the myofascial web

Myofascial Web and Fibromyalgia

Fibromyalgia Information Foundation 2014 Annual Conference

Ginevra Liptan, MD

Fibromyalgia (FM) pain

Hyper-reactive spinal cord and brain called “central sensitization”

Pain generated from muscle tissue

18 tender points used to diagnose FM

Fibromyalgia muscle pain sources

-Fascia –connective tissue around muscle

-Myofascial trigger points

What is fascia?

Connective tissue network Surrounds both individual and

groups of muscles Highly sensitive to pain Contracts to give muscles

extra strength

Myofascial “web”

Connective tissue that envelopes muscles

Connective tissue that’s left after muscle cells dissolved

Fascia in FM

Increased tension

Inflammation

Prone to “ knotting up”( myofascial trigger points)

Myofascial trigger points

Hyper-irritable or taut band of muscle

Painful on compression

Refers pain

Can occur in any muscle under strain

Myofascial trigger point

Treatments for fascia/trigger points

Myofascial release (MFR)

Trigger point injections

Self-care

Myofascial release therapy

Manual traction and prolonged assisted

stretching

Breaks up painful adhesions in the

connective tissue surrounding muscle

MFR is not massage

Myofascial release for FM

Castro-Sanchez et al . 2011

20 weeks myofascial release therapy

Compared to sham ultrasound

Significant improvement in pain and tender

points

Pain reduction persisted at 1 and 6 months

post-intervention

Our study- MFR vs. massage

Women between the ages of 21 and 50 with a confirmed FM diagnosis

Randomized to myofascial release or Swedish massage

Therapists had advanced training using the John F. Barnes MFR approach

90 minutes weekly for 4 weeks

FIQ-R Percentage Change in Myofascial Release Subjects

Pe

rce

nta

ge

ch

an

ge

in F

IQ-R

Myofascial release subjects 1–8

A change of 14% or more is considered significant

FIQ-R Percentage Change in Massage Subjects

Pe

rce

nta

ge

ch

an

ge

in F

IQ-R

Massage subjects 1–4

A change of 14% or more is considered significant

Trigger point injections

Injection of lidocaine

“Dry needling”

Trigger point self-treatment

Resources

www.theracane.com

www.myofascialrelease.com

Book: The Trigger Point Therapy Workbook: Your Self- Treatment Guide for Pain Relief by Clair Davies

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