Tipos de dolor en la fibromialgia, ¿Cuál(es) padeces?.

Hola a todas, de nuevo aquí estoy , para aquellas lectoras que están en medio de una crisis les envío un abrazo suavecito con mi cariño y mi apoyo y para aquellas que ya superaron su crisis de fibro, las felicito y me alegra que hayan ganado una batalla más.

Hoy les voy a hablar del dolor, ¿Otra vez Moni : \ ?; sí, pero con un enfoque técnico por un lado pero necesario conocerlo, y por otro lado, recurriendo a explicaciones libres para poder digerir esta información (toda la terminología médica puede llegar a marear ), espero les sea de utilidad.

Primero definamos al dolor, según el diccionario el dolor es un término que procede del latín y que señala una sensación molesta, aflictiva, y por lo general desagradable en el cuerpo o el espíritu. Puede tratarse, por lo tanto, de una experiencia sensorial y objetiva (el dolor físico) o emocional y subjetiva (el dolor anímico). Una definición médica del dolor es de una sensación desencadenada por el sistema nervioso. El dolor puede ser agudo o sordo. Puede ser intermitente o ser constante.

Se ha escrito mucha bibliografía a cerca de los tipos del dolor, pero distingamos hoy especialmente dos de ellos que a su vez agrupan a otros subtipos de dolor (más adelante referiré algunos), uno es el dolor espontáneo y dos es el dolor provocado; el primero  es aquél que el paciente experimenta sin aplicar ningún estímulo ni realizar ningún tipo de maniobra, el segundo es el dolor que aparece en respuesta a estímulos aplicados a una zona determinada o tras realizar una determinada maniobra exploratoria. (véase IASP, asociación internacional para el estudio del dolor en sus siglas en inglés).
Como ya dije hay muchos subtipos de dolor pero solo me enfocaré en aquellos que, hasta ahora, estén relacionados con la fibromialgia.

Tipos de dolor en la fibromialgia.

  1. Hiperalgesia: Aumento anormal de la sensibilidad dolorosa, es decir, un estímulo normalmente doloroso es aún más doloroso. Por ejemplo te golpeas levemente el brazo pero tú sientes como si el golpe hubiese sido demasiado fuerte de lo que en realidad fue.Alodinia: Es la percepción anormal del dolor, es decir, un estímulo por general indoloro se vuelve muy doloroso; por ejemplo cuando te van a tomar la tensión con el tensiómetro y este a medida que va haciendo presión en tu brazo vas sintiendo el dolor in crescendo, en condiciones normales esto no debe darte ningún tipo de dolor o molestia pero la fibromiálgica sí.Parestesia con dolor o disestesia: La parestesia más frecuente es la sensación de hormigueo que se siente al comprimir un nervio, notando adormecida un área corporal, la parestesia dolorosa o disestesia es la sensación anormal desagradable (con dolor), independientemente de que sea espontánea o provocada. Por ejemplo este tipo de dolor se siente cuando se nos “duerme” un brazo como resultado de permanecer durante mucho tiempo recostadas en él y al cambiar de postura notamos como si un batallón de hormigas subieran por lo largo del brazo, sin embargo sentimos este hormigueo con dolor como si en las patas de estas hormigas tuvieran fuego.

    Pungitivo o punzante: Como su nombre indica, hace referencia a la sensación que produce el dolor, como si este se originara a razón de algún objeto puntiagudo que punzara una parte de nuestro cuerpo; suele ser de intensidad variable y no perdurable en el tiempo. El dolor de colon en los casos de colon irritable, es un ejemplo de este tipo de dolor.

    Pulsátil: Latido doloroso, este tipo de dolor es más común en los casos de migraña (también presente en gran cantidad de pacientes con fibromialgia), en la cabeza se siente un dolor rítmico con la pulsación de las arterias, es como si tu corazón se alojará en tu cabeza y con un dolor intenso respondiera a cada latido que da, en el caso de la migraña puede ser incapacitante.

    Fulgurante:dolor de poca duración pero de gran intensidad, se siente como si un rayo se descargara sobre ti, este tipo de dolor lo he sentido al principio de mi migraña, siento como si un rayo atravesara mi cabeza, esto me indica que se trata de una migraña y no de una simple cefalea, luego se asienta el dolor pulsátil descrito más arriba.

    Urente: el que se percibe como escozor, ardor, sensación de quemazón o que abrasa. este emite un tipo de sensación a quemadura incómoda que puede llegar a ser insoportable, el dolor producido por la cistitis es un ejemplo.

    Cólico: este dolor es más reconocido por las mujeres, está caracterizado por ser un dolor abdominal que varía de intensidad en el tiempo, desde muy intenso, opresivo (retortijón o retorcijón) hasta casi desaparecer, para volver a aumentar de intensidad. Pueden ser menstrual o abdominal.

    Opresivo o gravativo: Sensación de presión o peso. En la fibromialgia este tipo de dolor, es más molesto que intenso, y se presenta más comúnmente en el pecho o en los hombros, cuando es en el pecho esta sensación es parecida a que alguien se sentara encima de tu pecho cortándote o dificultando tu respiración, cuando es en los hombros sientes como si cargaras un peso en ellos y debido a esto te pueden dar algunos espasmos.

    Difuso: Un dolor difuso es un dolor difícil de localizar porque no es nítido y se extiende a diferentes partes del cuerpo. Este tipo de dolor a menudo es un signo revelador de una fibromialgia. La fibromialgia es difícil de diagnosticar porque el paciente no siempre llega a describir los dolores que siente. Además los análisis de sangre y los otros exámenes no suelen revelar ninguna anomalía.

    Sordo: Aquel que sin ser muy intenso se muestra insidioso o continuo y, generalmente, es difícil de describir o localizar. En la fibromialgia es la sensación de dolor constante y permanente con la que tenemos que convivir diariamente, este dolor a cuestión de costumbre se va convirtiendo en “paisaje”, es decir, lo llevamos con nosotras siempre y tratamos de hacer vida a pesar de su presencia.

    La lista es interminable pero creo que estos definen a grandes rasgos los tipos de dolor que padecemos las pacientes con Fibro, si ustedes conocen el nombre de otros tipos de dolor por favor compártanlo, así todas podremos hacer buen uso de sus descripciones y completaremos el cuadro de tipos de dolor.

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