¿Cuál es el origen de la fibromialgia? Causas y tratamientos

Investigaciones recientes la vinculan con el sistema nervioso central y el inmunológico, aunque estaba considerada una enfermedad reumatológica


La fibromialgia provoca dolor y sensibilidad al tacto en todo el cuerpo. Un dolor que suele venir acompañado de fatiga y dificultad para conciliar el sueño. Hasta hace poco, no había un criterio muy claro de qué era la fibromialgia… Aunque durante mucho tiempo se la consideró una enfermedad reumatológica, hoy todos los estudios científicos apuntan a un origen central, principalmente al sistema nervioso central y, posiblemente, al inmunológico. Hablamos de esta enfermedad con el neurólogo José Mª Gómez Argüelles, que lleva muchos años estudiando el origen y las técnicas más eficaces para tratar esta enfermedad crónica.

Una enfermedad difícil de diagnosticar

En 1993 la Organización Mundial de la Salud la reconoce como una enfermedad, y la tipifica con el código M79.7 en el Manual de Clasificación Internacional de Enfermedades. En 1994, la Asociación Internacional para el Estudio del Dolor (IASP), la reconoció como tal. Hasta hace pocos años solo se hacía el diagnóstico en base a sufrir dolor crónico generalizado y tener una serie de puntos de dolor a la presión (conocidos como ‘Tender Points’). Pero desde 2010 se disponen de nuevos criterios de clasificación, en los que se da también importancia a otros síntomas como los trastornos de sueño, los problemas de memoria o la fatiga. Pero sigue habiendo diagnosis tardías porque aún no disponemos de ninguna prueba objetiva que demuestre lo que les ocurre. Aunque cada vez estamos más cerca de disponer de técnicas de neuroimagen para visualizar las áreas cerebrales responsables de estos síntomas, todavía son técnicas experimentales. No obstante, en el futuro, se le podrán realizar a cualquier paciente.

La sufren más las mujeres

Es mucho más frecuente en mujeres (el 90% de los pacientes lo son), pero hay un 10% de hombres. El motivo se desconoce, podría ser hormonal o genético.
Aunque no se conoce el origen, podría existir una relación con la flora intestinal

. La relación intestino-cerebro es una línea de investigación muy atractiva. Si conseguimos conocer qué alimentos desencadenan o empeoran la sensibilización inmunológica y neurológica, podremos mejorar la sintomatología.

¿Existe un tratamiento?

No existe un tratamiento farmacológico aprobado. Se usan técnicas de relajaciónpsicoterapia, ejercicio físico, meditación, osteopatía, mindfulness… Pero esto no modifica el curso de la enfermedad, ayuda a convivir con el problema. Se están usando otras técnicas, como la estimulación magnética o tratamientos dietéticos específicos, con buenos resultados.

Para saber más…

• Según Afibrom (Asociación de fibromialgia, síndrome de fatiga crónica y sensibilidad química múltiple de Madrid; afibrom.org), en España podría haber más de 2.000.000 de afectados de fibromialgia.
• Tradicionalmente se interpretaba que cuantos más puntos de dolor refería el paciente, más grave era la enfermedad. Sin embargo, los ensayos clínicos han demostrado que el número de puntos es una variable que apenas se modifica cuando el paciente mejora u empeora.
•Hay pacientes que pueden presentar también depresión o ansiedad, como en otras patologías crónicas, pero no es algo generalizado

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