Chronic pain can range from daily discomfort to debilitating, but wherever you fall on the scale, you are suffering. The most common type of chronic myofascial pain is head and back pain, followed by joint pain. While chronic pain tends to be more common as we age, it can affect anyone, depending on their condition and whether their pain was caused by an injury. Thanks to emerging research, the root cause of much of our chronic pain is becoming more clear, opening opportunities for more precise treatments and much needed relief. The evidence points to the fascia, an area of the body some researchers have deemed a “new organ.”
What is Fascia and How Does it Function?
Fascia is found throughout the body and holds every organ, blood vessel, nerve fiber, bone and muscle in place. The fascia forms complex connective tissue made mostly of collagen, a protein that creates strength and flexibility in the fascia. Between its multiple layers is a liquid called hyaluronan that helps the fascia stretch with your movement. Trauma and inflammation can cause the hyaluronan to dry up, leading to damaged fascia. When the body is stressed, the fascia tightens up, leading to limited mobility, pain and other conditions.
Fascia’s Role in Chronic Pain
The role fascia plays in debilitating conditions has only recently been discovered.
Discoveries were made possible by previously unavailable technologies that allowed researchers to view the fascia while still inside the body. Previously it was removed and lost much of its important structure. This is a great example of the exponential growth that technology allows for in medical science. Historically, fascia was thought of as only an inert support structure, but many researchers now agree that the fascia should be considered its own organ. Significantly, it’s the only tissue that modifies its consistency when under stress. Researchers also believe the biological activities that happen within the fascia explain some connections between health and lifestyle.
Interestingly, there are very few diseases that the fascia doesn’t play a role in due to its relationship to the body. Every structure is either connected with or enveloped by fascia. So far, research has indicated that structural integration bodywork has improved certain physical symptoms in patients with chronic fatigue, neck pain, and muscular dystonia. Beyond movement, evidence is pointing to the impact the fascia has on cancer, lymphedema (swelling due to build-up of lymph fluid), and gastrointestinal distress. One cancer study in 2018 led by Harvard Medical School researchers indicated that stretching reduced breast tumor growth in mice. More research will be needed before this science could be applied to humans, but it’s encouraging to know we may soon have another defense against breast and other cancers.
Fascia and Chronic Pain Treatment and Prevention
Chronic pain is an area I’ve worked with extensively in my two decades as a physician. The solution to chronic pain is never one dimensional. Getting relief requires a holistic approach, continuity of care and support for lifestyle change.
Evidence-based treatment is led by a thorough investigation into the source so we can target pain with a combination of physical therapy, lifestyle change, and medication, as appropriate.
Treatment care plans will vary depending on the client, but here is an example of how treatment and prevention would look for someone presenting with chronic back or shoulder pain. You will notice that the treatment and prevention methods are targeted at the fascia.
Typically I take a three-pronged approach, beginning by identifying and treating any underlying factors that may be leading to the chronic myofascial pain, such a muscle dysfunction, poor posture, anxiety disorder or any offending medications they may currently be taking.
The next step is manual therapy, dry needling or trigger point therapy. Trigger point therapy is the injection of a procaine solution into specific areas of muscular adhesions, or “knots” in the vernacular localized in the lower back or shoulder, for example. Depending on how chronic the complaint is, it may require on average 5-10 treatment sessions.
The focus then turns to prevention and building resilience through gentle stretching and strengthening.
Other treatments may include medications, massage, heat and what I consider “the foundations” such as stretching, yoga, healthy nutrition, optimal hydration, optimal sleep, stress reduction and the avoidance of substances like alcohol, cigarettes, illicit drugs.
Chronic Pain’s Effect on Mental Health
Chronic pain also has a significant impact on your mental health. Being in constant discomfort or pain takes a toll, so it’s important to integrate psychological interventions into a client’s care plan. This can include cognitive behavioural therapy and mindfulness-based stress reduction. In fact, a number of randomized controlled trials provide evidence that psychological interventions lead to clinical improvements in chronic pain in 30-60% of patients compared to 20-30% in the control group, at 18 and 52 weeks respectively.
Chronic Pain Solution
Finding a solution to your chronic pain can feel daunting if you are on your own. Having professional expertise, guidance, and support on the therapeutic options that are currently available to you could make all the difference in your life. Chronic pain relief requires a multidisciplinary approach with a personalized combination of treatment methods – one size does not fit all. At Harrison, we stay up to date on the latest research and treatments to help you achieve a pain free life. We’re here for you.
Chronic Pain and Fascia inflammation FAQs
Fascia inflammation can manifest as a sensation of tightness or stiffness throughout the body. Individuals may experience a dull, achy pain that is consistent and persistent, sometimes intensifying with movement or touch. The pain is often hard to localize and may not respond to traditional methods of pain relief. It can feel like the pain is spread out beneath the skin, following the web-like pattern of the fascia itself.
Hydration and nutrition play crucial roles in maintaining fascia health. Proper hydration keeps the fascial tissue supple and elastic, allowing it to move smoothly against muscles and other structures. Nutrition-wise, a diet rich in anti-inflammatory foods can help reduce inflammation within the body, including the fascia. Vitamins such as C and B complex, magnesium, and omega-3 fatty acids are particularly beneficial for fascial health.
Yes, there is a link between stress and fascia inflammation. Stress triggers the release of cortisol, a hormone that, in high levels, can lead to inflammation throughout the body, including in the fascial tissues. Chronic stress can cause the fascia to tighten and become rigid, leading to increased pain and decreased mobility. Mindfulness and relaxation techniques may help manage stress and, in turn, reduce fascial inflammation.
Sleep is vital for managing fascia inflammation as it is during sleep that the body repairs and rejuvenates itself. Quality sleep allows for the natural healing processes to take place, including the reduction of inflammation. Poor sleep can exacerbate pain and inflammation, making it harder for the fascia to heal and remain healthy. Ensuring a regular sleep schedule and creating a restful environment can thus contribute to better fascial health.
Posture significantly affects fascia health and chronic pain. Poor posture can lead to imbalances in the fascial network, causing certain areas to become overstrained and tight, while others become weak and underused. This imbalance can create a cycle of pain and dysfunction. Conversely, maintaining good posture helps to distribute stress evenly throughout the body, reducing the risk of fascia-related pain. Regular practice of posture-correcting exercises and being mindful of body alignment can make a significant difference in fascia health and overall well-being.
