Фасциальная система: анатомо-физиологические основы и реабилитационное значение

Фасциальная система представляет собой сложную соединительнотканную сеть, обеспечивающую структурную целостность, подвижность и сенсорную иннервацию организма. Несмотря на широкую распространенность фасциальных нарушений (хроническая боль в спине, миофасциальный синдром, фибромиалгия), их патогенез изучен недостаточно, а существующие методы лечения не всегда эффективны. В связи с этим назрела необходимость систематизировать современные данные об анатомии, гистологии, патофизиологии и теоретических моделях фасциальной системы, а также критически оценить методы лечения фасциальной патологии. В настоящем обзоре представлены сведения об анатомо-гистологическом строении и функциональной гетерогенности фасций. Проанализированы три теоретические модели: биотенсегрити, механотрансдукция и миофасциальные цепи. Рассмотрены ключевые патофизиологические механизмы (активация миофибробластов, ишемия, ацидоз, деполимеризация гиалуроновой кислоты, периферическая и центральная сенсибилизация), методы лечения (мануальная терапия, физические упражнения, метод «сухой иглы», акупунктура, ударно-волновая терапия, фармакотерапия (нестероидные противовоспалительные препараты, глюкокортикостероиды, локальные анестетики, миорелаксанты)), а также реабилитационные подходы. Результаты могут быть полезны для ревматологов, ортопедов, неврологов и специалистов по физической реабилитации.

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