Fascia: A Hidden Piece of Fibromyalgia Pain

Fascia: A Hidden Piece of the Puzzle of Fibromyalgia Pain – Fibro News Daily | April 25, 2017 | By Ginevra Liptan, MD

Many studies have shown that the fibromyalgia nervous system has become sensitized and therefore has overactive responses resulting in pain.

This is the target of the three FDA approved medications for this illness, and these medications can indeed be helpful—usually resulting in about 30 percent reduction of pain.

In my experience, both as someone with the illness personally and as a physician treating fibromyalgia, utilizing these medications alone is inadequate. 

For me, I didn’t find any relief from that deep, burning ache in my neck and upper back muscles until I found a treatment that addressed my pain in a different way.

It turns out there is another huge factor that may be the missing piece of the pain puzzle

The massive connective tissue network that surrounds all of our muscles—think of the shiny outer coating on a raw chicken breast—plays a key role in generating the pain and muscle tenderness of fibromyalgia.

In order to get more effective pain relief, both patients and providers need to understand exactly how this connective tissue (also called fascia) contributes to fibromyalgia pain, and use this information to target treatment.

Medical understanding has lagged behind on this vital component of the body, but is finally catching up.

The first Fascia Research Congress was held at Harvard in 2007 and started a tidal wave of research.

We know that fascia is a continuous network of web-like connective tissue that envelopes all our muscles.

This network of connective tissue contains lots of pain-sensing nerves and is about as sensitive to pain as our skin.

Fascia can also contract, or tighten, in response to “danger” signals from the brain.

Fascia is the connective tissue “armor” of the body, tightening immediately in response to signals from the many nerves running throughout it. 

This provides strength in emergency situations and can be life-saving in the short-term.

Researchers believe that a rapid contraction of the fascia is what creates the enormous extra strength that humans can produce in emergencies; for example, when a mother overpowers a mountain lion that is attacking her child, as happened recently in Colorado.

In fibromyalgia we know that the brain is mistakenly triggering the danger or “fight-or-flight” alarm bells all the time, instead of only in emergencies.

This occurs not in our thinking brain, but in those areas that control basic housekeeping functions like breathing and digestion. Sustained danger signals from the brain to the muscles results chronically tight muscles.

As research advances, we are learning that the tightness lies not only in the muscles themselves but also in the fascia, that connective tissue casing that surrounds the muscles (think of the casing around a sausage that surrounds and contains the meat inside)

This is one of the best analogies for connective tissue function in the muscles (it’s everywhere else in the body too).

And this sustained tightness of the fascia not only

  • causes pain, it also
  • generates inflammation, and
  • contorts the muscles into painful knots called trigger points.

If you want to dive more into the science supporting the role of fascia in fibromyalgia pain, you can read more in my article for Journal of Bodywork and Movement Therapy.

The treatment that has helped me the most personally is a form of manual therapy called myofascial release (MFR), specifically the John F. Barnes Myofascial Release Approach.

This technique involves a combination of sustained manual traction and prolonged gentle stretching of fascia and is by the far the most effective treatment I have found to unstick the fascia and reduce fibromyalgia pain.

Two large European studies found that after 20 sessions of myofascial release, fibromyalgia subjects reported significant pain reduction.

20 sessions of any treatment are far more than the vast majority of people can afford – money-, energy-, or time-wise.

All the manual therapies require repeated treatments, so insurance companies would much rather pay for pills.

What is really great, though, is this provided more long-lasting pain relief, with most still reporting reduced pain levels one month after their last session.

Wow, it lasted for ONE month (out of the decades of pain we experience). I’m sorry, but 20 treatments (at 2/week, this would take over 2 months) for one month of relief seems unsustainable.

There are also several ways you can treat your own fascia.

Learning these self-care tricks may be the most important step you take to manage your pain, and are a huge emphasis in my clinic’s treatment program.

It seems that self-treatment is the only reasonable option for these kinds of manual therapies because otherwise, you’d have to be seeing a practitioner all the time.

One way is to place a small, soft ball under any tight and painful areas of muscle. Allow yourself to sink onto the ball for a few minutes to provide the right amount of sustained pressure to allow the fascia to release.

Some resources

  • To learn more about myofascial release and find a therapist in your area, visit myofascialrelease.com or mfrtherapists.com. You can also check out my clinic’s video that shows MFR in action.
  • To learn more about Rolfing, or find a therapist in your area, www.rolf.org To find an osteopathic physician (DO) who performs OMT go to www.osteopathic.org.
  • Learn how to do self-myofascial release with Myofascial Stretching: A Guide to Self-Treatment by Jill Stedronsky and Brenda Pardy available on amazon.com
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