pain; and tailbone
pain. Functional problems include infertility, restricted mobility, poor digestion, constipation, loose
bowels, and irritable bowel syndrome (IBS) and small bowel obstruction (SBO).
What does therapy feel like?
Sometimes, therapy can feel like a deep stretch; other times, the work can be very light, as it follows
the subtle rhythm within the connective tissue sheath that surrounds the spinal cord and brain.
Depending on the diagnosis and treatment area, the therapist may work to improve the mobility of the
body’s muscles, joints and organs or to improve motility – subtle organ movements. During therapy,
we may ask the patient to flex large muscles, or move in certain ways to improve the body’s
symmetry and function. We continuously communicate with patients throughout treatment to ensure
that they understand our intent and findings, and maintain their comfort level. We educate our
patients in self-help techniques to prevent reinjury and to maximize the results of therapy.
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Who may benefit from this therapy?
The best candidates have any of the conditions in this Guide to Services or histories indicating
possible adhesion formation. These histories include:
•
•
•
•
radiation therapy
surgery anywhere in the body,
a fall, trauma, accident, or sexual abuse,
infection or inflammatory process (e.g., endometriosis, appendicitis, PID)
Who is not appropriate for this therapy?
Applicants with the following conditions may need to obtain physician clearance prior to scheduling
therapy or may not be appropriate for therapy.
•
HIV
•
IUD
•
Hernia
•
Lymphedema
•
Active infection
•
Endometrial cyst(s)
•
Cancer in the last 5 years
•
Surgery in the last 90 days
•
Cardiac or kidney dysfunction
•
Blood clotting disorder or abnormal bleeding
•
Immune disorder (e.g. lupus, rheumatoid arthritis)
•
Active inflammatory process (e.g. Crohn’s, celiac, colitis flare)
• Fallopian tubes that have been removed or closed surgically and never reopened (These
women may be appropriate for our pre-IVF therapy but not for natural infertility reversal.)
How do I arrange a personal consultation?
We are glad to review medical history questionnaires from applicants interested in our therapy and
provide telephone consultations at no change. After we thoroughly review your reported medical
history, we can provide information that is specific to your situation. Our therapists will gladly answer
your specific questions by phone or e-mail. This will give us both a realistic sense of whether our
therapy may help you meet your goals. Please call for more information.
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Who can perform this treatment?
The Wurn Technique is unique in the world; it is only be performed by professional staff who are
trained and licensed by Clear Passage to perform our work. These designations insure you receive
the certified therapy that has been developed and researched, with published results, for over two
decades.
Where and how can I get this treatment?
We have locations in the U.S. and abroad. While local patients may choose to spread therapy over
several weeks, most patients visit Clear Passage locations from out-of-town or other countries, and
receive our full 20-hour therapy program over five days (e.g. Monday-Friday). Patients with extensive
history of surgery or adhesions may benefit from additional therapy. We try to save a few hours the
following week to accommodate patients need to book additional hours.
From the initial evaluation through therapy, discharge and follow-up, every aspect of treatment is
thorough, private, respectful, and focused on each patient’s individual needs and goals. Please call
our Headquarters in the U.S. at 1-352-336-1433 or visit www.clearpassage.com to learn about our
clinic locations.
Does the medical community accept this work?
Due to published studies on our therapy, physician acceptance of our work is growing steadily. At this
printing, our Advisory Council consists of doctors from Harvard, Columbia, UCLA and Northwestern
Medical Schools, as well as the Founder of the Endometriosis Association.
Physicians recognize that physio/physical therapy is a conservative approach. Since there is such a
low risk of complications, most physicians encourage patients to attend or to make their own
decisions regarding therapy. Patients with recent onset of pain should be screened by their physician
for the few conditions that would prevent treatment, such as active infection, cancer or abnormal
cysts. We are glad to consult with your physician to explain our work or discuss your case.
Will my health insurance cover treatment? (U.S. Patients)
While you will pay us directly for our services, your insurer may reimburse you for part or all of your
therapy. You may wish to contact your insurer to clarify your benefits before you schedule treatment.
Ask them about your “out-of-network, outpatient physical therapy benefits for adhesions and/or pain.”
We provide you with copies of your initial evaluation, daily notes, progress report and a statement
noting all charges, payments, provider information, diagnosis and procedure codes to support your
claim for reimbursement.
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Our procedure codes are defined and approved by the American Medical Association, and include
these common physical therapy codes for patients in the U.S.:
97001 evaluation
97110 therapeutic procedure
97112 neuromuscular reeducation
97140 manual therapy
97530 therapeutic activities to increase function
97535 self care instruction
Ask your insurer if you need pre-authorization and a physician’s written referral. If so, have your
physician write on his prescription pad “physical therapy for treatment of abdominal and pelvic
adhesions (or pain).” If you are coming for the five-day program, it should specify “20 hours of manual
physical therapy over five days.” S/he should sign, date and give you the referral slip.
Twenty hours of physical therapy per year falls within the parameters of most insurers in the U.S., but
some limit therapy to one hour per day. Explain that this is a special case and that this is one of the
only clinics in the country that treats adhesions non-surgically. Ask to speak with a supervisor, if
necessary. Record the name, time and date of every person with whom you speak and what they tell
you.
Upon request, we are happy to provide you with a letter that you may forward to your insurance
company. This document provides advice regarding our specialized therapy program and notes your
pre-treatment diagnosis codes, based on your reported medical history.
References
1.
Diamond, M. P. & Freeman, M. L. Clinical implications of postsurgical adhesions. Hum. Reprod. Update 7, 567–76
2.
Trew, G. Postoperative adhesions and their prevention. Rev. Gynaecol. Perinat. Pract. 6, 47–56 (2006).
3.
Wurn, B. F. et al. Treating female infertility and improving IVF pregnancy rates with a manual physical therapy
technique. MedGenMed 6, 51 (2004).
4.
Kodaman, P. H. & Arici, A. Intra-uterine adhesions and fertility outcome: how to optimize success? Curr. Opin.
Obstet. Gynecol. 19, 207–14 (2007).
5.
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