FIBROMIALGIA É AGORA CONSIDERADO UM DISTÚRBIO DO SISTEMA NERVOSO CENTRAL PARA A VIDA

A fibromialgia é uma desordem reumática segunda mais comum atrás osteoartrite e embora ainda muito mal compreendidos, é agora considerada um distúrbio do sistema nervoso central para a vida, que é responsável pela dor amplificado que dispara por meio do corpo em aqueles que sofrem.

Daniel Clauw, MD, Professor de Anestesiologia da Universidade de Michigan, analisou a base neurológica da fibromialgia em uma sessão plenária hoje na reunião científica anual da American Pain Society.

“Fibromialgia pode ser considerada tanto como uma doença distinta e também como uma via comum final de centralização e cronologia de dor. A maioria das pessoas com esta condição têm uma história de dor crónica a longo prazo em seus corpos “, disse Clauw. “A condição pode ser difícil de diagnosticar se a pessoa não sabe os sintomas clássicos, porque não existe uma causa única e nenhum sinal externo.”

Clauw explicado que a dor da fibromialgia é mais do cérebro e da medula espinal que as áreas do corpo em que a pessoa sofre de dor periférica. A condição é considerado a ser associada com perturbações na maneira como o cérebro processa dor e outras informações sensoriais. Ele disse que os médicos devem suspeitar de fibromialgia em pacientes com dor multifocal (principalmente músculo-esqueléticos) que não explica totalmente por lesão ou inflamação.

 

“Uma vez que as vias da dor durante todo o corpo são amplificados em pacientes com fibromialgia, dor pode ocorrer em qualquer lugar, a fim de que as dores de cabeça crónicas, dor visceral e a hipersensibilidade sensorial são comuns em pessoas que sofrem desta condição dolorosa “, disse Clauw.

“Isto não implica que a entrada nociceptiva periférica não contribui para a dor sofrida pelos pacientes com fibromialgia, mas eles se sentem mais dor do que o que seria normalmente esperado a partir do grau de contribuição periférica. Pessoas com fibromialgia e outros estados de dor caracterizada pela consciência vai sentir a dor Desde que aqueles cuja condição não descreve como toque “, disse Clauw.

Devido à origem do sistema nervoso central de dor da fibromialgia, Clauw disse que o tratamento com opióides e outros analgésicos narcóticos geralmente não são eficazes porque não reduzem a atividade dos neurotransmissores no cérebro . “Estas drogas nunca foram consideradas eficazes em pacientes com fibromialgia, e há sinais de que os opióides podem até piorar a fibromialgia e outros estados de dor central”, disse ele.

Clauw aconselha clínicos para integrar tratamentos farmacológicos, tais como as gabapentinoids trycycliques e inibidores da recaptação da serotonina, com abordagens não farmacológicas, tais como a terapia comportamental cognitiva, exercício e a redução do stress.

“Por vezes, a escala da resposta ao tratamento para terapias não-droga simples e baratos que excede de produtos farmacêuticos,” disse Clauw. “O maior benefício é a função melhorada, que deve ser o principal objetivo do tratamento para qualquer dor crônica. A maioria dos pacientes com fibromialgia pode ver uma melhora em seus sintomas e viver uma vida normal com a medicação certa e uso intensivo de terapias não-medicamentosas. “

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