Japanese Non-surgical Orthopedics Society (JNOS)

一般社団法人 日本整形内科学研究会

For non-medical personnel

One of activities by Japanese Non-surgical Orthopedics Society (JNOS) is develop treatment, academic, education and research for musculoskeletal pain and intractable pain related to Fascia.

1.What is Non-surgical Orthopedics? 

One of medical fields to release pain with non-surgery method such as local injection,exercise therapy, manual therapy, cognitive behavior therapy, pharmacotherapy and so on by multi-professional collaboration doctors, dentists, rehabilitation staffs and acupuncturists

2.What is Myofascial Pain Syndrome, MPS?

MPS is general disease with symptoms that was made by muscle stiffness.

MPS is not Fibromyalgia. MPS is not well knows even by doctors. MyoFascia is part of Fascia.

When human takes heavy items or put repeated load to muscles by abnormal body style, muscles take excessive load.

Normally excessive load makes general muscle pain that will be released in few days. However muscles might not be recovered with cold temperature, repeated excessive load, poor circulation and so on. This situation on muscle is called MSP. MPS has wide severe pain and numbness that are different from general muscle pain.

3.Symptoms by abnormal Fascia 

肩の痛みHave you been told no problem on X-Ray or MRI, although you have symptoms.

If yes, there is possibility of Myofascial Pain Syndrome(MPS).

Whole human body might have MPS. Also depending on position of abnormal Fascia, pain and numbness position might different as following example.

Position of abnormal FasciaPosition of pain and numbness
Gluteal muscleWhole legs
Upper back saw bladeWhole arms
Lumbar muscleWide are of waist and buttocks

One of characteristics is to move pain and numbness as a time proceeds.

4.Similar diseases caused by MPS

Followings are example of diseases that is caused by abnormal Fascia with MPS and so on.

  • Myotonic headache
  • Migraine
  • Temporomandibular disorders
  • Tongue pain
  • Cervical spondylosis
  • Cervical shoulder arm syndrome
  • Thoracic outlet syndrome
  • Frozen shoulders
  • Shoulder periarthritis
  • Tennis elbow
  • Golf elbow
  • Carpal tunnel syndrome
  • Tenosynovitis
  • Intervertebral disc disease
  • Intervertebral hernia
  • Spinal stenosis
  • Lumbar spondylolisthesis
  • Hip osteoarthritis
  • knee osteoarthritis
  • Meniscal disorder
  • Diabetic neuropathy, etc.

Depending on position of abnormal Fascia, following diseases may be adapted.

  • Vertigo (non-rotatable)
  • Palpitation
  • Cardiac neurosis
  • Numbness
  • Tinnitus
  • Functional gastroenteropathy
  • Stomach cramps
  • Menstrual pain
  • Pain during urination
  • Defecation pain
  • Anal pain, etc.

5.Treatment method 

Treatment method for MPS is still under development. Currently local injections, exercise therapy, manual therapy, cognitive behavior therapy are major treatment methods. Sometimes pharmacotherapy is adapted.

Currently there are both direct method and indirect method as local treatment. To adapt combination of direct method and indirect method are ideal.

5-1 Direct method such as Fascia release 

Direct method is to treat abnormal fascia by direct access such as local injection of saline, local anesthetic, acupuncture, exercise therapy, manual therapy and so on.

(*) Fascia release by injection may be called Fascia hydro release.

JNOS researches method to treat abnormal fascia safely and certainly under ultrasound devices.

5-2 Indirect method such as relaxation, cognitive therapy

Indirect method can release pain without direct access to abnormal fascia.

Typical indirect method is cognitive therapy, manual therapy with relaxation technique, treatment for meridian.

Removing anxiety by cognitive therapy relieves tension of the body and affects sensitivity of pain.

6.Duration of treatment 

Usually treatment takes not just one time. it takes a certain period and number of times. 

For example, it takes few months for strong pain that makes difficulties on daily life.

Although it’s very important to combine various treatment methods, best combination for each case is not confirmed yet.