Abdominal Adhesion Case Study Report
Abdominal Adhesions
Case Study of Extracorporeal Shockwave therapy Intervention
Glenn J Cameron RMT. Chronic Pain Therapy
Objective
Abdominal adhesions are the formation of severely hardened and adhered fascial connective tissue fibres (adhesions) amid healthy fascial tissue whose purpose is to maintain the form of all abdominal organs providing essential cohesion and internal support to them, as well as to the multitude of muscles in the abdomen. These adhered fascial fibres form an intricate weave of dysfunctional, inelastic, fibrotic, and ischemic bands or large regions within the organ’s fascial connective tissue layers and throughout the muscles of the abdomen.
These myofascial adhesions exert considerable and potentially damaging compression/torsion/elongation forces on entrapped abdominal organs, trigger heightened sensory responses, disrupt vascular and lymphatic circulation, compress nerves, and significantly reduce muscle length, thereby impacting the normal function of organs and abdominal muscles.
Abdominal adhesions, a condition often referred to as “Frozen Abdomen,” can arise following a spectrum of abdominal surgical procedures, encompassing appendectomy (appendix removal), cholecystectomy (gallbladder removal), hysterectomy, caesarean section, midurethral/transvaginal mesh insertion, cosmetic lipectomy, colorectal cancer colectomy, and colostomy, among others. Additionally, they may manifest as a consequence of post-surgical complications as infection, peritonitis, from chronic inflammation stemming from conditions such as irritable bowel syndrome (IBS) and Crohn’s disease, and surprisingly from persistent stress.
This case study tracked 20 participants whose abdominal adhesions were identified as the underlying cause for their symptoms experienced by their surgeons, physicians, physiotherapists, osteopaths, naturopathic doctors, chiropractors, or visceral massage therapists. Extracorporeal shockwave therapy demonstrated effectiveness in 19 participants, with the longest-lasting relief extending to more than 8 years without symptom recurrence.
Symptoms of abdominal adhesions observed in these participants encompassed a wide spectrum, including severe and unremitting neuropathic and musculoskeletal pain, as well as dysfunctions in their digestive, urinary, reproductive, and peripheral nervous systems.
Specific symptoms reported by these 20 participants included:
• Intense abdominal cramps
• Pulling sensations in abdominal muscles leading to a flexion contracture posture
• Inability to eat, resulting in hazardous weight loss and malnutrition
• Severe bloating and pain following even small food intake
• Persistent acid Reflux
• Chronic constipation
• Pronounced centralized pain at the xiphoid process post-meals
• Headaches
• Heart Palpitations/arrythmia
• Nausea
• Sleep disturbances
• Cognitive fog
• Small intestinal bowel obstruction
• Small intestinal bacterial overgrowth
• Urinary incontinence
• Pelvic Pain Syndrome and Pudendal Neuralgia
• Lymphatic congestion in the abdomen and/or lower limbs
• Chronic fatigue
• Difficulty bending to lift objects
• Excruciating pain episodes lasting days, confining to bed rest
• Chronic persistent genital arousal disorder
• Lower limb paresthesia and neurological efferent motor weakness
• Persistent point-specific abdominal pain
• difficulty breathing
• Unrelenting urinary tract infections unresponsive to medication
Before treatment, pain management and additional abdominal adhesion removal surgery were the only interventions offered to these participant.
Method
Acoustic extracorporeal shockwave therapy sessions, lasting 75 minutes each, administered on a weekly/biweekly or monthly interval, based upon the participants availability.
The treatments utilized an EMS Swiss Dolorclast Master acoustic wave generator with a 15 mm power + radial applicator, operating at a frequency of 6 to 8 CPS and pressure intensity gradually increasing from 1 to 6 bars at 120 PSI.
Initially, treatments targeted either the left or right side of the abdomen, guided by healthcare professionals’ recommendations, predominant symptoms, or the author’s palpation.
The total number of sessions varied between 3 and 5, with more serious cases requiring up to 8, and 2 particularly severe cases requiring 14.
The dynamic nature of acoustic wave application was administered with:
• Varying angles for effective access to deep lying adhesions
• Varying intensity levels based upon the degree of damaging compression/torsion/elongation forces present affecting the organs
• Level of discomfort based upon active or latent adhesion formation
• Location and severity of organs affected whether nerves were involved and entrapped
Discussion
Extracorporeal shockwave therapy, initially developed in the 1980s for lithotripsy to fragment kidney stones, has evolved over time.
The EMS Swiss Dolorclast acoustic wave generator utilized in this study, is a patented version of this technology that emerged in the late 1990s.
It produces the most effective and deep penetrating impulses among all acoustic shockwave generators worldwide by propelling a metal projectile, propelled by high-pressure compressed air through an exceptionally long cylinder within the applicator to strike an alloy tip. These impulses, akin to those used in diagnostic ultrasound, are transmitted to the body through a conductive gel. They create a distinctively high-energy wavefront, triggering rapid expansion of blood/lymphatic gas molecules, inducing a cavitation vacuum effect within intricately interlinked fascial fibres, succeeded by a swift cavitational implosion force.
This rapid expansion and implosion wave cycle (shockwaves) results in the creation of beneficial fascial adhesion tissue disruption effectively degrading the collagen bonds of adhered fibres, causing them to disintegrate. Physiologically, healthy tissues such as nerves, smooth muscle of organs, outer fascial layers, ligaments, tendons, blood vessels, and lymphatic channels possess varying degrees of elasticity and can expand without repercussions as shockwaves traverse their cellular structures.
Outcome
A total of 20 participants, comprising both male and females, were selected for this study which began in 2015.
Their ages ranged between 13 and 64.
All suffered from life-altering symptoms directly caused by their abdominal adhesions.
Fascial tissue regeneration typically requires up to three months to fully complete, prompting all participants to be advised to report any lingering symptoms beyond this timeframe.
After treatment, analysis revealed that all participants experienced a complete elimination of their symptoms caused by the abdominal adhesions, though the time taken to achieve this varied among the participants.
Of the 20 participants who underwent treatment, only 2 felt the need to return for an additional 2 sessions each following completion of the original treatment protocol, due to a perceived slight return of a specific symptom, aiming to prevent the recurrence of their initial condition. According to the author, both individuals have not had to seek further treatment following these subsequent sessions.
One participant reported in advance of the 3-month waiting period that her pain level has decreased to 2 out of 10 on the pain scale, with ongoing improvement observed as tissue regeneration progressed.
One participant ceased treatments prematurely after the second of eight scheduled sessions, citing a lack of noticeable improvement in her symptoms.
One participant attested to the life-saving efficacy of this protocol in her 2020 video testimonial, has not experienced any recurrence of symptoms since receiving treatments in 2019.
The longest participant in this study has not seen a return of symptoms since her treatments in 2016.
As of the writing of this case study in 2024, none of the 19 participants who completed treatments have reported any recurrence of symptoms.
The author of this study concludes by recommending the use of EMS shockwave technology to treat abdominal adhesions, which he has been employing since 2008 to address abdominal adhesions and all myofascial adhesions responsible for chronic pain throughout the musculoskeletal system.