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.
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Dr. Piero G. Pavan, Dr. Antonio Stecco, Dr. Robert Stern, and Dr. Carla Stecco each declare no potential conflicts of interest.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Myofascial Pain
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Pavan, P.G., Stecco, A., Stern, R. et al. Painful Connections: Densification Versus Fibrosis of Fascia. Curr Pain Headache Rep 18, 441 (2014). https://doi.org/10.1007/s11916-014-0441-4
- Connective tissue
- Loose connective tissue
- Overuse syndrome
- Stress–strain curves
- Lines of forces