Diagnosis and treatment of muscle pain according to Tipaldos (literature review)

 This review contents the information on the theory of the structure and mechanisms of damage to the body fascial system, proposed by American osteopath S. Tipaldos and named by him the Fascial Distortion Model (FDM), as well as on the original method of diagnosis and treatment of muscle pain syndromes associated with fascial damage (distortion). The author describes classifications of connective tissue and fascial structures, created by S.  Tipaldos, which are based on anatomical and functional features that determine the role of each type of fascia in compensating for various types of external influences. The conditions, mechanisms of formation and characteristics of six types of fascial lesions identified by S. Tipaldos are considered in detail: triggerband, herniated triggerpoint, continuum distortion, folding distortion, cylinder distortion, tectonic fixation. All elements of the fascial distortions diagnosis are discussed in detail, including the specification of complaints (characteristics of pain syndrome), anamnesis (history of the pain onset and its development) and an objective examination (the actual diagnostic techniques). At the same time, the special role of the patient’s description of his own painful sensations with the help of specific gestures and movements, called «body language», is emphasized. The principles and some methods of therapeutic effects used in FDM-therapy, indications and contraindications for the use of the considered manual techniques, possible side reactions that may occur during manipulation or after a session of FDMtherapy are presented. Particular attention is paid to  the evidence base of FDM therapy effectiveness in comparison with traditional methods of myofascial pain syndromes manual treatment: the results of controlled studies by foreign authors, confirming the new technique effectiveness in the treatment of certain muscle algic phenomena types, are considered. 

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