Painful Connections: Densification Versus Fibrosis of Fascia

• Published in: Current pain and headache reports Vol. 18; no. 8; p. 441
• Main Authors: Pavan, Piero G., Stecco, Antonio, Stern, Robert, Stecco, Carla
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.08.2014; Springer Nature B.V
• Subjects: Connective tissue; Connective Tissue - pathology; Connective Tissue - physiopathology; Fascia - anatomy & histology; Fascia - pathology; Fascia - physiopathology; Fibrosis - diagnosis; Humans; Internal Medicine; Mechanical properties; Medicine; Medicine & Public Health; Musculoskeletal Physiological Phenomena; Myofascial Pain (R Gerwin; Myofascial Pain Syndromes - pathology; Myofascial Pain Syndromes - physiopathology; Myofascial Pain Syndromes - psychology; Pain; Pain Medicine; Section Editor; Topical Collection on Myofascial Pain; Load; Densification; Lines of forces; Loose connective tissue; Overuse syndrome; Stress–strain curves; Connective tissue; Hyaluronan; Fibrosis; Aging; Mechanics; Fascia; Hysteresis
• ISSN: 1531-3433; 1534-3081; 1534-3081
• DOI: 10.1007/s11916-014-0441-4

Deep fascia has long been considered a source of pain, secondary to nerve pain receptors becoming enmeshed within the pathological changes to which fascia are subject. Densification and fibrosis are among such changes. They can modify the mechanical properties of deep fasciae and damage the function of underlying muscles or organs. Distinguishing between these two different changes in fascia, and understanding the connective tissue matrix within fascia, together with the mechanical forces involved, will make it possible to assign more specific treatment modalities to relieve chronic pain syndromes. This review provides an overall description of deep fasciae and the mechanical properties in order to identify the various alterations that can lead to pain. Diet, exercise, and overuse syndromes are able to modify the viscosity of loose connective tissue within fascia, causing densification, an alteration that is easily reversible. Trauma, surgery, diabetes, and aging alter the fibrous layers of fasciae, leading to fascial fibrosis.