Médicamente revisado por Lindsey Marcellin, MD, MPH
Cuando tiene fibromialgia, puede parecer que no puede obtener un descanso del dolor, que puede incluir dolor de espalda. Hasta dos tercios de las personas con dolor lumbar crónico también tienen fibromialgia. Al observar los números de la otra dirección, hasta el 49 por ciento de las personas con fibromialgia tienen dolor lumbar. De hecho, el dolor de espalda es tan prevalente entre las personas con fibromialgia que una vez fue uno de los síntomas que los médicos buscaban al hacer un diagnóstico de fibromialgia.
No hay duda de que vivir con fibromialgia es un desafío suficiente por sí solo, y mucho menos cuando tienes dolor de espalda. Pero puede hacerte sentir un poco mejor saber que hay una explicación para la intensidad del dolor que estás atravesando.
“Tanto el dolor de espalda como la fibromialgia pertenecen a un grupo de trastornos llamados síndromes de hipersensibilidad central”, dice el especialista en control del dolor Ronald Staud, MD, profesor de medicina en la Universidad de Florida en Gainesville. Aunque las raíces de las dos condiciones difieren, por ejemplo, el dolor de espalda puede ser causado por un disco vertebral dañado, las experiencias de dolor de las dos condiciones tienen algunas similitudes. Entre ellos está la sensación de que estas condiciones de dolor crónico hacen que te encuentres en un entorno de “alerta alta” (los médicos lo llaman hiperexcitación). Y luego, para colmo, el dolor lo desgasta, causando fatiga, depresión y ansiedad que hacen que la vida con fibromialgia y dolor de espalda sea más agotador.
“La hiperactivación es realmente una respuesta normal”, dice el Dr. Staud. Normal, sí, pero da una llave inglesa para encontrar la combinación correcta de tratamientos para aliviar dos problemas muy dolorosos.
Una cosa esencial es obtener un diagnóstico preciso de su dolor de espalda. Según Staud, muchos médicos que tratan la fibromialgia también pueden evaluar las posibles causas del dolor de espalda. Sin embargo, solicite una referencia a un especialista en dolor si tiene dudas sobre la capacidad de su médico para analizar los factores que contribuyen a su dolor de espalda y prescribirle el tratamiento médico adecuado.
Tratamiento de la fibromialgia y el dolor de espalda
Los medicamentos para el dolor generalmente son parte de la prescripción para los síntomas de la fibromialgia, pero a menudo no son suficientes para la mayoría de las personas, especialmente si se trata de una afección de la espalda. Reunir un plan de dolor de varias partes es imprescindible, dice Staud. Esto es aún más cierto si necesita terapia específica para su espalda. Considere estas ideas adicionales para crear una estrategia de tratamiento integral que pueda combinar enfoques tradicionales y alternativos:
- Cambios en el estilo de vida. Tanto el dolor de espalda como los síntomas de la fibromialgia pueden mejorar a medida que trabaja en un estilo de vida más saludable: ajustar su dieta, aumentar el ejercicio y, si es necesario, perder peso.
- Tratamiento de salud mental. La ansiedad, la depresión y los problemas para dormir pueden empeorar el dolor. Las estrategias de tratamiento integral pueden incluir terapia y medicamentos dirigidos a la depresión y la ansiedad, dice Staud.
- Terapia física. “El dolor de espalda es el pilar de los fisioterapeutas”, dice Staud. Los fisioterapeutas pueden enseñarle cómo moverse a través de su día de manera más efectiva y mostrarle estiramientos para aliviar el dolor de espalda y, quizás, facilitar la vida con fibromialgia.
- Enfoques de tratamiento alternativo. La acupuntura, el biofeedback y la musicoterapia pueden ayudar a aliviar el dolor de espalda. Según Staud, los especialistas en control del dolor conocen bien la complejidad del tratamiento del dolor y estarán abiertos a cualquier pregunta que pueda tener sobre enfoques alternativos. Hablar con su equipo sobre las opciones que está considerando también lo ayudará a evitar cualquier interacción entre tratamientos alternativos y medicamentos recetados.
- Educación. Finalmente, un poco de conocimiento puede ser de gran ayuda para aliviar la ansiedad que pueda estar sintiendo. Hable con su equipo médico sobre la fisiología del dolor y los factores complejos que influyen en su percepción del dolor cuando se enfrenta a condiciones relacionadas con la hipersensibilidad.
Cuando estás luchando contra el dolor lumbar y la fibromialgia, es posible que sientas que estás librando dos batallas. Pero una combinación de terapias, algunas dirigidas a la fibromialgia, algunas dirigidas al dolor de espalda y otras dirigidas a ambas, es más probable que te alivien los síntomas.
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