What Is the Aponeurosis?

Fasciitis, also known as fibrositis, is a comprehensive concept. It is a non-specific inflammation that occurs in myofascia. Can occur in various parts of the body, more common in the waist, sacrum and scapular area. For some patients with low back pain, small nodules can be palpated on the surface of the iliac spine muscle or on the attachment site of the iliac muscle, accompanied by pain and tenderness, and sometimes found on the buttocks. The nodules involved in clinical practice is essentially a limited fatty connective tissue, so it is also called fatty hernia. Such nodules may stimulate peripheral nerve endings and cause local muscle spasms and pain. More common in middle-aged and above, especially those who lack muscle training for a long time and often suffer from damp and cold. This article introduces orthopedics-related myofiberitis and plantar fasciitis.

Basic Information

nickname: Fibrositis
English name: fasciitis
English alias: fibrositis

Visiting department: orthopedics
Common causes: May be related to cold, trauma, immune factors, and vascular inflammation
Common symptoms: Muscle soreness, stiffness, or pressure

Causes of Fasciitis

Fasciitis refers to aseptic inflammation that occurs when muscle fascia is attached to the bone. At present, the etiology of fasciitis is not clear. It may be related to excessive and prolonged stretching of certain muscles. Related to cold, trauma, immune factors and vascular inflammation. When the body is stimulated by external adverse factors such as wind and cold, fatigue, trauma, or improper sleeping position, it can induce the symptoms of fasciitis to worsen and present an acute attack.

Clinical manifestations of fasciitis

Most manifested as pain at the onset site, mostly soreness and discomfort, muscle stiffness, or stagnation. Symptoms worsen in the morning or after changes in weather and cold, and pain is relieved after exercise, often recurrent. During an acute attack, local muscles are tense, spasm, and movement is limited. Due to inadequate treatment in the acute phase, the patient becomes chronic, or because the patient is exposed to repeated strains, wind chills, and other adverse stimuli, he may have persistent or intermittent chronic muscle pain and weakness. During the physical examination, a fixed tenderness point can be touched at the affected area. The location is usually fixed near the starting and ending points of the muscles or at the intersection of two groups of muscles in different directions. The swelling painful muscle cord can be felt deep in the tenderness point.

1. Shoulder and back muscle fibrositis

It mainly occurs in the shoulder and back muscles and fascia. Due to the symptoms of shoulder and back and neck, it is easy to be confused with cervical spondylosis and often occurs at the same time as periarthritis. Manifestations include neck, shoulder, and back pain and discomfort, persistence or recurrence, exacerbation after exertion, and neck involvement and discomfort when moving, but most of them have no significant movement disorder. The trapezius and scapularis fasciitis reflexes to the neck; the rhomboid fasciitis can cause vest pain and can stimulate the intercostal nerves and cause a feeling of anterior chest pressure. Chronic inflammatory lesions in the body, such as chronic cholecystitis, dental caries, upper respiratory tract infections, or other inflammations that cause fever, climate changes such as cold and wetness, and excessive physical exertion can all cause symptoms to worsen.

2. Plantar Fasciitis

Namely, plantar fasciitis, mostly chronic foot injuries caused by long walking (such as mountain climbing, hiking, shopping, etc.). In addition, the heel is too hard to cause pressure on the heel, often wearing high heels will also increase the sole injury. Most are onset of one foot. In addition to heel pain, another 10% of patients feel pain in the arch or forefoot. In the morning, when the foot just touched the ground and was ready to stand up, the pain was very severe. It can be relieved by a little activity, and then aggravated after walking for a period of time. Gout patients often have this symptom, except for the need to check blood uric acid.

Fasciitis check

Histopathological biopsy

Biopsy of painful connective tissue shows inflammatory edema and hyperplasia of connective tissue such as subcutaneous fat, myofascial or periosteum.

2. Other inspections

Laboratory tests for anti-O or normal or slightly higher ESR. On magnetic resonance examination, a strip-shaped long T1 long T2 signal can be seen subcutaneously at the lower back and the border is clearer. It is an exudate liquid signal.

Fasciitis diagnosis

It is not difficult to draw a diagnosis based on clinical manifestations and related examinations. The current diagnostic criteria for fasciitis are:

1. There are fixed pain points and tender points on the attachment points of tendons or muscle belly. Pressing the pain point can cause regional pain that is not distributed according to the sensation of the nerve roots but in the direction of the muscles.

2. Pain worsens when the temperature decreases or fatigue, and symptoms are mild after the activity starts.

3. Treatments that promote muscle blood flow and promote the accumulation of local aseptic inflammatory exudate concentrations (such as local massage or contraction of related muscle activities several times) can immediately reduce pain.

4. Exclude local occupying or destructive lesions.

Differential diagnosis of fasciitis

Acute sprain contusion

A history of acute contusion injury, pain immediately after injury.

2. Disc herniation and lumbar spinal stenosis

A clear diagnosis can be made based on physical examination, CT, and magnetic resonance (MRI).

3. Third lumbar transverse process syndrome

There is obvious tenderness at the third lumbar transverse process.

4. Pain in tumor metastasis

There has been sudden weight loss recently, and the pain at night is more severe. Tumor metastasis must be ruled out.

Fasciitis Treatment

Some patients can be relieved after resting. Hot compresses and massage can diffuse local metabolites, reduce irritation, and have an effect on the closure of pain points. Non-steroidal anti-inflammatory drugs are commonly used in the treatment of fasciitis, such as ibuprofen and diclofenac, and musk strong bone paste is applied to the pain points, but it should not be applied for a long time, it can be used for 3-5 days. Prevention and treatment mainly rely on exercise. Targeted muscle training is the most important preventive treatment. Neck and chest stretching exercises are targeted: sit on a solid chair, back to the chair back, and extend the neck and thoracic spine at the same time. Enlarge the chest twice, do it once every 5-6 seconds, three times a day, 15-20 minutes each time. You can receive treatment and preventive effects. Exercise during acute attacks will be painful, but don't worry, keep doing it several times. After that, the symptoms were immediately relieved.