Fibromialgia e sindrome da stanchezza cronica: quando la stanchezza e il dolore diventano cronici

By admin  On  In Italian 357 Comments

Il dolore e l’esaurimento sono sintomi comuni che, se diventano cronici, possono causare preoccupazione.

Si stima che tra il 2 e il 10% della popolazione generale possa essere colpita, con più casi che si verificano nelle donne. La diagnosi precoce è importante

  • Il 40% degli argentini ha la pressione alta

Dal 1992, l’     Organizzazione mondiale della sanità (OMS) ha riconosciuto la   fibromialgia   , una delle condizioni di dolore cronico più comuni, nella sua   classificazione internazionale delle malattie   . Può essere colpito tra il 2 e il 10% della popolazione generale, il che è nove volte più frequentemente nelle donne.

A quali sintomi dovremmo prestare attenzione? Quali progressi ci sono nella diagnosi e nel trattamento? Qual è il tuo rapporto con la sindrome da stanchezza cronica? Il   Dra. Evangelina Melgar   (MN 133447), medico psichiatrico e coordinatore dell’ambulatorio per pazienti con fibromialgia e stanchezza cronica   INECO   , fornisce le chiavi per comprendere queste patologie che possono influenzare le attività della vita quotidiana e le relazioni interpersonali di chi ne soffre.

Di solito, la   fibromialgia inizia   tra i 30 ei 40 anni, anche se una percentuale minore può comparire durante l’infanzia e l’adolescenza. Il sintomo principale è il dolore muscoloscheletrico generalizzato, che peggiora con la pressione dei punti dolenti. L’intensità del dolore varia a seconda dei cambiamenti climatici, dell’attività fisica, dello stress psicologico o della mancanza di sonno. Di solito inizia in una zona del corpo e migra attraverso diverse aree, fino a quando non si diffonde nel tempo.

Il 90% dei pazienti soffre di affaticamento, il 70-80% ha problemi a dormire e fino al 25% soffre di ansia o depressione. È comune anche una scarsa tolleranza all’esercizio; sensazione di pesantezza agli arti, rigidità generalizzata (soprattutto quando ci si alza al mattino); sensazione di infiammazione e formicolio mal definita alle mani e ai piedi. Può essere associato a mal di testa, vertigini, deterioramento cognitivo della memoria e dell’attenzione, bruxismo, sintomi gastrointestinali, come sindrome dell’intestino irritabile, dispepsia, nausea. La presenza di questi sintomi o sindromi associati varia in ogni persona.

La stanchezza stessa è un sintomo che può essere riscontrato in diversi grafici, ma la   sindrome da stanchezza cronica   (CFS), chiamata anche encefalomielite mialgica, è un’entità clinica riconosciuta da tutte le organizzazioni mediche internazionali e   dall’OMS   . Solo l’8% delle volte, la fibromialgia è associata alla   CFS   .

La sindrome può manifestarsi a qualsiasi età, anche durante l’infanzia, ma è più comune nelle donne di età compresa tra i 20 ei 40 anni. In molti casi, inizia improvvisamente dopo un episodio infettivo o dopo un trauma fisico o mentale, come un intervento chirurgico, un incidente o la morte di una persona cara. In altri, appare gradualmente. Questo può durare diversi mesi e persino anni; solo una piccola percentuale si riprende completamente.

La   CFS   è caratterizzata da una stanchezza estrema di oltre 6 mesi e non alleviata dal riposo, insieme ad un altro gruppo di sintomi che sono costanti per più di 6 mesi. Tra questi: disturbi del sonno, dolori muscolari o articolari, mal di testa, mal di gola, disturbi della concentrazione e della memoria, sensazione di vertigini o nausea. La gravità dei sintomi varia di giorno in giorno.

La diagnosi precoce è la chiave del successo

Sebbene le cause di entrambe le condizioni siano sconosciute, i fattori genetici potrebbero predisporre allo sviluppo della fibromialgia, mentre per   la sindrome da stanchezza cronica   (CFS) esistono molte teorie, che vanno dalla loro relazione con le infezioni virali allo stress psicologico.

La diagnosi delle due patologie è eminentemente clinica. Per il momento nessuno studio aggiuntivo li conferma, viene stabilito durante un colloquio con il professionista, in cui il paziente descrive i sintomi. Vengono utilizzate alcune scale: questionari sul dolore in diverse regioni del corpo e sulla gravità dei sintomi, dove viene valutata la presenza di alterazioni cognitive, sonno, stanchezza e altri sintomi somatici. Si consiglia inoltre la valutazione di uno specialista reumatologo per escludere patologie associate o che condividono sintomi simili.

La diagnosi precoce è la principale sfida presentata da queste malattie, per evitare la loro cronicità e un maggiore impatto sulla funzionalità della persona, migliorandone la qualità della vita.

La corretta segnalazione di queste condizioni dovrebbe essere il primo passo nel trattamento. Il paziente deve conoscere fin dall’inizio le caratteristiche della malattia, il suo decorso, nonché le aspettative positive e realistiche che rafforzano la sua collaborazione con le terapie, con fiducia in un probabile miglioramento.

C’è un consenso sul fatto che i programmi di esercizio dovrebbero essere uno dei trattamenti di base per tutti i pazienti con   fibromialgia   . Ad esempio, la rigidità mattutina, sintomo caratteristico, è dovuta a modificazioni del microcircolo che generano una sensazione di intorpidimento e provocano difficoltà e dolore nel muoversi dopo lunghi periodi di immobilità.

In questo senso sono indicati esercizi quotidiani di stretching e ossigenazione, nonché attività fisica aerobica non intensa. Gli anaerobi non sono raccomandati perché peggiorano la sensazione di pesantezza e dolore.

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