Myofascial Therapy for the Treatment of Acute and Chronic Pain
Myofascial therapy eases soft tissue restrictions that cause pain. Some causes of chronic myofascial pain or low back pain are easier to identify than others: trauma (such as an automobile accident or fall), cumulative posture misalignment or mechanical deficits, a compressed nerve from a herniated disc, or inflammatory conditions.
When pain is caused by myofascial tightness within the fascial system (the web of connective tissue that spreads throughout the body and surrounds every muscle, bone, nerve blood vessel, and organ to the cellular level) the diagnosis is more difficult, as fascia restrictions do not show up on MRI scans or X-rays. Yet, those restrictions can play a major role in creating pain and malfunction in the structure of the spine, extremities and organs.
What Is Myofascial Therapy?
Myofascial Therapy (also called myofascial release therapy or myofascial trigger point therapy) is a form of safe, low load stretch that releases tightness and pain throughout the body caused by myofascial pain syndrome, which describes chronic muscle pain that is worse in specific areas called trigger points.
What Is Fascia?
Fascia is a three-dimensional web that permeates the entire body. The most effective way to picture the expanse of the fascial system is to think of it as a layer of connective tissue (similar to a tendon or ligament) that starts with the top layer directly below the skin, and extends to two deeper layers.
When the fascia is in its normal healthy state it is a relaxed and flexible web - like the weave in a loose-knit sweater. When it is restricted, it is more rigid and less flexible, and can create pulls, tensions, and pressure as great as 2,000 pounds per square inch. The fascia is a continuous system, running from the bottom of the feet to the top of the head and has three layers:
- Superficial fascia, which is located right below the skin. It stores fat and water, allows nerves to run through it, and allows muscle to move the skin.
- Deep fascia, which surrounds and infuses with muscle, bone, nerves, and blood vessels to the cellular level.
- Deepest fascia, which sits within the dura of the craniosacral system.
Fascia restrictions can occur within any or all of the layers.
Myofascial release (MFR) therapy focuses on releasing muscular shortness and tightness. There are a variety of conditions and symptoms that myofascial release therapy addresses.
Many patients pursue myofascial treatment after losing flexibility or function following an injury or if experiencing recurring back, shoulder, hip, or virtually pain in any area containing soft tissue.
Other conditions treated by myofascial release therapy include Temporo-Mandibular Joint (TMJ) disorder, carpal tunnel syndrome, or possibly fibromyalgia or migraine headaches. Patient symptoms generally include:
- Tightness of the tissues that restricts motion or pulls the body out of alignment, causing individuals to favor and overuse one hip or shoulder, as an example
- A sense of excessive pressure on muscles or joints that causes pain
- Pain in any part or parts of the body, including headache or back pain.
Sources of Myofascial Pain
Myofascial pain can have two sources. Pain can be produced from the skeletal muscle or connective tissues that are 'bound down' by tight fascia. In addition, pain can also be produced from damaged myofascial tissue itself, sometimes at a 'trigger point' where a contraction of muscle fibers has occurred. In either situation, the restriction or contraction prevents blood flow to the affected structures, therefore accentuating the contraction process further unless the area is treated.
The objective of myofascial therapy is to stretch and loosen the fascia so that it and other contiguous structures can move more easily, and the patient's motion is restored. For this reason, myofascial therapy is sometimes referred to as 'myofascial release' therapy. It might also be referred to as 'myofascial trigger point therapy' by others.
Who Offers Myofascial Release Therapy?
Many different types of health professionals can provide myofascial release therapy, including properly trained osteopathic physicians, chiropractors, physical or occupational therapists, massage therapists, or sports medicine/injury specialists. Distinct training and courses in Myofascial Release Therapy are generally necessary and can be extensive to acquire a high level of proficiency.
Therapy sessions follow a pattern similar to physical therapy for post-operative rehabilitation. An initial consultation will be devoted to locating the areas of the fascia that appear to be restricted, and measuring the level of loss of motion or loss of symmetry in the body. Future therapy sessions might:
- Last a minimum of 30 but optimally 50 minutes or more per session
- Be administered daily or every few days
- Take place at outpatient clinic or health center
- Have a trained therapist provide hands-on treatment in a relaxing, private therapy room
- Take place over a few weeks or months, depending on the nature and intensity of disability.
The specific releases to different parts of the body vary, but generally include mild application of pressure or sustained low load stretch to the affected area. Progress is gauged by the level of improved motion or function experienced, and/or decrease in pain experienced by the patient.
Additional Treatments with Myofascial Release Therapy
Myofascial therapy can be a precursor and complement to other treatments. Patients that participate in myofascial therapy also may benefit from other forms of nonsurgical treatment that aim to manage pain and keep muscles and joints warm and loose. These include:
- Using non-prescription pain relievers such as acetaminophen or ibuprofen
- Applying heat to relieve constricted muscles or using ice to calm swollen areas
- Conducting self-stretching exercises to maintain flexibility and increase range of motion or aerobic exercise to increase blood flow to the affected areas.
Myofascial therapy can also enhance or assist other treatments to increase their effectiveness such as acupuncture, manipulation, physical therapy, or occupational therapy. Myofascial release therapy can also improve skeletal and muscular alignment before a surgery, or help athletes acquire better alignment before sports competitions.
By targeting certain areas of the fascial system, myofascial therapy can help prepare individuals for more vigorous kinds of strengthening, or provide pain relief for individuals with restricted flexibility and movement, therefore allowing individuals to return to normal movement and greater function.
