Muchas personas la padecen. A pesar de las visitas al médico, la condición general no parece mejorar. Los pacientes sienten lo mismo: una condición de dolor muscular crónico que se extiende a más o menos todas las partes del cuerpo y se manifiesta por astenia y fatiga permanente con importantes trastornos del sueño. ¿Es la fibromialgia?
La fibromialgia, también llamada síndrome idiopático difuso o polialgico, SPID es una enfermedad psicosomática que causa dolor generalizado en los pacientes: tienen mal … en todas partes. Esta enfermedad se presenta en personas entre los 30 y 60 años de edad, pero en su mayoría alrededor de los 45 años, afecta al 2-6% de la población en los países industrializados, con un predominio de mujeres (80% mujeres).
Varias causas… involucradas
Se pueden mencionar los factores genéticos: las personas que padecen fibromialgia a menudo tienen a alguien en la familia que ha experimentado el mismo problema. También se puede asumir una anomalía del sistema nervioso central, con tasas más bajas de neurotransmisores, como la serotonina en los pacientes. También incluyen la posibilidad de un trastorno metabólico de la sustancia P que conduce a la transmisión de los impulsos nerviosos nociceptivos, lo que aumenta la sensibilidad al dolor. Factores infecciosos, como el virus de la hepatitis B o C, también pueden ser la causa de este síndrome. Por otro lado, los problemas psicológicos, particularmente el estrés patológico, la ansiedad y la depresión, también están involucrados. finalmente,
Dolor, trastornos del sueño, fatiga crónica.
La fibromialgia se puede considerar como un trastorno de la percepción del dolor, con un umbral de dolor reducido y falta de capacidad para hacer frente al dolor. Clínicamente se manifiesta como dolor difuso, predominantemente muscular asociado con fatiga crónica y trastornos del sueño. El dolor muscular difuso afecta ciertas áreas del cuerpo que son muy dolorosas e involucran una contracción muscular, comenzando con el cuello, los hombros y luego incluso tocando la espalda, el pecho y los brazos para finalmente alcanzar las piernas.
El paciente a menudo siente que las áreas dolorosas están hinchadas. Los dolores de cabeza intensos y las migrañas a veces se asocian con SPID, así como con el síndrome del intestino irritable (estreñimiento, dolor abdominal, flatulencia …). También se encuentran dificultades para concentrarse en estos pacientes y, a menudo, depresión y ansiedad o en un tercio de los pacientes.
En cuanto al diagnóstico médico, se realiza de acuerdo con los criterios establecidos por el American College of Rheumatology desarrollado en 1990. Para mantener el diagnóstico de fibromialgia, debe asistir a una historia clínica de dolor muscular generalizado durante 3 meses, así como en la evaluación clínica Del paciente de 11 puntos dolorosos en 18 puntos característicos de la enfermedad.
Advertencia: ¡factores agravantes!
Trauma, estrés, shock emocional, otras enfermedades somáticas (diabetes, infección …), ruido, promiscuidad, esfuerzo físico intenso, frío, humedad, calor, algunas conversaciones estresantes, falta de sueño … Todo esto puede provocar una crisis de fibromialgia.
La fibromialgia no es una enfermedad grave en el plano vital, que no causa problemas de salud importantes, pero es crónica y, a menudo, resistente al tratamiento médico. Puede tener consecuencias familiares para la pareja y la familia como tensiones familiares. También puede sonar sobre el trabajo con un alto índice de ausentismo e incapacidad para concentrarse, lo que puede disminuir el rendimiento.
¡Vamos a evitarlo!
En cuanto a la prevención, se basa esencialmente en el examen de estados de ansiedad, crónicos o depresivos, en pacientes con dolor crónico difuso, principalmente dolor muscular. Es necesario un tratamiento para evitar la cronicidad de los dolores y para evitar la instalación del círculo vicioso.
Tratamiento, un verdadero dolor de cabeza.
“El tratamiento es muy difícil y está mal codificado”, dice el especialista. Los analgésicos (con 3 niveles de la OMS) y los fármacos antiinflamatorios que se usan solos a menudo son ineficaces por sí solos. Eventualmente, puede usarse como antidepresivos o anticonvulsivos en lugar de sus efectos analgésicos en el sistema nervioso central. Y como antidepresivo, aquellos en la familia tricíclica que son muy efectivos contra la falta de sueño permiten reducir el dolor y mejorar la calidad de vida. Otros antidepresivos también son efectivos como inhibidores selectivos de la recaptación de serotonina (que parecen estar implicados en la fisiopatología de la fibromialgia).
“Eglología glosa, el término fibromialgia proviene de la fibra latina” (fibra), el griego antiguo “myos” o músculo y el griego “algos” que es dolor.
Los ansiolíticos también pueden usarse por su eficacia en el sueño. En particular, se pueden recetar benzodiacepinas, pero esto puede llevar a la adicción y la adicción. Otros tratamientos incluyen relajantes musculares como el tiocolicosico, que funciona en la contracción muscular. Finalmente, los hipnóticos se pueden usar para el efecto restaurador de los trastornos del sueño. Especial importancia para el apoyo psicológico para estos pacientes por parte de un psicólogo o psiquiatra. Algunos médicos proponen una dieta equilibrada, el vertido de estimulantes como el tabaco y el alcohol y el uso de la homeopatía. Ejercicios de balneoterapia y programas de fisioterapia, incluidos ejercicios aeróbicos,
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