It’s easy to blame pain on muscles, particularly after a day of physical exertion, or you may blame tender joints as the source of discomfort. Often, though, neither of these is the primary culprit. Instead, look to myofascial tissue, connective layers that surround and support blood vessels, bones, muscles, nerves, and organs.
Sheets of myofascial tissue seem to be one piece, but in fact they’re made from layers separated by a slick liquid called hyaluronan, which reduces friction and facilitates movement and stretching. Fascia has its own nerve network that’s almost as sensitive as skin, and the musculoskeletal pain you’re feeling may originate in the fascia.
At Southern Westchester Orthopedics & Sports Medicine, we consider the effects of myofascial dysfunction when evaluating your pain. Myofascial pain syndrome could be the source of lingering chronic pain, characterized by the presence of trigger points, or areas of stressed fascia. As injection treatment specialists, we offer trigger point injections to break up these myofascial scars.
An ultra strong tissue made of a web of collagen and elastin fibers, myofascial tissue envelopes virtually every component in your body. For example, myofascial tissue surrounds individual muscles, providing a slippery, low-friction interface so adjacent muscle groups can slide easily against each other, even when they move in different directions.
Fascia stretches and contracts to account for movement, protecting and supporting internal organs and then returning them to their original positions. When healthy, myofascial tissue is flexible, relaxed, and soft.
Inflammation and injury can cause normally relaxed myofascial tissue to bunch up in tight masses known as adhesions or knots. Hyaluronan dries up, and the local region around an adhesion becomes sticky and restricted in motion.
These localized adhesions develop into myofascial trigger points, and the fascial nerves involved can create pain, both at the site of the adhesion and elsewhere in your body, a phenomenon known as referred pain. Loss of flexibility, headaches, chronic back or neck pain, muscle spasms, and restricted breathing may all trace back to myofascial trigger points.
If you’ve ever felt a noticeable bump on your back that’s tender to the touch but that disappears with aggressive massage, you’ve experienced a myofascial trigger point. Adhesions near the surface of the skin typically respond well to massage.
There’s no surefire treatment that works best for every myofascial problem, though exercise is usually a part of any recovery program. Myofascial knots sometimes resolve with stretching and mobility, which may address the inflammation at the trigger point.
Trigger point injections into myofascial knots often work on stubborn adhesions. Techniques include injections of anesthetics or steroids — or nothing at all, a technique called dry needling. Acupuncture is sometimes effective, too. Inserting a needle stimulates a response at the trigger point, relaxing the myofascial tissue in the area.
With three New York locations, Southern Westchester Orthopedics & Sports Medicine can help you resolve your symptoms of myofascial pain syndrome. Call or click today to schedule your exam and diagnosis.