Currently, myofascial pain has become one of the main problems in healthcare systems. Research into its causes and the structures related to it may help to improve its management. Until some years ago, all the studies were focused on muscle alterations, as trigger points, but recently, fasciae are starting to be considered a new, possible source of pain. This systematic review has been conducted for the purpose of analyze the current evidence of the muscular/deep fasciae innervation from a histological and/or immunohistochemical point of view. A literature search published between 2000 and 2021 was made in PubMed and Google Scholar. Search terms included a combination of fascia, innervation, immunohistochemical, and different immunohistochemical markers. Of the 23 total studies included in the review, five studies were performed in rats, four in mice, two in horses, ten in humans, and two in both humans and rats. There were a great variety of immunohistochemical markers used to detect the innervation of the fasciae; the most used were Protein Gene Marker 9.5 (used in twelve studies), Calcitonin Gene-Related Peptide (ten studies), S100 (ten studies), substance P (seven studies), and tyrosine hydroxylase (six studies). Various areas have been studied, with the thoracolumbar fascia being the most observed. Besides, the papers highlighted diversity in the density and type of innervation in the various fasciae, going from free nerve endings to Pacini and Ruffini corpuscles. Finally, it has been observed that the innervation is increased in the pathological fasciae. From this review, it is evident that fasciae are well innerved, their innervation have a particular distribution and precise localization and is composed especially by proprioceptors and nociceptors, the latter being more numerous in pathological situations. This could contribute to a better comprehension and management of pain.

PURPOSE: Considering the fascial continuity and its biomechanical characteristics, the purpose of this study was to assess the change in muscular stiffness (Dm) of the upper trapezius muscles after the application of myofascial induction therapy (MIT) to the masticatory muscles of musicians. METHODS: This was a pre-posttest design involving one treatment. SUBJECTS: The total sample was 33 subjects (n = 33). The experimental group comprised 18 violin, viola, and woodwind players, and the control group was comprised of 15 non-musicians. The outcome measures included pre-posttest measurements with tensiomyography of the upper trapezius (muscle stiffness, Dm), and baseline neck disability (Neck Disability Index), and pain (SF-36 questionnaire). The experimental group received MIT for 5 minutes on each side of the lateral pterygoid muscle. The control group assumed a supine position for 10 minutes. RESULTS: After the intervention, there was a significant difference in Time per Group (F = 2.896, p = 0.034, 2p = 0.367, and w = 0.755). There were statistically significant differences in pre-post and side-by-side analyses for the Dm of the upper trapezius in the experimental group as well as between the two groups. CONCLUSION: MIT of the lateral pterygoids is effective in decreasing upper trapezius stiffness as measured by an increase in the Dm measured by tensiomyography. The greatest change occurred in musicians with a lower percentage of Neck Disability Index at baseline.

A request is made to include in musculoskeletal disorders the fascia as a structure that can also be affected and the reasons for this proposal are explained. Se realiza una petición de incluir en los traumatismos musculoesqueléticos a la fascia como estructura que también se puede afectar y se explican las razones de esta propuesta.

Given the growing body of literature on the relationship between musculoskeletal disorders and fascial tissue, there is an increasing need to understand and accurately measure deep fascia in order to detect pathological involvement and monitor the efficacy of therapeutic interventions. The objective of this scoping review is to identify the most commonly used diagnostic imaging tools for assessing deep fascia. Secondary aims include identifying which fascial characteristics have been evaluated and which anatomical structures have been most frequently examined. A systematic literature search was conducted across Scopus, Web of Science, and PubMed between January and July 2024. Studies were included if they evaluated animals or humans, assessed deep musculoskeletal fascia or muscle fascia, and were observational - whether conducted in vivo or in cadavers - or interventional in design. Of the 69 articles meeting the inclusion criteria, ultrasound emerged as the most frequently used imaging modality. Elastography, magnetic resonance imaging, and computed tomography were also employed. The plantar fascia was the most frequently evaluated structure, followed by the thoracolumbar fascia, while fascial thickness was the most commonly assessed characteristic. It is concluded that ultrasound represents the most cost-effective tool for real-time, structural evaluation of deep fascia. When assessment of biomechanical properties is required, ultrasound should be complemented with elastography. In both cases, it is essential that assessors are adequately trained and adhere strictly to internationally agreed-upon protocols and terminology.