Health professionals in the medical Western world have become extremely good at identifying and isolating problems. If you sprain your knee, you can have the exact ligament tested, scanned and graded along a scale to know how bad the damage is. Yet when it comes to treatment, isolating the area barely gives any indication of how to treat the problem. More than one physiotherapist has been confounded by solving one person’s back pain only to have it return a month later. Similarly, many patients have undergone surgery for a ‘bulging’ disc only to wake up to find even their last hopes disappointed. To their surprise they find themselves worse off after surgery. Pain is a daily occurrence. Even simple everyday tasks like picking up a kettle no longer seem possible.
Is Pain A Symptom or Condition?
Innovative health professionals such as Tom Myers and the Stecco family suggest they’ve found the answer in a lesser known tissue called fascia. Like the cling wrap that holds your sandwich together, fascia weaves its webs around the fibers and organs of your body. It’s literally everywhere. Without fascia, your body would disassemble and floor to the floor. Their research has found that fascia, which plays a big part in the regulation of the body’s soft tissues (from lymph nodes, blood vessels and nerves to bone, muscle and ligaments) is not just one of the most pain sensitive areas of the body but that it can also transmit forces and fluids to uninvolved joints through its to interconnected web. When an injury occurs, the force of the injury can be transferred to other joints, causing symptoms to appear only after the initial injury has subsided. An example I can think of is the ankle sprain I had last year, that led to knee pain afterwards.
Because of fascia’s elastic web around the body, repeated stresses such as excessive typing can also lead to painful overuse syndromes like bursitis or tendinopathies (inflammation or degeneration of a tendon). Every time the wrist is lowered, the strain is transmitted from the hand to the elbow, then the shoulder and lastly the neck. Like a child tugging on his grandma’s sweater, if he tugs hard enough, the sweater rips at its weakest point and causes a noticeable tear. These microtears are identified as tendinitis or tendinosis under scans but pain starts long before that.
Another way in which fascia generates musculoskeletal problems it through what Stecco describes as “densification”. Due to inactivity, fascia can build up and lead to a dense build up of soft tissue fibers together, like spun cotton candy. Unaware of this densification, a person might decide to go for a run like they used. As they take off, a tearing feeling in the hamstring is felt like the tightening of a rope and they instantly crumple to the ground. This occurs because densification leads to an inability to stretch the muscle either locally or further away from the area, until the stress is too much to handle and a tear is created.
Old Habits Die Hard
Traditionally these overuse injuries have been treated by 3 approaches: ingestion, injection or incision. In plain English, medications, corticosteroids and surgery. Sadly, the results don’t speak for the methods. These interventions often provide minimal pain relief and have a high rate of recurrence afterwards. In addition, a risk of numerous side effects remain. Medications risk hypersensitivity to pain and addiction. Corticosteroids or anti-inflammatories facilitate poor tissue healing. Surgery has the worst outcome by far. Reduced mobility, scarring and nerve damage often mean the pain returns the same or worse and last for years afterwards. It can also cause lead to pain in different areas. Just making it through the rehabilitation process is a trek for most.
Looking to the Future
While these medical interventions aim to reduce pain at the site of injury, they always miss the root of the problem and leave it unresolved: determining whether restrictions in other parts of the body are contributors and behaviors that led to the overuse. The irony of medicine is that use of external aids will never replace the body’s inner ability to recover and balance itself, provided of course it’s given the opportunity to. After all, you can’t medicate behavior. Faced with increasingly persuasive research the medical field is faced with a choice: is it going to stay with its 100 year old medical model or change the way it understands health and disease? Until medical providers start treating pain as a systemic problem and looking at people’s bodies as a sum of its parts, chronic pain and drugs are here to stay.