Myofascial Release as a Treatment for Neck Pain

Written By Jessie McNally

There are many reasons a person can experience cervical dysfunction. Dysfunction can stem from musculoskeletal, neuromuscular, or vascular problems and may or may not present with pain, decreased mobility, or dizziness. Myofascial release (MFR) is a soft tissue technique used by physical therapists to help relieve pain all over the body, including the head and neck. The benefits of MFR are not limited to pain relief; there is evidence that it can help improve posture, increase range of motion, improve circulation, and increase relaxation. Therefore, MFR may improve the signs and symptoms associated with common cervical dysfunctions.

Although there has been research done on fascia since the 80’s, exploration of the topic of fascia has increased by researchers within the last few years. There is some controversy regarding the definition of fascia, however, most agree that fascia is the connective tissue surrounding muscle, bone, nerves, vessels, and organs.

  • MFR can increase pliability which will allow mobilization before rehydration of the tissue.

  • Connective tissues become tighter and denser with overuse syndromes, after traumatic injury, or poor biomechanics. These restrictions place tension on the surrounding structures and decreases mobility.

  • In addition, fascia is richly innervated in nerve endings, which can help explain pain experienced by some people with no other identified pathology

  • Myofascial restrictions in one part of the body can cause tension in other areas due to the continuity of the fascial web.

MFR is a technique that can be used to release fascial restrictions causing or contributing to cervical dysfunction. MFR is the manual application of low load and long duration pressure to the myofascial complex to restore length, decrease pain, and improve function.

  • A piezoelectric event occurs when changing a mechanical force into electric energy.

  • Thixotropy is application of heat or pressure which makes material more fluid or less dense.  Mechanical loading of the fascia leads to changes at the cellular level. Cells are held in a state of continuous tension and respond to mechanical pressure applied.

  • Within 90-120 seconds, there is a release in the myofascial restriction.

  • This release reduces the tension of the surrounding structures such as nerves and blood vessels, which may be causing or contributing to pain. This release is also needed to correct structural alignment and improve mobility.

  • MFR allows the muscles to relax and improves blood circulation to the area.

  • MFR relies on clinical skill and the ability to detect subtle changes in the soft tissue.

Some evidence has shown that MFR helps improve posture and ROM. There is some evidence that MFR can be more effective than traditional manual therapies for improving cervical range of motion and quality of life in those with occupational neck pain.4

  • MFR over the Upper Trapezius as part of a treatment for myofascial pain syndrome has been shown to be as effective as transcutaneous electrical nerve stimulation (TENS) in reducing pain intensity and cervical ROM.

  • MFR has been shown to improve not only cervical ROM, but ROM in joints of the rest of the spine and lower extremities.

  • Any cervical dysfunction resulting from poor posture or lack of ROM has potential to be eliminated or reduced with the use of MFR.

People experiencing cervical pain can find relief with MFR. Myofascial release not only improves pain, but also improves pain perception. MFR has been used to effectively treat tension headaches, nonspecific cervical pain, and temporomandibular (TMJ) disorders. MFR has even been shown to be as effective as botulinum toxin injections when treating TMJ. MFR can reduce pain perception by improving mobility.

MFR is also effective at relieving pain all over the body. Studies have found improvements in low back pain, pain associated with internal snapping hip syndrome, and plantar fasciitis. In addition to all of the benefits seen on the musculoskeletal system, there have also been studies done on the effects of MFR on the autonomic nervous system, vascular function, and mental aspects such as quality of life. There was a study done that looked at the effects of myofascial techniques on heart rate variability. They found that myofascial techniques have an effect on the autonomic nervous system (ANS) which contributes to heart rate (HR) variability. Stimulation of the upper cervical region causes an increase in the parasympathetic nervous system (PNS) and decrease in the sympathetic nervous system (SNS), leading to greater relaxation and decreased stress response.

There are many reasons a person can experience cervical dysfunction (aka neck pain). Symptoms can range from loss of mobility, pain, or radiculopathy. Because cervical dysfunction is so common, MFR has the potential to help a large group of people. Targeting the fascia during treatment, in addition to more traditional tissues such as the muscles or bones, can not only help provide a greater relief of symptoms, but also has physiological effects that can promote healing. The scientific literature provides evidence that MFR can increase joint ROM, reduce pain, and improve quality of life.

 

References

1.    Barnes, M.F. The Basic Science of Myofascial Release. Journal of bodywork and movement therapies (July 1997); 1(4) 231-261.

2.    Beardsley C., Skarabot, J. Effect of self-myofascial release: a systematic review. Journal of bodywork and movement therapies (October 2015); 19 (4) 747-58.

3.    Ajimsha M.S., Al-Mudahka, N.R., Al-Madzhar, J.A. Journal of bodywork and movement therapies (January 2015); 19 (1) 102-12.

4.    Rodriguez-Huguet, M., Gil-Salu, S.L., Rodrigues-Huguet, P., Cabrera-Afonso J.R., Lomas,-Vega,R. Effects of Myofascial Release on Pressure Pain Thresholds in Patients with Neck Pain: A Single Blind Randomized Controlled Trial. American Journal of Medical Rehabilitation (January 2018); 97 (1) 16-22.

5.    Amoroso Borges, B.L., Bortolazzo, G.L., Neto, H.P. Effects of Spinal Manipulation and myofascial techniques on HR variability: A Systematic Review. Journal of bodywork and movement therapies (January 2018); 22(1) 203-208.

6.    Kim, J., Kim, S., Kim H., Moon, S., Lee, N., Lee, M., Jin, E., Choi, E. Effetcs of McKenzie Exercises, Kinesio Tape, and Myofascial Release on Forward Head Posture. Journal of Physical Therapy Science (August 2018); 30(8) 1103-1007.

7.    Rodriguez-Fuentes, I., De Toro, F. J., Rodrigues-Fuentez, G., de Oliveira I. M., Meijide-Failde, R., Fuentes-Boquete, I. M. Myofascial Release Therapy in the Treatment of Occupational Mechanical Neck Pain: A Randomized Controlled Trial parallel group study. American Journal of Physical Medicine Rehabilitation (July 2016); 95 (7) 507-15.

8.    Dissanayaka, T. D., Pallegama, R. W., Suraweera, H.J., Johnson, M. I., Kariyawasam, A. P. Comparison of the Effectiveness of TENS and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Trial. American journal of Physical Medicine Rehabilitation (September 2016); 95(9) 663-72.

9.    McKenney, K., Elder, A.S, Elder, C., Hutchins, A. Myofascial Release as a Treatment for Orthopedic Conditions: A Systematic Review. Journal of Athletic Training (Jul-Aug 2013); 48(4) 522-7.

10. Tozzi, P., Bongiorno, D., Vitturini, C. Fascial Release Effects on Patients with Non-Specific Cervical or Lumbar Pain. Journal of bodywork and movement therapies (October 2011); 15 (4), 405-16.

Jessie McNally
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