Self Care

Fascia and Chronic Pain

By Albert E PerryMay 23, 2023

Here we will explore the research of the the connection between fascia and chronic pain. This article is relatively technical with scientific language references. I’ve attempted to reference, in parentheses, what most of the terms mean. For a less technical article read here.

What is Fascia

Fibroblasts Role in Fascia and Our Body

What is the connection between fascia and chronic pain?

The connection between fascia and chronic pain is a topic of ongoing research and exploration. Fascia is a type of connective tissue that surrounds and interconnects various structures in the body, including muscles, bones, nerves, and organs. It plays a role in providing support, stability, and flexibility to the body. There are several ways in which fascia may be related to chronic pain:

  1. Fascial restrictions: Fascia can become tight or restricted due to various factors such as trauma, inflammation, surgery, or repetitive stress. These restrictions can result in pain, limited mobility, and altered biomechanics.
  2. Trigger points: Fascia can develop areas of increased sensitivity known as trigger points. These are localized knots or tight bands of muscle fibers within the fascia that may cause referred pain in other body areas. 
  3. Nerve entrapment: Fascial restrictions or adhesions can potentially compress or entrap a nerve, leading to chronic pain conditions such as nerve impingements or neuropathies.
  4. Altered sensory perception: Fascia contains a high concentration of sensory receptors called mechanoreceptors. Changes in the fascial tissue can potentially affect sensory input and perception, leading to altered pain signaling.
  5. Inflammation and immune response: Inflammatory processes within the fascia can contribute to chronic pain conditions. Chronic inflammation can sensitize nerves and amplify pain signals. It’s important to note that while fascia is being studied as a potential contributor to chronic pain, it is not the sole determinant.

Chronic pain is a complex and multifaceted phenomenon involving various factors, including but not limited to neurological, musculoskeletal, and psychological aspects. If you are experiencing chronic pain, seeking medical attention from a healthcare professional who can conduct a thorough evaluation, provide an accurate diagnosis, and offer appropriate treatment options based on your specific condition is recommended.

Fibroblast and Fibrocytes

Fibroblasts have two states; the active Fibroblast is a cell that spins the web of collagen fibers that make up our fascia. The Fibroblast changes into the dormant Fibrocyte, which is helpful in the wound healing process but limits the elasticity of the fascia in everyday activities. This can cause stiffness and pain.

The transition from fibroblast to fibrocyte involves changes in cell morphology, gene expression, and secretory profile. Fibrocytes are characterized by reduced synthetic activity and a more elongated appearance than fibroblasts. They have a reduced capacity for fascia production and remodeling but contribute to wound healing by secreting factors that modulate the inflammatory response and promote tissue remodeling.

Trauma’s Influence on Fibroblasts and Fibrocytes

Trauma or injury triggers fibroblasts to transition into a fibrocyte state. During the inflammatory phase of wound healing, various immune cells, such as macrophages, release cytokines (Cytokines are a broad and loose category of small proteins important in cell signaling) and growth factors that initiate the repair process. These signaling molecules, including transforming growth factor-beta (TGF-β), platelet-derived growth factor (PDGF), and interleukins (a group of related proteins made by leukocytes (white blood cells), play a crucial role in activating fibroblasts and directing their behavior.

Fibroblasts at the injury site activate when tissue damage occurs and undergo phenotypic changes. They increase their synthetic activity, proliferate, and migrate to the wound site to contribute to the healing process. However, the need for intense fascia synthesis decreases as the wound progresses from the inflammatory phase to the proliferative and remodeling phases. At this stage, fibroblasts transition into a fibrocyte state.

Therefore, trauma can stimulate fibroblasts to undergo phenotypic changes and enter into a fibrocyte state as part of the normal wound-healing process. Various factors influence this transition, including the wound microenvironment’s cytokine and growth factor milieu.

Can The Fibrocytes Transition Back To Their Active Fibroblast State?

Fibrocytes have the ability to transition back into the fibroblast state after an injury site has healed. While fibrocytes are considered a more mature and quiescent form of fibroblasts, they retain the capacity to revert to a fibroblast phenotype under certain conditions.

Fibrocyte-to-fibroblast transition is often referred to as fibrocyte activation or fibrocyte-to-myofibroblast differentiation. Various stimuli, such as mechanical tension, growth factors, and inflammatory mediators, can trigger it. Factors like TGF-β, PDGF, and connective tissue growth factor (CTGF) are known to play crucial roles in this transition.

When the wound healing process is complete and the tissue has undergone sufficient remodeling, the need for fibrocytes to actively contribute to repair diminishes, and fibrocytes can then be reactivated. The reactivation process involves phenotypic changes, including increased synthetic activity, enhanced contractile properties, and a return to a more fibroblast-like morphology.

The ability of fibrocytes to transition back to the fibroblast state highlights the dynamic nature of these cells and their role in tissue homeostasis and repair. They can adapt their phenotype based on the local microenvironment and tissue demands, enabling them to participate in ongoing repair processes if necessary.

Components of the fascia are produced intracellularly by resident cells and secreted into the fascia via exocytosis (Exocytosis is where cells shift materials, such as waste products, from inside the cell to the extracellular space)

Once secreted, they then aggregate with the existing matrix. The fascia is composed of an interlocking mesh of fibrous proteins. The dominant fibrous fascia proteins are collagens and elastins, which comprise the facia’s significant components.

Is Taking Collagen As A Dietary Supplement Effective To Help Chronic Pain?

There is research available specifically investigating the effects of dietary supplementation with types I, II, and III collagen on the transition of fibrocytes back to their fibroblast state after trauma. Collagen is a key extracellular matrix component and plays a crucial role in tissue repair. Numerous studies have explored the importance of collagen in various aspects of tissue healing and regeneration. Here are a few key points supported by research:

  1. Structural support: Collagen provides structural integrity to tissues, such as skin, tendons, ligaments, and bones. It forms a network of fibers that contribute to these tissues’ strength, flexibility, and resilience.
  2. Wound healing: During the wound healing process, collagen plays a vital role in all phases—hemostasis, inflammation, proliferation, and remodeling. After the injury, platelets and fibroblasts are activated, leading to the deposition and organization of collagen fibers. Collagen acts as a scaffold for cellular migration, supports tissue regeneration, and contributes to wound closure.
  3. Scar formation: Collagen is a major component of scars formed during tissue repair. Excessive or abnormal collagen production can result in hypertrophic or keloid scars, where collagen fibers are densely packed and oriented in a disorganized manner.
  4. Cell signaling and regulation: Collagen interacts with various cell surface receptors, such as integrins, discoidin domain receptors (DDRs), and glycoprotein VI (GPVI). These interactions can trigger intracellular signaling cascades, leading to cell adhesion, migration, proliferation, and differentiation, all essential for tissue repair processes.
  5. Modulation of inflammation: Collagen fragments released during tissue damage can have immunomodulatory effects. They can stimulate the recruitment and activation of immune cells, regulate the production of inflammatory mediators, and influence the resolution of inflammation.

In Conclusion

Many studies in cell biology, tissue engineering, wound healing, and regenerative medicine support these points. Collagen’s significance in tissue repair has been extensively studied, and its role as a fundamental component of the ECM is well-established. Collagen can be introduced as a dietary supplement but will only be effective if cofactors are included to make it bioavailable and include all three types of collagen. Here is a product that meets these requirements.

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  1. After reading this article, I found the connection between fascia and chronic pain very interesting. As someone who has struggled with chronic pain for many years, I appreciate the effort to better understand the underlying causes of the condition. I have tried various treatments, including physical therapy and medication, but have not found a long-term solution. I am curious about the potential benefits of taking collagen supplements for chronic pain relief and wonder if anyone has had success with this approach. Additionally, I would like to know more about the role of fibrocytes and fibroblasts in tissue repair and how they can be activated or transitioned back to their active fibroblast state. Overall, this article provides valuable insights into the complex nature of chronic pain and highlights the importance of seeking medical attention for accurate diagnosis and treatment options.

    1. Thanks for taking the time to read and respond, Akumendoh.

      Without assessing your condition, I cannot give you advice, except that I’ve found collagen is helpful if the connective tissue is the core issue.

      I’m happy to talk to you if you’d like a zoom assessment. No charge for 15 min call. 


      Keep thriving!


  2. So lately i’ve been experiencing some of the symptoms you talk about in this blog, I found it very interesting and relevant. I think it is very clever to have another page dedicated to simplifying this post. It is very technical in its content and if there was not another version to read it would be hard for me to understand. I commend you on this excellent attention to your audience. 

    I think the layout is very good,you obviously have great knowledge in your niche and it was educational for me to read, so much so that I have saved it into my favorites to read it in detail again

    Just something you may need to edit is at the end of your post you you have left in a title ‘conclusion’ title goes here. You may want to take that out

    overall it was a pleasure to read thankyou 


    1. Thank You for taking the time to read and respond, John!

      I also appreciate your input and will correct that error immediately!

      Keep on Thriving!


  3. This is a very detailed and helpful article on fascia and chronic pain. My son is a computer programmer and tend to be working in the same position for much of the day. He has been mentioning stiffness in part of his body. Could this be because of the fascial tissues? Or is it that the fibroblasts have changed into the dormant fibrocytes? 

    Would taking collagen possibly help with this? Or does he need to change position on a more regular basis and maybe stand at a desk to work, rather than sitting? Thank you.

    1. Hi Line,

      Thanks for taking the time to read and comment on this article.

      Collagen is a helpful tool but not a cure. Together with light stretches, helped with props so they can be held for at least 2 minutes after applying heat. Then taking breaks from working in the same position every 30 minutes and move for at least a minute to break the pattern. Your son can then reactivate the fibrocytes into their fibroblast state.

      I hope that is helpful!

      Keep on thriving, Line!

  4. This is a great article, very informative and interesting, if somewhat technical. I think it’s a little known topic for the general public so it’s great that you write about it.

    I am a fan of the incredible power of the body to heal itself naturally. I have a question: can Qigong help keep the fascia healthy and prevent it from becoming stiff or inflamed?

    Thank you for sharing your knowledge and experience with us.

    1. Hi Pablo, 

      Thanks for taking the time to read and respond to this article!

      Qigong does help, especially if combined with visualizations and affirmations.

      Staying in one position for a long time, along with stress, is at the root of the fibroblasts turning into their fibrocyte state. Qigong’s slow, deliberate movements, along with synchronized breathing, is very helpful in correcting that.

      Keep on thriving, Pablo!

  5. The article delves into the concept of fascia, a connective tissue in our bodies, and its potential role in chronic pain. It explains how disruptions or restrictions in the fascia can contribute to persistent pain and discomfort.

    What impressed me about the article was its comprehensive exploration of the topic. It not only defines fascia and its functions but also delves into the potential mechanisms by which fascial restrictions can lead to chronic pain. The article discusses the interplay between fascia, muscles, and nerves, shedding light on the complex nature of chronic pain conditions.

    I appreciated the inclusion of practical information on techniques and therapies that can help address fascial restrictions and alleviate chronic pain. From myofascial release to stretching exercises, the article offers insights into various approaches that individuals experiencing chronic pain can explore in consultation with healthcare professionals.

    Furthermore, the article emphasizes the importance of a holistic approach to chronic pain management. It discusses the role of lifestyle factors, such as nutrition, hydration, and stress management, in maintaining healthy fascia and reducing pain symptoms. This holistic perspective resonated with me as it aligns with my belief in the interconnectedness of our overall well-being.

    Overall, “Fascia and Chronic Pain” is a valuable resource for individuals seeking a deeper understanding of the potential role of fascia in chronic pain conditions. The article’s comprehensive exploration, practical insights, and holistic approach provide a solid foundation for individuals looking to explore new avenues in their journey towards pain relief and improved quality of life.

    1. Thank you, Steve, for your detailed comment, which showed you thoroughly studied the article.

      I also appreciate that you believe it has value. I share your resonance with a holistic approach to understanding and managing pain. Pain, after all, is a messenger for us and not something bad happening to us. We are responsible for maintaining these bodies in which we reside, as they are our vehicles for awakening.

      Keep on thriving!


  6. Chronic pain affects thousands of people daily. Some of this could be alleviated by diet, exercise, and proper rest. However, there are times when a supplement such as collagen can serve as a means to promote the fascia to respond in ways that will support the muscles better and help alleviate the pain.


  7. I recently read an article on the impact of collagen on cell replacement and hair growth. I never knew it could contribute to the healing of wounds and healing from inflammation. I am currently investigating relevant dietary supplements that can help with skin replenishment. I will appreciate reading more from you on those containing collagen.

    1. Thanks for taking the time to read and comment, Parameter!

      Yes, collagen is the primary component of fascia, the connective tissue surrounding every part of our body, even our organs; I heavily researched this, and bioavailability is the most important. Most over-the-counter collagen supplements do not have all three types of collagen and are not bio-available.

      The one that has everything you need is from IDLife. https://healthyqi.idlife.com/s..

      I use it. I’m 71 this year, and my skin is like that of someone 20 years younger.

      Ping me if you want to know how to get it wholesale or be an affiliate.

      To your health!


  8. As someone who has experienced chronic pain, I truly appreciate this post and the information it provides about the role that fibroblasts and fascia play in contributing to pain. It’s important for people to understand that chronic pain is not simply a matter of “mind over matter” but is a complex issue involving multiple factors. This post offers valuable insights into the various ways that fascia can become tight or restricted, leading to pain and limited mobility. It’s reassuring to know that seeking medical attention from a healthcare professional is recommended, as they can help to accurately diagnose and offer appropriate treatment options. Thank you for shedding light on this important topic!

    1. Thanks for taking the time to read and comment, Liam.

      I’m happy you’ve found this article helpful.

      Keep thriving!


  9. I have been reading a lot about the importance of the health of your Fascia system lately and although research I still ongoing, it seems to make sense that if your fascia is healthy, then you can move with more ease and less pain as you age. Besides taking collagen, what are the best forms of exercise to do for the fascia to keep it healthy?

    1. Hi Michel…

      The strategy i use successfully with my clients is passive stretching.

      That is using a prop, like a wall or doorway, to stretch a muscle group and lengthen the fascia. You then hold a lighter version of a stretch, just to the first edge of the stretch, and hold it longer, about 2 minutes. It is important to use as few muscles as possible in this process, thus the props to aid in your fascia lengthening.

      I hope that’s helpful.

      Keep thriving!


  10. I am so grateful that you gave so many details, my mum due to old age maybe, has been feeling much pain in her bones and muscles every month. And I was thinking to put her on collagen but I needed some proof to validate my understanding. But I have a question, will she have to drink the collagen indefinitely? or is it something that she can take as a cure for a given time until it repairs her body? 


    1. Thanks for reading and responding to this article.

      You have an excellent question!

      The answer depends on your Mum. Have her take the collagen daily and begin a daily regimen of conscious movement. This includes daily walks, perhaps some tai chi or something that gets her entire body involved. After a couple of months, she can cut back on her collagen by half if her diet is balanced and complete. After another month, she can get off it if she keeps up the movement. “Move it or lose it,” is a great saying to live by.

      Keep on thriving!


    2. Thanks for taking the time to read and reply!

      You have an excellent question!

      The answer depends on your mum. If she is consistent with the collagen for a couple of months and begins a daily movement program, that will help her. She can stop taking the collagen daily if her diet is balanced and complete. The main thing is that she keeps moving. “Move it or lose it” is a good saying to live by.

      Keep on thriving!


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