Fascial Restrictions and Chronic Pain

manual medical massage - releasing the fascia

manual medical massage – releasing the fascia

Chronic pain seems to be so prevalent these days. According to the National Institute of Neurological Disorders and Stroke, about 80 percent of adults experience low back pain at some point in their lives. Sometimes the pain goes away on its own, other times it lingers and becomes a chronic condition (defined as persisting for 12 weeks or longer), and many people have to deal with chronic pain for years (the author included!).

While there are many potential causes of the initial pain, it often can become a chronic condition because of the fascial restrictions that result from the injury. What is fascia? Fascia is the connective tissue in your body beneath the skin that attaches and stabilizes muscles and internal organs. There are several layers of fascia, which include your muscular and visceral tissues. It looks like a spider’s web or a sweater, and it is a continuous structure throughout your body, so everything is connected! 

Restrictions can occur in fascia from every day activities and the regular stressors we all experience, which usually are easily worked out with exercise, stretching, yoga and regular bodywork. All of these provide a very healthy maintenance system for your musculoskeletal system, and we all probably need to take better care of our bodies. Restrictions will definitely occur after any kind of trauma or injury, and these are the kinds of restrictions that your fascial system tends to hold on to in an effort to guard against repeated injury. This is especially common with low back pain — there could be nothing structurally wrong in a low back, but tightness in the surrounding muscles or fascia will result in chronic pain anyway. It takes time to retrain the fascial system to not behave defensively and let the body return to its normal activities; it’s as if your fascia has a memory of the injuring trauma and goes into protective mode. Then it likes to stay in that mode. Protective mode tends to mean tightness and being “on guard,” which then promotes more adhesions or other restrictions in the tissue, which limits blood flow and oxygen, which results in pain.

What can help? Our muscles and most of our fascia are retrainable, which is great news! For chronic pain, it is important to work through the muscles and other fascia to release the adhesions and retrain those tissues. Exercises and stretching can be very helpful too, if you consult with a physical therapist or a personal trainer with experience in the issues you are experiencing. And of course if anything structural is a problem, then a chiropractor visit would be in order. But before seeing all kinds of specialists, often it’s enough to just get some regular massage and bodywork from a licensed massage or bodyworker therapist. This can be enough to alleviate the restrictions and let the muscles both get to know and also embrace a new normal. Sometimes the fascial restrictions can also contribute to a structural misalignment because the muscles are so used to being in an incorrect position, and they prefer to stay how they are. So before you see that chiropractor, do your body a favor and get a massage first!