LA FIBROMIALGIA ES AHORA CONSIDERADO UN TRASTORNO DEL SISTEMA NERVIOSO CENTRAL A LA VIDA

La fibromialgia es un trastorno reumático segundo más común detrás de la osteoartritis y aunque todavía ampliamente entendido mal, ahora se considera un trastorno del sistema nervioso central a la vida, que es responsable del dolor amplificado que dispara a través del cuerpo en los que sufren.

Daniel Clauw, MD, Profesor de Anestesiología, Universidad de Michigan, analizó las bases neurológicas de la fibromialgia en una sesión plenaria de hoy en la reunión científica anual de la Sociedad Americana del Dolor.

“La fibromialgia puede ser considerada tanto como una enfermedad discreta y también como una vía final común de centralización y cronología de dolor. La mayoría de las personas con esta enfermedad tienen una historia de dolor crónico a largo plazo en sus cuerpos “, dijo Clauw. “La condición puede ser difícil de diagnosticar si uno no conoce los síntomas clásicos porque no hay una sola causa y ninguna señal externa.”

Clauw explicó que el dolor de la fibromialgia es más el cerebro y la médula espinal que las áreas del cuerpo en el que una persona sufre de dolor periférico. La condición se considera que está asociada con alteraciones en la forma en que el cerebro procesa el dolor y otra información sensorial. Él dijo que los médicos deben sospechar de la fibromialgia en pacientes con dolor musculoesquelético multifocal (principalmente) que no explica totalmente por una lesión o inflamación.

 

“Debido a las vías del dolor en todo el cuerpo se amplifican en los pacientes con fibromialgia, el dolor puede ocurrir en cualquier lugar, por lo que los dolores de cabeza crónicos, dolor visceral y la hipersensibilidad sensorial son comunes en las personas que sufren de esta condición dolorosa “, dijo Clauw.

“Esto no implica que la entrada nociceptiva periférica no contribuye al dolor que sufren los pacientes con fibromialgia, pero se sienten más dolor que lo que normalmente se espera del grado de contribución periférica. Las personas con fibromialgia y otros estados de dolor que se caracteriza por la conciencia sentirán el dolor Desde que aquellos cuyo estado no describe como el tacto “, dijo Clauw.

Debido al origen del sistema nervioso central del dolor de la fibromialgia, Clauw dijo que el tratamiento con opioides y otros analgésicos narcóticos son generalmente no es eficaz debido a que no reducen la actividad de los neurotransmisores en el cerebro . “Estos fármacos no se han considerado eficaz en pacientes con fibromialgia, y hay indicios de que los opiáceos podrían incluso empeorar la fibromialgia y otros estados de dolor central”, dijo.

Clauw aconseja a los médicos para integrar los tratamientos farmacológicos, como los gabapentinoides trycycliques e inhibidores de la recaptación de serotonina, con enfoques no farmacológicos como la terapia cognitivo conductual, ejercicio y reducción del estrés.

“A veces la magnitud de la respuesta al tratamiento para las terapias simples y baratos no farmacológicos supera a la de los productos farmacéuticos”, dijo Clauw. “El mayor beneficio es la mejora de la función, que debe ser el objetivo principal del tratamiento para el dolor crónico. La mayoría de los pacientes con fibromialgia puede ver una mejoría en sus síntomas y vivir una vida normal con los medicamentos adecuados y el uso intensivo de las terapias no farmacológicas. “

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