Me Canso, me Duele, me Olvido, me Quema, me Pincha=Fibromialgia

Emoción y dolor: la fibromialgia
Es un diagnóstico que se repite en los consultorios, y que afecta sobre todo a las mujeres.

Te contamos de qué se trata y qué se puede hacer.
Desde hace tiempo se conoce la asociación entre depresión y dolor.
Las estadísticas estiman que entre un 20 a 30% de pacientes con depresión tendrán episodios de dolor, y hasta un 50% de los pacientes con dolor crónico desarrollarán, a lo largo de su enfermedad, un trastorno depresivo, cifra que se incrementa si, además, se suman otros males, como el estrés, ataques de pánico, fobias, obsesiones, etc., todos cuadros clínicos que suponen un mal manejo de la ansiedad.

En ese marco, una palabra se ha vuelto frecuente en los consultorios: fibromialgia.
¿De qué hablamos?

La Fibromialgia es uno de los trastornos que certifica la relación entre las emociones desagradables, y el dolor.

Se la considera un conjunto de síntomas y signos (síndrome*), caracterizado por la presencia de dolor crónico intenso (con más de 3 meses de evolución), con puntos específicos en la zona cervical, lumbar y (con frecuencia) también en manos, rodillas, tobillos, pies, etc.

Junto a estos síntomas se presentan otros de índole psicológica: insomnio, o sueño no reparador, fatiga fácil, pérdida de la concentración y la atención, fallas en la memoria, disminución de la líbido (interés sexual), y un estado de preocupación constante que gira en torno al fenómeno de dolor.

Las personas afectadas por el síndrome refieren sentir “que los músculos están retorcidos”, “duros como piedras” o bien que “son atravesados por un cuchillo”, todas imágenes que acompañan a las sensaciones dolorosas.

El síndrome es más frecuente en mujeres, en una proporción aproximada de, 7 a 10 Mujeres por cada Hombre.

Se estima que la padecen entre 3 a 4% de la población general.
La fibromialgia puede iniciarse luego de una situación traumática de distinta índole: accidentes, infecciones virales, conflictos familiares, de pareja, laborales, etc.
No se conocen las causas profundas de la Fibromialgia, aunque la hipótesis más aceptada es la alteración del sistema nociceptivo, es decir, las vías del sistema nervioso que elaboran el dolor en nuestro cuerpo.

Este sistema discrimina los diferentes estímulos (físicos, temperatura, heridas), y nos prepara para afrontar una situación que conlleva dolor (como ir al dentista).

En las personas sanas existe un umbral que las preserva, dándole el tono preciso -y real- al estímulo desagradable.

En cambio, las personas con Fibromialgia tienen un umbral muy bajo a dichos estímulos, convirtiendo mínimos eventos, sin implicancia clínica, en síntomas molestos e incapacitantes.

Con el tiempo la afectación es cada vez mayor, y la interpretación patológica de los factores provenientes del medio se exacerban, haciendo difícil la resolución de problemas cotidianos, o dificultando las relaciones sociales: cansancio fácil, visión catastrófica de la vida, irritabilidad, impaciencia, baja estima,

, etc.

Una vez que el sistema nervioso se sensibilizó (fenómeno de sensibilización central), se van desarrollando en cascada todos los síntomas sin que exista, o el paciente reconozca, un motivo desencadenante.
¿Existe un tratamiento?
Hasta el momento la Fibromialgia no tiene un tratamiento que la cure, pero se pueden aliviar los síntomas permitiendo mejorar la calidad de vida.
Es un síndrome que requiere de una evaluación profunda, tanto física (médicos clínicos, reumatólogos, neurólogos) como psicológico/psiquiátrica.

Es necesario abordar los síntomas dolorosos y la interpretación anómala que se tiene de los mismos, así como un cambio en los hábitos de vida, reduciendo el estrés, y el sentimiento de incapacidad para afrontar la vida diaria.
En la actualidad existen tratamientos farmacológicos aprobados para calmar los síntomas de la Fibromialgia, pero su indicación y posología, debe ser siempre controlada por el médico Reumatólogo y/o Neurólogo.

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