Un dolor que no se entiende y que se intenta justificar con otras enfermedades, una búsqueda que hace el paciente cuando los síntomas y desencadenantes del dolor en fibromialgia pueden justificar un dolor tan intenso y para algunos, continuo.La complejidad del uso en el diario de las manos en todas las habilidades que hay que desarrollar unido a la complejidad del dolor en fibromialgia. Un misterio para todos que lo sufren.
¿Qué no permite hacer el dolor de manos en fibromialgia?
Abrir frascos, puertas de coches o cajones.
Dolor cuando simplemente te apoyas en tus manos
Asir cualquier objeto
Sacar la ropa de la lavadora
Cortar y preparar los alimentos
Usar utensilios
Atar cordones
Arreglar el pelo
Llevar bolsas de supermercado
hacer la cama
Coger una escoba,aspirar
Sacar un enchufe de una salida
Escritura manual
Escritura en teclados de ordenador
Usar herramientas
No poder coger un libro
Usar el móvil
Tipos de dolor en la manos en fibromialgia
Las parestesias
Las parestesias en las manos y brazos de la fibromialgia se asocia con un entumecimiento u hormigueo (por ejemplo, en las manos o los pies). También conocida como parestesia, la sensación se puede describir como picazón o ardor.
La parestesia también incluye pérdida de sensibilidad, pérdida de las sensaciones, sensación de hormigueo y entumecimiento, adormecimiento o ardor, o pérdida de la sensibilidad superficial y profunda. En fibromialgia estos síntomas aparaecen y desaparecen sín causa justificada.
Hinchazon exclusiva de Fibromialgia
Una queja común es que el anillo ya no le cabe. Sin embargo, este tipo de hinchazón no es equivalente a la inflamación asociada con la artritis; más bien, es una anomalía localizada de la fibromialgia cuya causa es desconocida actualmente.
Otros tipos de dolor de manos en fibromialgia
El dolor puede ser profundo, agudo, sordo y continuo, palpitante, este es el dolor que está localizado en los músculos, tendones y ligamentos alrededor de las articulaciones.(Arthritis Foundation).
El dolor no está localizado en las articulaciones, los dedos no muestran signos de artritis como dolor e hinchazón. Pero fibromialgia puede ocurrir junto con otra forma de artritis como la artritis reumatoide o la osteoartritis, que podrá amplificar el dolor que se siente con estas dos últimas enfermedades.
¿Pero por qué se sufre dolor de manos en Fibromialgia?
Conociendo que la enfermedad de fibromialgia es un proceso de amplificación del dolor debido a mecanismos de sensibilidad central , que las manos son las herramientas que se usan a lo largo de todo el día para cualquier tarea, se olvida la complejidad de estos instrumentos que son capaces de intepretar por medio del sentido táctil cualquier estimulo. El frio, calor, o definir sin mirar cualquier objeto, complejos procesos que hace junto al cerebro gracias a todas las terminaciones nerviosas que tienen las manos para llevar a cabo estas complicadas tareas.
El sentido del tacto, como en otros sentidos: el oido, con el tinnitus, la vista con la fotofobia hace que esa sensibilidad táctil se convierta en estimulos constantes traducidos en dolor.
Es común oir las quejas de los estimulos táctiles, como el dolor al roce de las sábanas, de los tejidos de la ropa, de los abrazos en las manos se está expuesto las veinticuatro horas del día a estimulos exteriores constantes.
Dejemos los estimulos y pasemos a los movimientos, es conocido que la fibromialgia y sus brotes o determinados dolores son producidos por los movimientos, el dolor de la fibromialgia se produce en tendones y músculos y como herramientas que proporcionan la habilidad de hacer complejos movimientos, se olvida la cantidad de músculos, tendones, ligamentos que hay implicados para hacer cualquier movimiento.
El dolor de la fibromialgia en las manos y la conexión con la neuropatias
A continuación comprobamos la similitud del dolor en fibromialgia con otras neuropatias de dificil tratamiento y manejo para el profesional del dolor.
“El dolor neuropático a menudo puede estar relacionado con una sensibilización exagerada de los receptores del dolor en la piel, haciendo que las personas sientan un dolor fuerte (alodinia) por estímulos que normalmente no duelen. Por ejemplo, algunas personas pueden sentir dolor con el roce de las sábanas que cubren ligeramente el cuerpo”. ¹
Neuropatia del nervio cubital y síndrome de tunel carpiano
El esfuerzo repetitivo con frecuencia causa neuropatías de compresión neural, en que los nervios se dañan porque se encuentran comprimidos o atrapados.
El daño acumulativo puede ser el resultado de actividades repetitivas, con posturas poco naturales, o en las que se ejerce una presión grande y que requieren movimiento de cualquier grupo de articulaciones durante períodos prolongados. La irritación resultante puede hacer que los ligamentos, tendones y músculos se inflamen e hinchen, restringiendo las vías estrechas por donde pasan algunos nervios. La neuropatía del nervio cubital y el síndrome del túnel carpiano son ejemplos de los tipos más comunes de neuropatía de compresión o atrapamiento de los nervios en el codo o en la muñeca.¹
Este es uno de los grandes problemas que como enfermo no se entiende cuando se hacen electromiogramas para comprobar si el nervio está dañado. Se sufre dolor de manos en fibromialgia y los resultados pueden ser perfectamente negativos y seguir habiendo dolor. La complejidad del desarrollo del dolor en fibromialgia es suficiente para sufrirlo sin lesión en el nervio, hay dolor que bien por movimiento o estimulos táctiles son traducidos por la sensibilización central por dolor.
La sintomatologia es muy similar y lo que en un principio se puede evaluar como neuropatia del nervio cubital o síndrome de tunel carpiano la electromiografia puede que no indique que haya lesiones en nervios y sea calificado como un síntoma más de la fibromialgia, sintoma que deberá tratarse con los tratamientos para el dolor en fibromialgia. El tratamiento del dolor en la fibromialgia con fármacos no deja de se muy diferentes a otras enfermedades con dolor crónico.
Esto es si una electromiografia sale negativa, si por el contrario sale positiva también en fibromialgia se pueden padecer las dos neuropatias cubital o síndrome del tunel carpiano, además de fibromialgia.
Así llega la información táctil desde los dedos al cerebro
Hasta quí un largo recorrido por la complejidad del dolor de manos en fibromialgia, si además quieres adentrarte en la complejidad de la investigación y del dolor, a continuación una reproducción de una parte del articulo Así llega la información táctil desde los dedos al cerebro
Dirigido por Ardem Patapoutian, del Instituto Médico Howard Hughes, este otro grupo de investigación ha averiguado que el importante papel de las células de Merkel para la detección del tacto se debe a una proteína llamada Piezo2.
Incrustada en la membrana celular, esta proteína se comporta como una compuerta -o canal- que se abre con la presión sobre la piel, dejando pasar iones positivos que provocan una corriente eléctrica que se transmite a las terminaciones nerviosas y viaja en forma de impulso nervioso hasta el cerebro a la nada despreciable velocidad de 70 metros por segundo. De hecho, se había observado con anterioridad que las células de Merkel establecían contactos parecidos a las sinapsis con las fibras nerviosas y que también tienen neurotransmisores.
Estos hallazgos pueden ayudar a comprender mejor y a tratar algunos síndromes en los que las sensaciones táctiles ligeras, como el roce de una prenda de vestir sobre la piel o de una sábana, desencadenan un dolor intenso, un fenómeno que se conoce como alodinia. Y es que, el tacto y el dolor están íntimamente relacionados.
Alta precisión táctil
Estos nuevos hallazgos destacan el papel de estas células de Merkel, de las que hasta hace poco se desconocía su función exacta en la formación de las sensaciones táctiles. Ahora pasan a ocupar un papel destacado, ya que son esenciales para iniciar y mantener la transmisión del impulsos en las terminaciones nerviosas de la piel y al parecer son las responsables de la alta precisión de las sensaciones táctiles finas.
En concreto se encargarían de transformar la presión en estímulos eléctricos que puedan viajar al cerebro. Estas células receptoras de la piel forman un “equipo” inseparable con las terminaciones nerviosas que hacen posible que las yemas de nuestros dedos o nuestra boca, dos zonas ricas en células de Merkel, tengan una sensibilidad tan acusada y precisa.
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