ФАСЦИАЛЬНАЯ СИСТЕМА ЧЕЛОВЕКА: АНАТОМИЯ, ГИСТОЛОГИЯ, ПАТОФИЗИОЛОГИЯ И МЕТОДЫ ЛЕЧЕНИЯ (ОБЗОР)

Abstract

The fascial system is a complex connective tissue network that plays a key role in maintaining structural integrity, mobility, and sensory innervation of the body. Despite the high prevalence of fascial disorders (chronic back pain, myofascial pain syndrome, fibromyalgia), their pathogenesis remains insufficiently understood, and current treatment methods are not always effective.
Aim – to systematize current knowledge on the anatomy, histology, pathophysiology, and theoretical models of the fascial system, as well as to critically evaluate treatment methods for fascial pathology.
Materials and Methods. A literature search was conducted in the PubMed database following PRISMA guidelines. Inclusion criteria were full-text English-language publications published within the last 10 years (January 2016 – April 2026), including reviews, systematic reviews, and meta-analyses comprising data from experimental in vitro studies, information on healthy volunteers, and patients. From 2988 initially identified records, after removal of duplicates, screening of abstracts, and full-text analysis, 45 relevant sources were selected.
Results. The review presents current data on the anatomical and histological structure of the fasciae (superficial, deep, and visceral), their embryonic origin, and functional heterogeneity. Three main theoretical models are analyzed: biotensegrity (an architectural principle of integrity), mechanotransduction (a cellular mechanism of adaptation), and myofascial chains (a clinical-anatomical reference point). Key pathophysiological mechanisms of fascial disorders are examined, including myofibroblast activation, ischemia, acidosis, hyaluronan depolymerization, peripheral and central sensitization. Current treatment methods are systematized: manual therapy, physical exercise, dry needling, acupuncture, shockwave therapy, pharmacotherapy (NSAIDs, glucocorticosteroids, local anesthetics, muscle relaxants), as well as rehabilitation approaches for various nosologies.
Conclusion. The fascia is an active mechanosensitive organ integrating proprioception, nociception, and tissue remodeling. Future research perspectives include standardization of terminology, development of functional imaging for myofascial chains, and the transition from empirical techniques to pathogenetically grounded rehabilitation programs.