It’s common to hear someone with fibromyalgia say, "My muscles ache all over my body, all the time." However, as scientists work to understand the cause of fibromyalgia pain, they’re looking less and less at the muscles and instead focusing on a part of the body most of us don’t even know we have -- the fascia.
Evidence that the unique pain of fibromyalgia may stem largely from the fascia has lead to interest in a type of massage called myofascial release, and early evidence is promising.
What Is Fascia?You know that white, filmy layer on the outside of a chicken breast? That's what we're talking about.
Fascia (FASH-ah) is a thin but strong tissue that wraps around every muscle in your body and the structures inside the muscles. It also surrounds other structures in your body, including organs, nerves and blood vessels. Fascia forms a body-wide network of connective tissue that's essential for proper function.
Like muscle tissue, fascial tissue can become injured, inflamed and painful. Myofascial release practitioners say the fascia can form adhesions, which are places where it's bunched up and stuck together, causing the fascia to pull on other structures, create pain and impair function.
Fascia in Fibromyalgia
A condition called myofascial pain syndrome, in which fascial restrictions and trigger points cause widespread pain, is extremely common in people with fibromyalgia. In fact, fibromyalgia and myofascial pain syndrome are considered risk factors for each other. Portions of the healthcare community believe they are actually the same condition.
A 2010 review suggested that inflammation and poorly functioning fascia surrounding muscle cells were causing the all-over pain of fibromyalgia and may be due to a dysfunctional healing response.
Researcher Dr. Ginevra Liptan hypothesizes that problems with the fascia may lead to central sensitization, which is a key factor of the condition and involves the central nervous system becoming hyper-sensitive to pain. In her book, Figuring Out Fibromyalgia, she outlines her theory of how the fascia is chronically tensed and how that leads to a cascade of other symptoms.
Read my review of Dr. Liptan's book.
What Is Myofascial Release?Myofascial release, also called the "trigger point method," is a massage technique in which the therapist uses gentle, sustained pressure on the problem areas to release adhesions and smooth out the fascia.
Multiple studies show that myofascial release can result in decreased pain, better posture, reduced symptoms, increased range of motion and improved quality of life.
Myofascial Release and FibromyalgiaWe don't have a lot of research on myofascial release for fibromyalgia, but what we do have is promising.
One review suggested that we get more benefit from treating fibromyalgia pain at myofascial trigger points and other places with active pain was more effective than treating the tender points that doctors use to diagnose the condition. (Tender points are painful when pressure is applied, but they're not generally linked to active, ongoing pain.)
A study showed that 20 weeks of myofascial release improved sleep, pain, anxiety levels and quality of life in people with fibromyalgia for at least a month after the treatment ended. At the six-month mark, sleep quality was still higher but other improvements had tapered off, suggesting a need for continued treatment.
Because fibromyalgia makes us so sensitive to touch and pressure, some people are reluctant to try massage. The gentleness of myofascial release may make it easier for many to tolerate than deeper forms of massage, such as Rolfing. With any form of hands-on therapy, it's crucial to communicate with your therapist about how much pressure you can tolerate and any pain you may experience during or after treatment.
Before you try myofascial release or another form of massage, be sure to read:
Castro-Sanchez AM, et al. Evidence-Based Complementary and Alternative Medicine: eCAM. 2011;2011:561753. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia.
LeBauer A, Brtalik R, Stowe K. Journal of Bodywork and Movement Therapies. 2008 Oct;12(4):356-63 The effect of myofascial release (MFR) on an adult with idiopathic scoliosis.
Kain J, et al. Journal of Bodywork and Movement Therapies. 2011 Jan;15(1):63-7. Comparison of an indirect tri-planar myofascial release (MFR) technique and a hot pack for increasing range of motion.
Liptan GL. Journal of Bodywork and Movement Therapies. 2010 Jan;14(1):3-12 Fascia: A missing link in our understanding of the pathology of fibromyalgia.
Martin MM. Journal of Bodywork and Movement Therapies. 2009 Oct;13(4):320-7. Effects of the myofascial release in diffuse systemic sclerosis.
Meltzer KR, et al. Journal of Bodywork and Movement Therapies. 2010 Apr;14(2):162-71. In vitro modeling of repetitive motion injury and myofascial release.
Staud R. Current pharmaceutical design. 2006;12(1):23-7. Are tender point injections beneficial: the role of tonic nociception in fibromyalgia.
Walton A. Journal of Bodywork and Movement Therapies. 2008 Jul;12(3):274-80. Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon.