Fascia: A Hidden Piece of the Puzzle of Fibromyalgia Pain

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Maybe you have heard somewhere from tv or any doctor that fibromyalgia is caused by over-activity of pain sensing nerves. It’s true, this is one important basis of fibromyalgia pain, but there are some even more significant things that can bring out pain, that may be noticed to get your reduced. And unluckily may be your doctor has no knowledge of them.

It is shown by many studies  that the fibromyalgia patients nervous system has become sensitized and it leads to overactive responses that leads to pain. The three FDA approved medications have this goal for this illness, and these medications can certainly be helpful—and can cause 30 percent reduction of pain.

According to my point of view, theses alone medicines are insufficient, if you are a doctor treating this illness or a patient experiencing it. For me, my burning dull pain in my neck and upper back muscles still hurt and pain was not reduced until I found a treatment that addressed my pain in a different way. May be there is some factor in pain puzzle that is still missing and not understood yet.

The massive connective tissue network that surrounds all of our muscles—imagine a shiny outer coating on a raw chicken breast—plays an important role in generating the pain and muscle tenderness of fibromyalgia. If you want more effectual pain relief, both patients and providers need to understand the role of this connective tissue (also called fascia) in generating fibromyalgia pain, and apply information to get target treatment.

If you gently bend your head to the side, you will able to feel your own fascia, as if trying to rest your ear on your shoulder. You will feel a pulling or stretching sensation on the opposite side of your neck, from shoulder to jaw. What you are feeling is definitely not actually stretching of the muscle, it is misunderstood—there is no one muscle present that runs from your shoulder to your ear—it is actually the stretching of the fascia surrounding and it involves all the muscles between those two points.

Medical understanding has not enough information about this important component , they fail to keep up with others in this studies. The first Fascia Research Congress was held at Harvard in 2007 and started a wide spread and overwhelming research. Fascia is a unremitting network of web-like connective tissue that envelopes all our muscles. This network of connective tissue contains lots of pain-sensing nerves and it is about as sensitive to pain as our skin. Fascia can also contract, or squeeze, when receive “danger” signals from the brain.

Fascia is the connective tissue “protective covering” of the body, contracting instantly in response to signals from the many nerves running all the way through it. This provides power in crisis situations and can be life-saving in the very short time. According to research a rapid tightening of the fascia is responsible for  the massive 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 erroneously triggering the danger or “fight-or-flight” alarm bells all the time, instead of only in emergencies. This not occurs in our thinking part of the brain, but in those areas that are responsible for controlling basic maintenance functions like breathing and digestion. Constant danger signals from the brain to the muscles results chronically tight muscles.

In advances research, we came to know that the tautness is not present in muscles only, but it also involves fascia. It is the connective tissue covering that environs the muscles (think of the covering around a sausage that environs and contains the meat inside). And this unremitting tightness of the fascia not only causes pain,  it also generates irritation and swelling, and twist and bend the muscles into painful knots called trigger points. If you want to submerge more into the science that supports the role of fascia in fibromyalgia pain, you can read more in an article for Journal of Bodywork and Movement Therapy.

A lot of studies have established the effectiveness of treatments that decrease stress and that can “unstick” painful knots in the muscles and surrounding fascia. The treatment that personally benefited is a form of Manual therapy called myofascial release (MFR), specifically the John F. Barnes Myofascial Release Approach. This method involves amalgamation of constant physical grip and extended mild stretching of fascia and is most effective treatment until now. I have found to unstick the fascia and decrease fibromyalgia pain.

Two large European studies found that after 20 sessions of myofascial release, fibromyalgia subjects reported noteworthy pain lessening. It was  great, although, is this provided more long-lasting pain release, with most still reporting reduced pain levels one month after their last session.

I suggest that my patients at least try two to three MFR sessions to decide if it will help them or not. It may momentarily cause increased muscle tenderness, comparable to what you feel right after powerful exercise. Muscle pain should be much better than it was before after a day or two, previous to the session. If you find it useful, I suggest going once or twice a week for about eight weeks, alike to a typical schedule for corporal treatment. After that it can be done as needed for pain flares. Most therapists will also teach you techniques using balls or other tools that you can do at home to expand the advantage of each treatment.

In addition to myofascial release, there are a few other manual therapies that can treat uptight and painful fascia. Rolfing Structural Integration, or Rolfing™, is a manual therapy that approaches fascial treatment a little differently but can also be more useful. A form of hands-on treatment developed more than 50 years ago, Rolfing focuses on the fascia around the joints, with treatment giving special importance to correct stance and joint arrangement in a series of 10–12 sessions.

A connected therapy is osteopathic manipulative treatment (OMT), a mishmash of moderate stretching and force on the muscles and joints. As this treatment is performed by physicians (usually osteopathic physicians) it is often covered by indemnity. Health care providers can also carry out trigger point injections to break up the painful muscle knots.

You can treat your own fascia in many ways. Having knowledge of these self-care tricks may be the most significant step you take to manage your pain, and have a massive importance in my clinic’s treatment program. One way is to place a small, soft ball under any tight and painful areas of muscle. Allow yourself to go under the ball for a few minutes to provide the right amount of constant force to allow the fascia to let go.

Finally, Yin yoga (also called restorative yoga) is a slow, mild form of yoga that includes supported stretching using props such as pillows and bolsters to settle into a relaxed position for numerous minutes, allowing the fascia to melt and becomes softer. Go for yin yoga classes or videos to study and perform the poses.

Accepting the role of fascia to fibromyalgia pain expands our treatment options. Surely pain from the fascia is not the whole story of fibromyalgia pain—a hypersensitive nervous system that over-reacts is also the problem, and we have to look into it. But in my understanding, tautness in the fascia is the flicker that lights the pain fire and needs to be treated in order to have effectual pain relief.

Reviewed by: Dr. Muniba , MD MBBS, FUMDC.

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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