man with myofascial pain and inflammation

The Connection Between Fascia & Chronic Pain

Fascia: What Exactly Is This Stuff?

You’ve probably heard the term fascia—pronounced /fa-shuh/—popping up more and more in medicine these days. Although certainly not a “new” discovery, fascia has achieved buzzworthy status as we come to understand more about its significance. Composed of firm but flexible collagen, fascia forms a complex system of connective tissue that permeates every corner of your body. More specifically, your fascia coats the underside of your skin, muscles, brain, and each and every vein in your body.

We can get a better understanding of fascia by visualizing the structure of a grapefruit. (Although this may not be the most appetizing visual, it will definitely help in understanding the purpose of fascia.) Okay … now, back to the grapefruit! The rind of the grapefruit represents our skin. And, the fruit inside of the grapefruit symbolizes all of our internal organs and muscles. The white pith that coats the underside of the rind and the exterior of each sliver of fruit? That connective pith is your fascia.

The pith of a grapefruit to represent fascia in analogy.

In addition, this white pith even contains strands that extend down between each piece of fruit. Likewise, the thin skin on the outside of each juicy fruit section mimics fascia in both appearance and function. And, if you take a closer look, a group of small tear-shaped particles unites to compose each sliver of fruit. The white pitch (aka. the fascia) also encapsulates each of these miniscule particles.

Long story short, if the grapefruit didn’t contain its own form of fascia, it would dissolve into a ball of mush. Essentially, fascia is the substance that binds your organs—and organ systems—together. It’s the glue that holds you and me together!

Fascia is formed from extracellular matrix including collagen fibers.

What Does Fascia Actually Do?

On a fundamental level, fascia functions as the cellophane wrap for every part of our internal body. Its primary objective? Firm yet flexible support while creating and maintaining the basic form and structure of the body. Moreover, your fascia promotes the smooth and pain-free movement of your tissues and organs. Your fascia accomplishes this by wrapping around your muscles to prevent friction as these structures shift against your bones. Likewise, your fascia coats your veins and arteries to reduce any abrasion from smooth muscles that power your circulation. And, your fascia also encapsulates your fragile organs to enable fluid, non-abrasive shifts in position as we move about our day.

What Does Fascia Have To Do With Pain?

Up until now, we have been led to believe that fascia functions purely as a supportive tissue. Although fascia helps to hold things together and aids in movement, the reality is far more complicated. In truth, our fascia also plays a key role in our movement and exists as some of the most innervated tissue in our body. Yes, fascia also coats your nerves. What does this translate to? Unfortunately, for a select few—chronic pain. And, because we can find fascia in widespread locations throughout the body, irritated fascia can cause lower back pain, neck discomfort, and joint inflammation.

Indeed, a number of adverse circumstances can lead to fascial damage and subsequent pain. Accidents, abnormal posture, repetitive movements, overextension injuries, or inactivity can all lead to fascial damage.

What is Fascial Adhesion?

However, there is some good news: Fascia can heal itself. The problem with this? Fascia doesn’t typically heal in its original configuration. Instead of restoring to its previous flat and smooth texture, fascia may heal into a jumbled clump. Called fascial adhesion, fascia can literally stick to existing muscle or developing scar tissue. As fascia stiffens through adhesion, fascia—rich in nerve endings in and of itself—can entrap surrounding nerves, leading to radiculopathy and a host of painful consequences. Likewise, fascial adhesion limits the independent motion and friction-reducing capabilities of fascia. This leads to muscles that cramp and spasm, as well as nerves that consistently misfire.

All of these instances of improper healing can lead to pain and discomfort. Moreover, because all fascia is interconnected, local damage to fascia can result in global pain. Even in areas of the body that don’t seem to make any sense. For example, damaged fascia in the foot—known as plantar fasciitis—can lead to discomfort in remove bodily areas, such as the shin. In rare cases, a patient with plantar fasciitis may feel pain as far away as in his or her shoulder!

To add fuel to the fire, medical practitioners cannot easily image and view fascia. In fact, modern imaging techniques can barely detect fascia. At least, not well enough for doctors to make a definitive diagnosis. For this reason alone, pain caused by fascia often gets overlooked by the medical community. Before you know it, you’ve already visited 10 different specialists, without receiving any useful information about the source of your pain. Don’t fret, however! Although doctors once expressed skepticism about fascial pain, more clinicians than ever before acknowledge the intimate connection between fascia and chronic pain.  And, finally, a diverse range of options exist to address and resolve fascial pain.

What Can We Do To Keep Our Fascia Happy & Healthy?

Movement: To keep your fascia happy, keep it moving. You can accomplish this in any number of ways. (Spoiler alert: Not all of these interventions involve a lot of strenuous exercise and sweating!) Yoga, Tai Chi, dance, and swimming, for example, will keep your fascia moving without the need for fancy gym equipment, boot camps, and treadmills.

Massage: Looking for a professional, who is especially adept at treating fascial adhesions? Look no further than your local massage therapist. Addressing fascia involves an in-depth knowledge of the interconnectedness of fascia with your muscular and skeletal systems. And, massage therapists must undergo specialized training devoted specifically to this topic.

Rolfing: Named after the doctor who developed it, rolfing addresses the body as a whole through deep tissue massage and myofascial manipulation. Certified practitioners will address your pain by realigning the entire body and encouraging better posture.

Man with fascial adhesion receives deep tissue massage from rolfing expert.

Have you exhausted conservative interventions without finding solutions for your pain? Seek the expert advice of a board-certified, orthopedic surgeon. A qualified orthopedist can recommend a fascial specialist (such as a chiropractor) or address any pinched nerves at their source. For plantar fasciitis and myofascial pain relief, contact NJ Spine & Orthopedic today to set up your consultation or free MRI review!

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