FASCIA ANATOMY AND MYOFASCIAL PAIN MECHANISMS

Myofascial pain syndrome (MPS) is one of the most common musculoskeletal disorders, significantly impairing daily function and quality of life. Traditionally explained by intramuscular trigger points, recent research has demonstrated that fascia is also a critical component of its pathophysiology. Fascia is a dynamic connective tissue network enveloping muscles, nerves, and organs. Owing to its dense innervation and vascularization, it plays not only a structural but also sensory and immunological role. Fasciocytes produce hyaluronan (HA), which facilitates gliding between fascial layers. Under conditions of chronic overload and hypoxia, HA densification and interlayer adhesions occur, increas-ing fascial stiffness, activating nociceptors, and promoting the release of algogenic mediators. These mechanisms enhance peripheral sensitization, contributing to the persistence of chronic pain.