Suggesting a mechanism for acupuncture as a global percutaneous needle fasciotomy that respects tensegrity principles for treating fibromyalgia

Abstract

Acupuncture is a minimally invasive therapeutic method that uses small caliber needles while inserting them through the skin into various areas of the body. Some empirical studies find evidence to support the use of acupuncture as a treatment for certain medical conditions, however, this peculiar practice is widely considered as the domain of alternative and non-evidence-based medicine. Several mechanisms have been suggested in an attempt to explain the therapeutic action of acupuncture, but the way in which acupuncture alleviates chronic non-cancer pain or psychosomatic and psychiatric disorders is not fully understood. A recent study suggested a theoretical model (coined “Fascial Armoring”) with a cellular pathway to help explain the pathogenesis of myofascial pain/fibromyalgia syndrome and functional psychosomatic syndromes. It proposes that these syndromes are a spectrum of a single medical entity that involves myofibroblasts with contractile activity in fascia and aberrant extracellular matrix (ECM) remodeling, which may lead to widespread mechanical tension and compression. This can help explain diverse psycho-somatic manifestations of fibromyalgia-like syndromes. Fascia is a continuous interconnected tissue network that extends throughout the body and has qualities of bio-tensegrity. Previous studies show that a mechanical action by needling induces soft tissue changes and lowers the shear modulus and stiffness in myofascial tissue. This hypothesis and theory paper offers a new mechanism for acupuncture therapy as a global percutaneous needle fasciotomy that respects tensegrity principles (tensegrity-based needling), in light of the theoretical model of “Fascial Armoring.” The translation of this model to other medical conditions carries potential to advance therapies. These days opioid overuse and over-prescription are ubiquitous, as well as chronic pain and suffering.

“Long COVID-19” and viral “fibromyalgia-ness”: Suggesting a mechanistic role for fascial myofibroblasts (Nineveh, the shadow is in the fascia)

“…Globally, the long COVID-19 wave has risen and is leading to extensive morbidity, decreased quality of life, and suffering in society. SARS-CoV-2 infection can lead to pro-inflammatory and pro-fibrotic responses in multiple tissues, including myofascial tissue, and leads to fibrosis and upregulation of The positive feedback loop of fascial armoring (fascial rigidity and tensegrity tension) with inputs into the vicious cycle of myofibroblasts [adapted for long COVID-19 from Figure 3 in Plaut (2023) (7)]. Fibroblasts, adipocytes, and other cell-types can differentiate to myofibroblasts (the intermediate proto-myofibroblast phenotype is not shown here).…”

“…Movement might help release fascial tensions by various mechanisms ( 4 ) and immobility leads to fibrosis and increase in myofibroblasts ( 4 , 133 ). Needling therapy (when done correctly) is expected to modulate the disease course because of its suggested effects on the bio-tensegrity system ( 7 ).…”

“… The positive feedback loop of fascial armoring (fascial rigidity and tensegrity tension) with inputs into the vicious cycle of myofibroblasts [adapted for long COVID-19 from Figure 3 in Plaut (2023) ( 7 )]. Fibroblasts, adipocytes, and other cell-types can differentiate to myofibroblasts (the intermediate proto-myofibroblast phenotype is not shown here).…”

“…Therefore, due to its similarity with other functional somatic syndromes, “long COVID-19” is speculated to involve myofibroblast-mediated-biotensegrity-tension and mechanical compression in the fasciomusculoskeletal system along with immune-related processes (e.g., viral persistence, immune dysregulation, subclinical neuroinflammation, etc.). In severe cases, it would manifest as a global chronic exertional compartment-like syndrome ( 4 , 7 ) impeding the function of various organ systems and hallmarked by multiorgan insidious progression as well as malaise and exertional fatigue. Figure 1 depicts the general overlap of conditions according to this framework where variation in manifestation depends, in part, on the overlap of anatomical areas of involved fascia and the severity of fascial armoring ( 4 ).…”

Transcutaneous Electrical Nerve Stimulation for Fibromyalgia-like Syndrome in Patients with Post-Acute Sequelae of Sars-Cov-2: A Pilot Randomized Clinical Trial

“…Currently, there are no diagnostic criteria for PASC, but some symptoms resemble those of bromyalgia (FM), a chronic disorder characterized by hyperalgesia and muscle weakness without a speci c location 9 . FM is listed by the CDC as one of the conditions sharing symptoms with PASC 10 and recent studies showed that 30-40% of individuals with PASC meet the American College of Rheumatology (ACR) FM diagnostic criteria 11,12 . FM's underlying cause has not been proven, but it is hypothesized to involve sensory sensitization of the spinothalamic tract, possibly attributed to microglial overactivation by numerous factors, including viral infections [13][14][15] .…”