Fibromialgia, il nostro dolore NON è un’invenzione! Sindrome da sensibilizzazione centrale, ipersensibilità al dolore.

Che cosa causa la sensibilizzazione centrale?
La sensibilizzazione centrale comporta cambiamenti specifici nel sistema 
nervoso. 
I cambiamenti nella parte dorsale del midollo spinale e nel cervello si 
verificano in particolare a livello cellulare, come nei nervi recettori. 
Come notato sopra, è noto da molto tempo 
che ictus e lesioni del midollo spinale 
possono causare sensibilizzazione centrale. 
È logico. 
Gli ictus e le lesioni del midollo spinale causano 
danni al sistema nervoso centrale: il cervello, in caso di 
ictus, e il midollo spinale, in caso di lesioni del midollo 
spinale. 
Queste lesioni alterano le parti del sistema nervoso 
direttamente coinvolte nella sensibilizzazione centrale.

Ma quali sono i disturbi del
dolore cronico sopra elencati, come mal di testa
mal di  schiena cronico o dolore alle 
estremità , più comunemente prominenti  
Le lesioni o le condizioni che portano a questi tipi di dolore cronico 
non sono lesioni dirette al cervello o al midollo spinale. 
Piuttosto, coinvolgono lesioni o malattie del
sistema nervoso  periferico, la parte del sistema nervoso che si trova al di fuori del 
midollo spinale e del cervello. 

Come le lesioni e le condizioni associate con la  periferica nervoso  vantaggio del sistema ai cambiamenti del centro del sistema nervoso  ,  che, a  sua volta, portare a dolore cronico nella zona  remota dal  l’  infortunio originale? 

In breve,  come si  trasformano le emicranie  isolate in cefalee croniche quotidiane? 
In che modo una
lesione acuta della parte superiore della  schiena si trasforma in  una lombalgia cronica? 
In che modo un infortunio alla mano o al piede si trasforma in una  complessa
sindrome del  dolore regionale?
Ci sono molteplici probabili fattori che portano allo sviluppo della 
sensibilizzazione centrale, e questi cosiddetti
disturbi “periferici” del  dolore cronico. 

Questi fattori possono essere suddivisi in due categorie:
Fattori associati allo stato del sistema nervoso centrale 
prima dell’inizio della lesione originale o della condizione di dolore.
Fattori associati al sistema nervoso centrale dopo l’ 
insorgenza della lesione o della condizione dolorosa originale
Il primo gruppo comprende quei fattori che potrebbero predisporre i 
pazienti a sviluppare una sensibilizzazione centrale, una volta che si 
verifica una lesione. 
E il secondo gruppo coinvolge gli antecedenti, che promuovono la 
sensibilizzazione centrale una volta che il dolore inizia.

1) Fattori predisponenti
Probabilmente vi sono fattori predisponenti biologici, psicologici e ambientali 
.
La bassa e alta sensibilità al dolore, o alle soglie del dolore, è in parte 
dovuta a molteplici fattori genetici. 
Sebbene non vi siano ricerche a sostegno di una relazione causale tra 
le soglie del dolore preesistenti e il successivo sviluppo della 
sensibilizzazione centrale dopo la lesione, si presume in gran parte che 
ne verrà trovata una.

2) Fattori psicofisiologici: 
come la risposta allo stress, sono anche in grado di svolgere un 
ruolo nello sviluppo della sensibilizzazione centrale. 
Test sperimentali diretti su animali e umani, così come 
studi sull’uomo, hanno mostrato una relazione tra stress e 
diminuzione delle soglie del dolore. 
Allo stesso modo,  diversi tipi di ansia, o paura di far 
male,  sono costantemente correlati a una maggiore 
sensibilità al  dolore. 
Tutti questi fattori psicofisiologici suggeriscono che lo stato preesistente 
del sistema nervoso è un determinante importante dello sviluppo del 
sensibilizzazione centrale dopo l’inizio del dolore. 
È logico. 
Se la risposta allo stress ha causato la reazione del sistema nervoso prima 
della lesione, allora  il sistema nervoso potrebbe essere maggiore 

incline  a essere  sensibilizzato centralmente una volta che  inizia il  dolore.
Ci sono anche prove indirette considerevoli per questa teoria. 
Una precedente storia di ansia, traumi fisici e psicologici e 
depressione  predice in modo significativo l’insorgenza del dolore 
cronico più tardi nella  vita. 

Il denominatore comune tra dolore cronico, ansia, trauma e 
depressione è il sistema nervoso. 
Sono tutte malattie del sistema nervoso , in particolare 
un sistema nervoso persistentemente alterato o disregolato.
Non è che questi problemi preesistenti rendano le persone più 
inclini a lesioni o insorgenza di malattie, poiché 
lesioni o malattie si verificano in modo casuale in tutta la popolazione. 
Al contrario,  questi problemi preesistenti possono rendere le persone inclini a sviluppare dolore cronico, una volta che si verifica una lesione o una malattia. 
Il sistema nervoso già disregolato , al momento di trauma, 
ferita, incidente, ictus, per esempio, può impedire la normale guarigione e quindi impedire che il dolore scompaia una volta che il
danno ai  tessuti guarisce.

209 thoughts on “Fibromialgia, il nostro dolore NON è un’invenzione! Sindrome da sensibilizzazione centrale, ipersensibilità al dolore.

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