La fibromialgia y el síndrome de dolor miofascial a menudo van de la mano. Debido al frecuente solapamiento y algunos síntomas similares, a menudo se confunden con las mismas condiciones y, como consecuencia, las personas con ambos a veces sólo se diagnostica y se trata de uno.
La distinción entre el síndrome de dolor miofascial (MPS) y la fibromialgia (FMS) es uno fundamental por tres razones principales:
Ellos requieren un tratamiento diferente.
Puede eliminar los puntos gatillo.
Dolor de MPS puede exacerbar FMS, y el tratamiento de MPS puede calmar FMS.
Algunos investigadores utilizan el nombre de “dolor miofascial crónico” (CMP) en vez del síndrome de dolor miofascial debido a la evidencia que es una enfermedad, no un síndrome.(Un “síndrome” es un conjunto de síntomas sin una causa conocida.)
¿Qué Es El Síndrome De Dolor Miofascial?
En MPS, los músculos y los tejidos conectivos (que constituyen la fascia) desarrollar lo que se llama un punto de disparo (TRP). (Estos son no lo mismo que los puntos sensibles de FMS.) Un punto gatillo es un pequeño y duro nudo que a veces se puede sentir bajo la piel. El nudo en sí mismo puede ser doloroso, especialmente cuando se lo pincha, pero a menudo causa dolor en otra zona, que se llama dolor referido.
Los puntos de activación típicamente se forman como resultado de un traumatismo en el tejido. Los expertos no saben por qué el daño que se cura normalmente en la mayoría de las personas hace que los PG en otros. Sin embargo, los estudios sugieren que el trauma muscular en algunas personas conduce a malformaciones en donde las células nerviosas se conectan a las células musculares. Esto sugiere MPS es una enfermedad neuromuscular.
¿Por Qué La Fibromialgia Y El Síndrome De Dolor Miofascial Van Juntos?
¿Por qué las personas con MPS frecuentemente desarrollan FMS aún no está claro, pero un creciente cuerpo de evidencia muestra que el dolor crónico puede realizar cambios en el sistema nervioso central, dando lugar a la sensibilización central . Sin embargo, no todas las personas con MPS desarrolla FMS. Si las teorías son correctas, el tratamiento temprano de MPS puede ayudar a prevenir la FMS.
Un término general que emerge de FMS, MPS, y otras enfermedades relacionadas con la sensibilización central es síndromes de sensibilidad centrales .
Los Síntomas Del Síndrome Miofascial Y Fibromialgia Dolor
Algunos de los síntomas asociados con MPS son similares a los síntomas asociados con FMS, mientras que otros parecen ser distintos. Los síntomas que tienen en común son:
Dolor de tejidos blandos que van desde leves a graves
Los dolores de cabeza y / o migrañas
Trastornos del sueño
Los problemas de equilibrio y / o mareos
Tinnitus (zumbido en los oídos) y dolor de oído
Los problemas de memoria
Sudoración inexplicable
Empeoramiento de los síntomas debido a estrés, cambios / extremos en el clima, y la actividad física
Los síntomas asociados con el SPM, pero no con FMS son:
Entumecimiento en las extremidades
Clics o chasquidos articulaciones
Rango limitado de movimiento en las articulaciones, especialmente la mandíbula
Ver doble o borrosa
Náuseas inexplicables
Los síntomas asociados con la FM, pero no con MPS incluyen:
Fatiga
Los ataques de pánico
Se siente abrumado por los altos niveles de la información sensorial
Alergias y sensibilidades
Periódico confusión y desorientación
El Diagnóstico De Síndrome De Dolor Miofascial
El dolor referido hace MPS especialmente difícil de diagnosticar y tratar. Por lo general, el médico le dice: “¿Dónde le duele?” y luego mira dónde apuntas. Para el tratamiento de MPS, usted y su médico necesita examinar sus síntomas y averiguar dónde están sus puntos gatillo son.
Su médico puede encontrar los puntos gatillo mediante el tacto o con base en los síntomas.Pruebas como la elastografía por resonancia magnética y biopsia de tejido puede mostrar anomalías en los PG, pero su papel en el diagnóstico de MPS aún no están claras.
Por el contrario, no existe ninguna prueba o análisis revela anomalías en los tejidos donde las personas con fibromialgia experimentan dolor.
El Tratamiento Del Síndrome Del Dolor Miofascial
Usted tiene varias opciones para el tratamiento de MPS:
Inyecciones punto de inflexión: el médico inserta una aguja directamente en un PRO o en varios lugares alrededor de aflojar las bandas tensas. El médico puede inyectar un medicamento para aliviar el dolor, tales como corticosteroides o lidocaína. (Nota:. algunos médicos creen que los corticosteroides pueden exacerbar los síntomas de fibromialgia) Cuando no se utiliza ningún medicamento, se llama punción seca.
Acupuntura : La acupuntura es una antigua práctica china similar a la punción seca.Mientras que los estudios de su uso en MPS son limitadas son prometedores, y muchos pacientes y médicos reportan buenos resultados.
Fisioterapia: Un tipo especial de terapia llamada por aspersión y strech es común para el tratamiento de MPS. Un fisioterapeuta le guía a través de ejercicios de estiramiento durante la aplicación de una sustancia de un anestésico en el músculo. El terapeuta también puede utilizar algunas técnicas de masaje para relajar los músculos y TRPS.Además, un terapeuta puede trabajar con usted en factores como la mala postura que pueden contribuir a MPS.
Medicamentos: Los medicamentos comunes para la MPS incluyen fármacos antiinflamatorios no esteroideos (AINE), t como Aleve (naproxeno) o medicamentos a base de ibuprofeno como Advil y Motrin, y antidepresivos tricíclicos como la amitriptilina ,doxepina y la nortriptilina .
MPS Tratamientos Tratamientos Contra FMS
Una vez más, existe un cierto solapamiento pero también diferencias importantes. Los tratamientos utilizados tanto para MPS y la FMS son:
Acupuntura
Terapia Physcial (aunque en diferentes formas)
Los antidepresivos tricíclicos (aunque ISRS / IRSN antidepresivos son cada vez más común para FMS)
Los estudios muestran inyecciones de punto gatillo no son eficaces en el alivio de los puntos sensibles de fibromialgia, y los AINE no son eficaces en el tratamiento del dolor FMS, ya que la inflamación de destino y FMS no se sabe que es una condición inflamatoria.
Viviendo Con Fibromialgia Y El Síndrome De Dolor Miofascial
Con diferencias significativas en sus síntomas, diagnóstico y tratamiento, es claro que la fibromialgia y el síndrome de dolor miofascial no son la misma condición. Como alguien que tiene los dos, sin embargo, sé que puede ser extremadamente difícil determinar qué condición está causando que el dolor.
Al trabajar tanto por su cuenta y con su médico y / o terapeuta físico, usted puede ser capaz de averiguar donde tiene puntos gatillo y la mejor manera de tratarlos sin exacerbar la fibromialgia. Aliviar el dolor miofascial es probablemente para calmar sus síntomas de fibromialgia, por lo que bien podría ver un doble beneficio.
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