Chronic pain affects millions of people worldwide and remains one of the major causes of human suffering yet to be resolved by medical sciences. Despite advances in imaging diagnostics, pharmacology, and physical therapies, many people continue without improvement. There is often talk of pain centralization, hypersensitivity, psychosocial factors… but what if we have been overlooking a fundamental anatomical structure?

At Fasciopathy Care Centres (CAF), we propose a clear and bold hypothesis: the superficial fascia, especially when congested, can be a direct source of persistent pain and functional limitation. This structure, integrated within the skin’s sensory organ, has been systematically ignored in medical practice. But why?

Why has the superficial fascia been ignored?

Many anatomical atlases omit subcutaneous fat and its fascial structures. During dissections, skin layers are often removed as if they were obstacles, and the study focuses on muscles, bones, tendons, ligaments, or other internal organs. Consequently, the study of the superficial fascia has been relegated to a secondary role, and its dysfunction has never been adequately considered as a possible cause of chronic pain.

Our model questions this inertia. We believe the skin and its deep layers are a key piece of the chronic pain puzzle. After all, the skin is the sensory organ through which we perceive pain, among many other sensations. If this structure presents an alteration—such as congestion—it is perfectly plausible that this dysfunction can generate chronic pain.

A paradigm shift: compression over inflammation

One of the most disruptive contributions of our approach is the distinction between inflammation and compression. In a fasciopathy, there is no redness or heat—that is, no inflammatory signs. What there is, is pressure, swelling, resistance to movement, and areas of extreme painful sensitivity. This difference may seem subtle, but it is actually a paradigm shift.

Does it make sense to continue treating as inflammation what is not? Can we talk about chronic pain without understanding what really happens in the superficial fascia? Are we facing a new way to understand musculoskeletal medicine?

Real clinical data, not just theory

At CAF, we do not just propose a theory: we work with real cases every day. And the clinical evidence is clear: when the superficial fascia is treated, pain decreases and mobility improves surprisingly in many patients.

We have our own research unit that is collecting all this evidence in order to design and publish scientific studies to advance the understanding of chronic pain from a new anatomical and functional perspective.

💬 Let’s open the debate:

• Do you think traditional medicine has overlooked important structures due to lack of anatomical visibility?
• Is it possible that many fibromyalgia cases, low back pain, or neck pain are explained by undiagnosed fasciopathy?
• What would it imply for medical training to incorporate the functional study of the skin and its superficial fascia?