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La Fibromialgia, dolor de cabeza a los pies

La Fibromialgia es un síndrome de evolución crónica caracterizado por dolor generalizado, etiología desconocida, evolución variable y con frecuencia puede ir asociado a otras patologías físicas y psíquicas. Pertenece a los cuadros de dolor difuso con múltiples mecanismos en su origen.

La frecuencia de la enfermedad en la población se encuentra en torno a un 3% y lo anterior unido a la gran demanda de recursos por parte de estos pacientes hace inevitable el plantear una abordaje terapéutico integral que cumpla con las demandas de los mismos y aporte el mayor beneficio basándonos en la literatura médica existente.

La falta de identificación en el momento actual de mecanismos fisiopatológicos, unido al hecho de que parte de los síntomas son compartidos con otros procesos de dolor crónico ha llevado a la controversia sobre la aceptación de la FM como una enfermedad con una fisiopatología diferenciada, se ha relacionado con los «síndromes de sensibilización central».

Algunos estudios han cuestionado la especificidad diagnóstica de los puntos dolorosos y varios estudios han señalado que estos puntos pueden variar con el grado de estrés psicológico.

Fibromialgia

Tratamientos

Otros estudios han demostrado que el manejo solo farmacológico del dolor resulta insuficiente, poniendo de manifiesto que muchos fármacos como los AINE´s y los opioides pueden resultar en la mayoría de los casos contraproducentes, no mejorando el dolor, aumentando los efectos secundarios y empeorando algunos de los síntomas de la enfermedad.

Basándonos en la literatura científica y en los estudios que han conseguido la mejoría de sus pacientes, entendemos que el abordaje que puede ayudar a los pacientes en esta situación es inevitablemente multidisciplinar, es decir que participan varios especialistas, y que abarque todas las dimensiones susceptibles de mejorar de nuestros pacientes.

En nuestro programa integral intervienen tres servicios del Hospital Universitario de Torrejón:

  • Medicina Física y Rehabilitación
  • Salud Mental
  • Reumatología

Programa de Fibromialgia en el Hospital de Torrejón

Nuestro programa se lleva a cabo durante 3 meses, en los cuales se trabaja con los pacientes 2 miércoles al mes por la mañana y todos los lunes por la tarde.

La primera parte del programa consiste en charlas psicoeducativas a cargo de un médico rehabilitador y un psiquiatra, donde se aborda la fibromialgia desde ambas especialidades, profundizando en todos los aspectos propios de los pacientes y la parte médica de la patología. Se tratan las posibles causas de la enfermedad, la epidemiología, se habla acerca del diagnóstico, etc.

Durante todo el programa se lleva a cabo un grupo psicoterapéutico en 12 sesiones, con el fin de tener una orientación psicodinámica de tipo humanista, desde una visión holística de la enfermedad y el sufrimiento humano, donde cuerpo-mente forman un todo interconectado e inseparable.

Minimizar el dolor

En otra parte del programa, se tienen en cuenta los beneficios del ejercicio físico y la fisioterapia, así como sus contraindicaciones. En la fisioterapia, impartida por un fisioterapeuta especializado, se trabajan ejercicios de todos los grupos musculares, con el fin de corregir la postura corporal y fortalecer la masa muscular, con el objetivo de que el paciente adquiera los recursos necesarios para poder continuar trabajando en ello el resto de su vida.

Luego están las técnicas de relajación, impartidas por una enfermera especialista en salud mental, y las sesiones de risoterapia, «que son la parte del programa más novedosa y la última en incorporarse, dirigida por un risoterapeuta», apunta el Dr. Sergio Trinidad, Jefe de Servicio de Rehabilitación del Hospital de Torrejón, quien añade que con esta técnica se potencian los beneficios mentales y emocionales a través de la risa. Algunos beneficios de esta terapia son: disminución de la percepción del dolor, reducción de la ansiedad, rebaja del nivel de cortisol, combatiendo el estrés y el insomnio, los problemas cardiovasculares; mejora del sistema inmunitario y reducción de las contracturas en la espalda.

 

Contenido validado por el Dr. Sergio Trinidad, Jefe de Servicio de Rehabilitación del Hospital Universitario de Torrejón



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