La fibromialgia y el síndrome de dolor miofascial a menudo van de la mano. Debido a la frecuente superposición y algunos síntomas similares, son a menudo confundido con la misma condición y, como resultado, las personas que tienen a veces sólo se diagnostica y se trata de uno.
Eso es un problema real, por tres razones principales:
- que requieren un tratamiento diferente
- puntos de activación de MPS se pueden eliminar
- MPS puede exacerbar el dolor FMS, y la reducción del dolor MPS puede calmar los síntomas del SFM considerablemente
Algunos investigadores utilizan el nombre de “dolor miofascial crónico” (CMP) en lugar del síndrome de dolor miofascial debido a la evidencia que es una enfermedad, no un síndrome. (A “síndrome” es un conjunto de síntomas sin una causa conocida).
Visión de conjunto
En MPS, los músculos y los tejidos conectivos (que componen la fascia) desarrollan lo que se llama un punto de activación (TRP). Estos son no lo mismo que los puntos FMS licitación.
Un punto gatillo es un nudo pequeño y duro que a veces puede sentirse debajo de la piel. El nudo en sí puede ser dolorosa, especialmente cuando se lo pincha, pero a menudo causa dolor en otra zona, que se denomina dolor referido.
típicamente puntos de activación se forman como resultado de un trauma en el tejido. Los expertos no saben qué daño que se cura normalmente en la mayoría de las personas hace que los PG en otros. Sin embargo, los estudios sugieren que la lesión muscular en algunas personas conduce a anormalidades en las células nerviosas se conectan a las células musculares. Esto sugiere MPS es una enfermedad neuromuscular.
Asociación
¿Por qué las personas con MPS frecuentemente desarrollan FMS aún no está claro, pero un creciente cuerpo de evidencia muestra que, en algunas personas, el dolor crónico puede realizar cambios en el sistema nervioso central, dando lugar a la sensibilización central. Si las teorías son correctas, el tratamiento precoz de MPS puede ayudar a prevenir la FMS.
Un término general que emerge para FMS, MPS, y otras enfermedades relacionadas con la sensibilización central es síndromes centrales de sensibilidad.
Los síntomas
Algunos de los síntomas asociados con MPS son similares a los síntomas asociados con FMS, mientras que otros están vinculados a una sola de.
Los síntomas que tienen en común incluyen:
- el dolor de los tejidos blandos que van de leves a severos
- dolores de cabeza y / o migrañas
- trastornos del sueño
- problemas de equilibrio y / o mareos
- tinnitus (zumbido en los oídos) y dolor de oído
- 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 MPS, pero no con FMS incluyen:
- entumecimiento en las extremidades
- clics o chasquidos articulaciones
- gama limitada de movimiento en las articulaciones, especialmente la mandíbula
- duplicado o visión borrosa
- náuseas inexplicadas
Los síntomas asociados con la FM, pero no con MPS incluyen:
- fatiga
- ataques de pánico
- sentirse abrumado debido a los altos niveles de la información sensorial
- alergias y sensibilidades
- confusión y desorientación periódica
Para más síntomas de la fibromialgia, consulte la lista de Monster síntomas de la fibromialgia.
Diagnóstico
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.
Las pruebas como la elastografía por resonancia magnética y la biopsia de tejido puede mostrar anomalías en los PG, pero su papel en el diagnóstico de MPS todavía no están claras.
Por el contrario, no existe ninguna prueba o exploración revela anormalidades en los tejidos en los que las personas con dolor FMS experiencia.
Tratos
Tiene varias opciones para el tratamiento de MPS:
- Las inyecciones de los puntos gatillo: El médico inserta una aguja directamente en un PRO o en varios lugares alrededor de él para 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 la fibromialgia.) Cuando no se utiliza la medicación, 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 limitados que son prometedores, y muchos pacientes y profesionales informan buenos resultados.
- Terapia física: Un tipo especial de terapia llamada de rociado y estiramiento es común para el tratamiento de MPS. Un fisioterapeuta le guía a través de ejercicios de estiramiento mientras se pulveriza una sustancia adormecedor en su músculo. El terapeuta también puede utilizar ciertas técnicas de masaje para relajar los músculos y los PG. Además, un terapeuta puede trabajar con usted en factores como la mala postura que puede contribuir a MPS.
- Medicamentos: medicamentos comunes para MPS incluyen fármacos antiinflamatorios no esteroideos (AINE) tales como Aleve (naproxeno) o medicamentos a base de ibuprofeno como Advil y Motrin, y antidepresivos tricíclicos tales como amitriptilina, doxepina, y la nortriptilina.
Tratamientos Tratamientos MPS vs. FMS
Una vez más, existe un cierto solapamiento, sino también diferencias importantes. Los tratamientos utilizados tanto para MPS y FMS incluyen:
- acupuntura
- terapia physcial (aunque en diferentes formas)
- antidepresivos tricíclicos (aunque antidepresivos SSRI / SNRI son cada vez más común para FMS)
Los estudios muestran inyecciones gatillo de punto no son eficaces en el alivio de los puntos sensibles fibromialgia, y los AINE no son eficaces en el tratamiento del dolor FMS.
Para más información sobre tratamientos para la fibromialgia, véase el tratamiento de la fibromialgia – un enfoque multidisciplinario.
Albardilla
Con diferencias significativas en sus síntomas, diagnóstico y tratamiento, está claro que la fibromialgia y el síndrome de dolor miofascial no son la misma condición. Sin embargo, puede ser extremadamente difícil determinar qué condición está causando dolor, que cuando una persona tiene ambos.
Al trabajar tanto por su cuenta y con su médico y / o terapeuta físico, que puede ser capaz de averiguar donde tiene puntos gatillo y la mejor manera de tratarlos sin exacerbar su fibromialgia. Aliviar el dolor miofascial es probable que calmar los síntomas de la fibromialgia, por lo que bien podría ver un doble beneficio.
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