Basic Information on Fascia Release Injection

What is Fascia?

To understand fascia, we must first understand the structure of our muscles.

At first glance, a muscle may look like a single solid lump of tissue, but its internal structure is remarkably delicate. The smallest unit of a muscle is a structure called a "myofibril," which is only about 1 μm thick. These myofibrils bundle together to form "muscle fibers." These fibers are further layered to create "muscle fascicles," which are then interconnected by connective tissues to form the complete muscle.

The thin, membrane-like tissue that wraps around the surface of these muscles is commonly referred to as "fascia." However, in reality, each of the individual components mentioned above is covered by its own membrane-like tissue, all of which are types of fascia.

※The membrane wrapping individual myofibrils is called the "endomysium."
　The membrane wrapping bundles of muscle fibers is called the "perimysium."
　The membrane wrapping the collection of muscle fascicles is called the "epimysium."

Furthermore, in recent years, the definition of fascia has expanded to include all connective tissues surrounding muscles—such as subcutaneous tissues—as well as those found in tendons, ligaments, fat, pleura, and pericardium. Because the Japanese word "筋膜 (Kinmaku)" cannot fully capture this broader anatomical definition, it has increasingly been referred to by its English-derived term, "Fascia," in recent years.

The Mechanism of How Fascia Causes Pain

Fascia plays two major roles in muscles. The first is to wrap and protect the muscles. The second is to ensure smooth gliding movement when adjacent muscles contract.

However, when prolonged poor posture or injuries cause inflammation in the muscles, changes occur within the collagen fibers of the fascia. This leads to adhesions (sticking) between fascia layers, restricting muscle movement. For instance, staring down at a smartphone for hours or working at a desk in the same posture can cause inflammation in muscles that have been left immobile for too long, eventually breaking down their internal structure. You can imagine fascial adhesions as what happens when plastic is heated in a microwave.

While the fascia itself does not melt away from inflammation, it becomes "sticky" and adheres tightly to the muscle fibers due to exposure to inflammatory substances. When the fascia—which is supposed to act as a lubricant—sticks to the muscle fibers, muscle mobility drops significantly. This gradually causes blood flow impairment, making the muscles stiff and contracted. As a result, inflammatory substances can no longer be flushed out through blood circulation, leading to a vicious cycle where these substances accumulate and chronic inflammation persists.

In short, "prolonged periods of immobility" lead to "muscle fiber breakdown" and "poor blood circulation." This may very well be the root cause of stubborn pain in the neck, shoulders, and back, as well as pain or heavy discomfort in the thighs and calves.

Furthermore, because muscles and fascia contain a high concentration of sensory nerves, prolonged inflammation continuously stimulates these nerves, eventually leading to chronic pain.

What is Fascia Release Injection?

When you hear the word "injection," you might instinctively flinch or feel hesitant. However, please hear us out. This treatment offers significant advantages, as outlined below.

A fascia release injection involves injecting water (physiological saline) around the inflamed fascia to separate the adhered layers. Its therapeutic mechanism works in two primary ways.

①Restoring Mobility: Separating the fascial adhesions increases the mobility of the connective tissues, which is expected to improve flexibility and extensibility.
②Flushing Effect: The injected fluid helps flush away accumulated inflammatory substances from the area.

How is the Procedure Performed?

The injection is performed under ultrasound guidance. The doctor inserts a needle and injects physiological saline to precisely separate the fascia causing the pain. Because the needle's position is monitored visually in real time, we can accurately target and release the adhesion. The injection takes about 30 to 60 seconds per site and is performed as an outpatient procedure.

What are the Characteristics of Fascia Release Injections?

A key feature of fascia release injections is that patients often notice a difference relatively quickly after the procedure. Even for severe, long-standing symptoms, many patients experience a sensation of immediate lightness right after the injection. The extent of the effect and how long it lasts vary individually depending on the patient's daily posture, lifestyle habits, and exercise routines, typically ranging from a few days to several months.

Who is a Good Candidate for Fascia Release Injections?

Fascia release injections have a wide range of applications. They are effective for full-body muscular pain, including chronic shoulder stiffness , lower back pain, neck pain, and arm pain. However, depending on the anatomical site, we may adjust the injection approach to avoid any risk of interfering with nerves or blood vessels.

Are There Any Pains or Side Effects?

Fascia release injections are generally considered to have minimal serious side effects. Since physiological saline is used, the risk of allergic reactions is extremely low. However, patients may experience a dull ache or heavy sensation at the exact moment the fascia is separated. If you are sensitive to pain, please let us know in advance; we can accommodate you by limiting the treatment areas or providing a resting period after the procedure.

Treatments That Cannot Be Combined

Fundamentally, there are no treatments that cannot be combined with this procedure. However, as the name "fascia" release implies, injections can generally only be administered into muscles and certain ligaments. For example, it is not applicable to joint pain, as joints do not have the fascial structures that require separation.

Recommended Frequency of Injections

There is no strict rule regarding treatment frequency. Generally, many patients choose to receive the treatment every 2 to 4 weeks.

Step-by-Step Flow of the Procedure

Fascia release injections are typically performed in the examination room.

1. Localization with Ultrasound: First, the doctor uses an ultrasound device to identify the target area. Depending on your condition and the affected site, fascia that has become thickened and swollen due to inflammation can be clearly observed.
2. Injection under Real-Time Guidance: Once the target is confirmed, the doctor injects physiological saline while continuously monitoring the area via ultrasound. Because the target is the muscle beneath the skin, a slightly longer needle than usual is used. The doctor then uses fluid pressure to separate the inflamed fascia, visible on the monitor.
3. Completion: After the separation, the needle is removed, and a bandage is applied. No special post-treatment downtime or bed rest is required. As long as you feel fine, you may return home immediately. The entire process takes only about 30 seconds from the moment the needle is inserted.

Advantages and Disadvantages

Advantages

Rapid Symptom Relief

A significant advantage is the potential for relatively quick relief following the procedure. While individual experiences vary, many patients feel a reduction in heaviness and discomfort shortly after the injection.

Low Burden on the Body

Because the treatment utilizes physiological saline, we can offer a plan with an extremely low risk of allergic reactions.

Precision via Ultrasound Guidance

Our fascia release injections are performed while verifying the localized condition using ultrasound. Visualizing the state of the fascia and the needle tip on the monitor allows us to precisely target the source of your pain.

Disadvantages

Discomfort/Pain

The moment the inflamed fascia is separated by the fluid pressure, patients experience a distinct heavy ache, or pain in some cases. While it is not an excruciating or unbearable pain, those who are highly sensitive to pain should thoroughly consult with the physician beforehand.

Out-of-Pocket Expense (Self-Pay)

This treatment is not covered by Japanese national health insurance and is classified as a self-pay (private) medical expense.

Difference Between Injection and Fascia Release Massage

We are often asked about the difference between this injection and a fascia release massage. The underlying concept for both is identical; the difference lies in whether you approach the inflamed area via digital pressure (fingers) or fluid pressure (saline).

That being said, massages offer distinct benefits that only manual therapy can provide, such as relaxation effects. Many people experience a refreshing sense of comfort after a massage. This is believed to be triggered by the secretion of oxytocin—a hormone responsible for emotional stability—when the body is relaxed by human touch.

These relaxation benefits of massage should not be overlooked. Unfortunately, while fascia release injections aim to relieve physical muscle and fascial pain, they do not provide emotional tranquility. Therefore, rather than viewing it as a binary choice between "massage or injection," we recommend combining and utilizing both effectively to efficiently relieve bodily pain while achieving peace of mind.

Primary Benefits of Fascia Release Injections

The typical effects of myofascial release injections are as follows.

Relief of Muscle Tension

The injection relaxes the tension within the fascia, improving muscle flexibility.

Pain Reduction

 It reduces inflammation and pressure within the fascia, thereby alleviating pain.

Improved Motor Function

Restored muscle flexibility contributes to better movement, offering high benefits for athletes and fitness enthusiasts alike.

Conditions That Respond Well to the Treatment

This treatment is highly effective for a wide range of pains originating primarily from muscles and fascia.

Costs and Frequency of Treatments

Fees

Per Site: ¥9,000 (¥9,900 including tax)

How many sessions are required to feel the effect?

Generally, patients experience a reduction in pain and stiffness after just one injection. Depending on your condition, multiple sessions may be scheduled over a certain period.

Frequently Asked Questions (FAQ)

Q1. Is there any special aftercare required after receiving the injection?

 No special care is needed. There are no restrictions on exercise or receiving massages after the injection.

Q2. Can anyone receive a fascia release injection?

As long as you do not have an extreme phobia of needles, anyone can undergo this treatment.

Q3.How long do the effects of a fascia release injection last?

This varies greatly from person to person, but generally, the effects are expected to last for 2 to 4 weeks. Especially for the neck and shoulders, the root cause is almost always daily posture. Even if the pain is relieved by the injection, returning to the exact same posture immediately afterward often leads to recurrence. Therefore, it is important to take this treatment as an opportunity to review and improve your posture and living environment.

Q4.How much pain or discomfort is involved?

Rather than a sharp, severe pain, it is best described as a "heavy ache." You may feel a temporary, deep pressure or heavy sensation while the physiological saline is being injected.

Q5.What precautions should I take before and after the injection?

No special care is required for the treated area. However, as mentioned above, if you maintain a posture that strains your body, the pain may recur. We encourage you to use this treatment as an opportunity to reassess your daily environment and posture.

Q6.Is it okay to get a massage after a fascia release injection?

Yes, there is no problem at all. In fact, because your muscle mobility will have improved, it may even enhance the effectiveness of your massage.

Summary

Fascia release injections are a treatment method that precisely targets the root of pain using physiological saline, while verifying the fascial layers under ultrasound guidance. The procedure is brief, and while results vary individually, it is characterized by providing rapid symptom relief for a certain period.

Important Notes on Fascia Release Injection (Private/Self-Pay Treatment)

• Treatment Details: A procedure that attempts to separate adhered fascial layers by injecting physiological saline while monitoring the area via ultrasound echo.
• Cost: ¥9,000 per site (¥9,900 including tax)
  ※ Out-of-network, private practice. A separate initial consultation fee of ¥6,600 (including tax) is required.
• Primary Risks & Side Effects: Mild dull pain or heavy sensation during injection, bruising, temporary swelling, infection, and in rare cases, nerve damage.
• Number of Sessions & Period: Varies depending on symptoms. Multiple sessions may be conducted over time while monitoring the condition (though improvement can often be felt after a single session).

To book a Fascia Release Injection at NAG Orthopedics, please click below.

Director of NAG Orthopedics: Yoshimasa Nagumo

Orthopedic Specialist & Sports Doctor

Dr. Nagumo initially built his career as a surgical oncologist specializing in orthopedic cancer treatment. Subsequently, he moved to the United States to engage in advanced research in the field of regenerative medicine.

It was during his time in the U.S. that a personal injury led him to realize the critical importance of sports medicine. Upon returning to Japan, he transitioned his focus to become a sports orthopedic surgeon.

Currently, he leads the "Athlete Support Program," which provides comprehensive medical support to athletes using a combination of blood analysis and cutting-edge regenerative medicine technologies.

[Click here for the program introduction page:https://nagseikei.jp/en/dr/]