Myofascial Therapy for the Treatment of Acute and Chronic Pain
Myofascial therapy relieves soft tissue restrictions that induce pain. Some causes of chronic myofascial pain or lower back pain are easier to diagnose than others: trauma (such as a car 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 significant 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 known as trigger points.
What is Fascia?
Fascia is a three-dimensional web that permeates the whole 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 pliable, and can develop 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 through the top of the head and has three layers:
- Superficial fascia, which lies directly 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 cranial sacral system.
Fascia restrictions can develop within any or all of the layers.
Myofascial release (MFR) therapy concentrates on releasing muscular shortness and tightness. There are a variety of conditions and symptoms that myofascial release therapy addresses.
Many individuals seek myofascial treatment after losing flexibility or function following an injury or if experiencing ongoing 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 usually include:
- Tightness of the tissues that restricts motion or pulls the body out of alignment, causing people to favor and overuse one hip or shoulder, as an example
- A feeling of excessive pressure on muscles or joints that causes pain
- Pain in any part or parts of the body, including headache or back pain.
Causes of Myofascial Pain
Myofascial pain can have two sources. Pain can be generated from the skeletal muscle or connective tissues that are 'bound down' by tight fascia. In addition, pain can also be generated from damaged myofascial tissue itself, sometimes at a 'trigger point' where a contraction of muscle fibers has occurred. In either case, the restriction or contraction prevents blood flow to the affected structures, therefore accentuating the contraction process further unless the area is treated.
The goal of myofascial therapy is to stretch and loosen the fascia so that it and other contiguous structures can move more freely, and the individual's motion is restored. Because of this, 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?
Several kinds of health professionals can offer myofascial release therapy, including properly trained osteopathic physicians, chiropractors, physical or occupational therapists, massage therapists, or sports medicine/injury specialists. Specific training and courses in Myofascial Release Therapy are usually necessary and can be extensive to attain a high level of competency.
Therapy sessions follow a pattern similar to physical therapy for post-operative rehabilitation. An initial appointment will be dedicated 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 treatment sessions may:
- Last at least 30 but ideally 50 minutes or more per session
- Be conducted everyday or every few days
- Occur at outpatient clinic or health center
- Have a trained therapist provide hands-on treatment in a relaxing, private therapy room
- Occur 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 gentle 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 felt by the patient.
Additional Treatments with Myofascial Release Therapy
Myofascial therapy can be a predecessor and complement to other treatments. Patients who participate in myofascial therapy also may benefit from other types of nonsurgical care that aim to control pain and keep muscles and joints warm and loose. These consist of:
- Using non-prescription pain relievers such as acetaminophen or ibuprofen
- Applying heat to relieve constricted muscles or using ice to relax swollen areas
- Performing self-stretching exercises to preserve flexibility and increase range of motion or aerobic exercise to increase blood flow to the impacted 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 prior to sports competitions.
By targeting particular areas of the fascial system, myofascial therapy can help prepare patients for more aggressive forms of strengthening, or offer pain relief for patients with restricted flexibility and movement, thus allowing individuals to resume normal movement and better function.
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