Issue link: https://www.massageandbodyworkdigital.com/i/766890
IS FASCIA CONNECTED TO FIBROMYALGIA PAIN? Fascia, often referred to as connective tissue, is a continuous network of weblike tissue that surrounds, supports, and gives form to the other tissues of the body. The densest fascia envelops the muscles grossly and surrounds every bundle of muscle fibers and each individual muscle cell. This connective tissue is richly innervated, highly vascularized, and very sensitive to pain. The fascia surrounding muscles actually contain more pain-sensing nerves than the muscle cells themselves, akin to the pain sensitivity of our skin. Fascia is not just an inert covering wrapped around the muscle. It has a contractile ability, especially in response to activation of the sympathetic (fight-or- flight) nervous system. There are direct nerve linkages from the sympathetic nervous system to the fascia, and the fibroblasts (the primary cells of the fascia) have specific receptors for the chemicals secreted by this nervous system. Researchers believe rapid contraction of the fascia in response to sympathetic nervous system 50 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 1 7 Author Ginevra Liptan, MD, has fibromyalgia that was diagnosed in medical school and that forced a medical leave of absence. It was only when she found the appropriate manual therapy that she was able to get enough pain relief and improvement to get back to completing her medical training. She says John Barnes's Myofascial Release Approach was the most effective pain- relieving treatment she found. The benefit she received from this fascia- focused manual therapy led her to study the role of fascia in causing fibromyalgia pain, with more and more studies now confirming the key role that tight and inflamed fascia plays as a pain generator in fibromyalgia. 2 activation is what creates the enormous extra strength that humans can produce in emergencies; for example, when a woman lifts a 2,000-pound car to rescue her child, or fights off a much stronger male attacker. 3 What happens if the sympathetic nervous system goes haywire and is continually activating fascial contraction and tension? That scenario is what results in the widespread muscle pain and tenderness seen in fibromyalgia. PATHOPHYSIOLOGY OF FIBROMYALGIA In general, medicine has been slow to grasp the contribution of fascia to chronic musculoskeletal pain, although this is slowly changing. To effectively address this complex condition, the massage therapist must first understand the pathophysiology of the disorder. Fibromyalgia is characterized by widespread muscle pain, tenderness to touch, and fatigue; it affects an estimated 10 million people in the United States. The majority of patients are middle-aged women, although it is now being recognized