You wake up feeling stiff and achy. When you walk, your joints might crackle or pop, and you may even feel a bit uncoordinated. Odds are you are suffering from chronic hip, knee, leg, shoulder or spinal pain.

Most people would be quick to blame an injury or osteoarthritis. But for many of those with chronic pain and immobility, the culprit is myofascial pain syndrome (MPS), a soft-tissue problem that most people—including the majority of those suffering from it—have never even heard of. 

With MPS, pain originates within the fascia, the thin, white or nearly transparent connective tissue that covers every muscle fiber, blood vessel, nerve and organ in our bodies. Often, the fascia can stiffen, thicken or lose flexibility due to past injuries, inactivity or mismanaged pain.

Unfortunately, most doctors are unable to diagnose MPS because there is no standard diagnostic criteria or lab test to indicate that you have this condition. It can only be diagnosed with a physical exam that reveals a loss of motion in joints and/or diminished muscle strength related to painful nodules, especially in areas from which pain is referred. 

That’s why you’ve probably treated only the symptoms of your pain rather than the root cause. Or perhaps you have simply lived with it. Either way, you need to know that long-lasting relief is possible for people with MPS.

4 Ways to Keep Your Fascia Healthy

If you have MPS, you need to… 

• Do one-minute stretches. Your brain communicates with an army of receptors in the fascia every time you move your body. Whenever you use your muscles, the fascia receptors must stretch. If pain or injury inhibits that stretch, muscle fibers don’t work at full capacity, leading to more stress on the joint. 

Stretching is critical to ensure that your muscle fibers continue firing properly. The good news is, just one minute of static stretching (holding the stretch in place) can effectively activate the fascia in an affected area, such as the neck, shoulders, legs and arms.

My advice: To wake up your muscle fibers, start your day with a hot shower. Throughout the day, remember to do one-minute stretches, targeting areas that are particularly painful. For best results, consult a fascial stretch therapist. Some physical therapists, massage therapists and personal trainers are certified in fascial stretch therapy. Check with your doctor or search “fascial stretch therapy” online for a practitioner near you.  

• Move your body. Immobility leads to stiffness, pain and more immobility. That’s why you have to move your body. The specific type of exercise is not that important—just remember to back off when you feel pain. When you move, your body is talking to you. If you listen, you’ll be more likely to avoid injury. 

My advice: Walking is often the easiest and most convenient form of physical activity. If you’ve been sedentary, start by doing just five to 10 minutes daily and gradually increase your distance by a quarter mile at a time until you are walking a mile or more daily. Other good exercise options include swimming and tai chi.

• Try this supplement. A good way to support your fascia is to get more hyaluronic acid (HA). Our bodies naturally produce this gooey substance to retain water and lubricate our joints, muscles and connective tissues, including fascia. But HA production declines with age. 

Up to 80% of my patients experience significant relief after using an oral HA supplement called Baxyl, which should provide relief within the first month. Typical dose: For the first week, take one teaspoon in the morning and another at night. After the first week, take just one-half teaspoon twice a day.* 

Note: For people with bone-on-bone damage and severe cartilage degeneration, HA injections, which are administered by some rheumatologists and orthopedic surgeons, can be given. An injection can provide three to six months of pain relief.

• Get Fascial Manipulation. The goal of this therapy is to release restrictions, mobilize areas that are stuck and restore function to your fascia. It is based on myofascial pathways, which are similar to the meridians (energy pathways or channels) of traditional Chinese medicine

Before treatment, the practitioner (usually a chiropractor, physical therapist or massage therapist) will examine you to find the affected pathways. The practitioner then uses his/her knuckles, elbows and/or hands to manipulate the fascia and muscle using vertical pressure. In some cases, there may be increased pain for a day or two due to the inflammatory process that’s needed to heal local fascial points.

Most of my patients show increased mobility after just one or two treatments. Others require three to five treatments before they experience noticeable pain reduction. Check with your health insurer to see whether Fascial Manipulation is covered. For about an hour-long session, the cost will be approximately $125 and up, depending on your location.

To find a certified Fascial Manipulation practitioner: Go to or (for practitioners worldwide). Certified practitioners have passed a test after taking the 96-hour Fascial Manipulation course, which originated in Italy and has been taught in 47 countries.

*Consult your doctor before taking this—or any other—supplement.

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