Posted by Steve Middleton, MS, ATC, CSCS, CES, CKTP

Fibromyalgia is a condition characterized by widespread pain and tenderness. Due to this, it tends to be a symptomatic based diagnosis. The rationale is that increase in central sensitivity cre
ates enhanced sensitivity of the dorsal horn receptors of the spinal cord which influence the nociceptors in the peripheral nervous system. Functional MRIs of the brain have demonstrated this increased sensitivity causes exaggerated responses to external stimuli whereas the body can internalize even light touch as an extreme amount of pressure. Prior thought was that myofascial trigger points contributed to the central sensitivity however trigger points can be found in individuals without fibromyalgia and may not appear in patients with fibromyalgia.

New research is looking at the role of fascia in this condition. Fascia is separated into two layers: deep and superficial. The superficial fascia is highly innervated. It is also composed primarily of fibroblasts. In the event of injury or perceived injury, fibroblast activity and peripheral inflammation lead to thickening of the fascia. Since fascia is a tissue spread throughout the entire body, it seems to play a previously misunderstood role in chronic pain syndromes.

Liptan; J Bodywork Movement Therapies 14 (2010) 3-12. All rights reserved to Elsevier Ltd.

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