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¿Cómo se define la fibromialgia?

17 febrero 2009 3.216 visitas 168 Comentarios

¿Cómo se define la fibromialgia?

La Fibromialgia (FM) es un síndrome complejo en el que el síntoma fundamental es la alteración en la modulación del dolor a nivel del sistema nervioso, produciéndose una mayor sensibilidad al dolor. Este síntoma se acompaña de otros como, trastornos del sueño y del estado de ánimo, fácil fatigabilidad, dificultad en la regulación térmica, intolerancia al estrés, entre otros.

 

¿Quiénes pueden padecerla? ¿Qué factores la desencadenan?

Sabemos que la genética juega un papel importante en la susceptibilidad a la enfermedad, sin embargo, no conocemos bien las causas que la desencadenan, aunque se supone que el estrés grave y mantenido, algunas infecciones y la presencia de otras patologías que cursen con dolor, pueden favorecer su desarrollo y persistencia. Es mucho más frecuente en mujeres sin que sepamos, a fecha de hoy año 2007, a que se deba esta predilección.

 

¿Qué síntomas se sufren?

Los enfermos con FM relatan un abanico muy extenso de síntomas pero siempre dominan el dolor y la fatiga. El resto de síntomas que pueden aparecer no deben atribuirse de forma automática a la FM, sino que debe ser consultados con el especialista pues pueden estar causados por otras enfermedades.

 

¿Qué papel juega el estrés y las presiones diarias en la aparición de la fibromialgia?

Es importante no confundirse cuando se utilizan estos términos. Si nos situamos en una calle concurrida de cualquier ciudad y pasamos, al azar, cuestionarios de medida de estrés, observaremos que gran parte de la población lo sufre pero no por ello desarrollará una fibromialgia. El estrés postraumático, como por ejemplo el que ocurre en las personas que han sido sometidas a la denigración de la tortura o la violencia de género, sí favorece el desarrollo de la fibromialgia, pues estas graves alteraciones sabemos que afectan a la síntesis de neuromediadores, cortisol y otras moléculas relevantes en el organismo. Lo que sí es cierto es que, una vez que se padece la enfermedad, el enfermo tolera muy mal cualquier situación de estrés mínimo que antes superaba sin dificultad. Los enfermos deben evitar las situaciones de estrés.

 

¿Qué incidencias tienen las experiencias individuales de trauma en relación a la fibromialgia?

Como hemos comentado antes, son importantes. Sin embargo, estudios recientes epidemiológicos, seguidos tras los atentados en las Torres Gemelas en Nueva York, no han demostrado un incremento de la FM en la ciudad, al contrario de lo que se esperaba. La FM afecta a la población de todo el mundo de una forma homogénea, tanto en áreas rurales como urbanas y en zonas del primer o tercer mundo. El diagnóstico de Trastorno por Estrés Postraumático es diferente al de FM y puede cursar también con dolor generalizado o con la presencia de trastornos somatomorfos. Es relevante un correcto diagnóstico diferencial.

 

¿Desde cuándo se tienen antecedentes de la enfermedad, y qué grado de complejidad presenta para la medicina actual?

El dolor es el síntoma más frecuente de la patología humana, desde el inicio de los tiempos. El dolor generalizado de causa desconocida es un concepto más reciente que se comenzó a acuñar en la década de los 80. La actual definición de la enfermedad, que utilizamos para el diagnóstico, es de 1990 y en este momento se encuentra en fase de revisión. Las fronteras entre las diferentes especialidades médicas, a veces tienen poco que ver con la complejidad de las patologías que nos plantean los enfermos. Estamos en un momento de cambio, donde el conocimiento, cada vez más profundo de los mecanismos del cuerpo humano, nos lleva a una integración de sistemas y aparatos. Por ejemplo, la relación entre los sistemas neurológico, endocrino e inmunológico, se conoce hace poco tiempo, aún se conoce menos su implicación en nuestra personalidad, temperamento o estado de ánimo, o a la inversa. En este contexto se desarrollan la Fibromialgia y otras muchas patologías. No son enfermedades somáticas o psicosomáticas, como los conceptos tradicionales pretenden clasificar, sino enfermedades complejas en las que el cuerpo y las emociones forman un conjunto con diferentes participaciones en cada caso. Tenemos que dejar de considerar a los enfermos con FM como un grupo homogéneo y deben ser tratados desde una perspectiva de complejidad, es por ello que la medicina tiene tantos problemas para su abordaje.

 

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168 Comentarios »

  • Gustavo dice:

    “La actual definición de la enfermedad, que utilizamos para el diagnóstico, es de 1990 y en este momento se encuentra en fase de revisión.”

    Os envío un link para que podáis seguir la Propuesta de cambio de nombre y definición de la Fibromialgia; Síndromes de Sensitivización Central.

    http://www.fibromialgia.nom.es/noticias-fibromialgia-sindrome-fatiga-cronica-sqm-2009/Sindromes-de-sensitivacion-central-cambio-de-nombre-de-fibromialgia.html

    Gracias por publicar este interesantísimo blog.

  • MariaN dice:

    Saludos Gustavo¡

    Me parece muy interesante el cambio de nombre que en el link que nos envías, se propone para la fibromialgia, aunque debo confesarte que casi me pierdo en el montón de palabras, supongo técnicas, que hay en el mismo.
    Me gustaría contar que, desde hace más de cinco años, estoy siguiendo un tratamiento prescrito por un médico de USA, el cual a su vez está casado con una doctora que padece fibromialgia, te cuento esto porque de momento de curar nada de nada, pero es el empujón que muchos días necesito para ponerme en pie y afrontar un nuevo día, son simplemente antioxidantes y me pregunto, entre mil cosas más, porque no se investiga más sobre esto y nos dejan llevar una calidad de vida aceptable. El nombre que le den si al menos sirve para que investiguen pues me parece bien.
    Si encuentras más noticias me gustaría leerlas.
    Un saludo.

  • myan dice:

    Hola Marian, llevo muchos años con fibromialgia,actualmente tengo mchos dolores y mucho cansancio y me interesaria poder hablar contigo del tratamiento que tomas.He tomado muchos tratamientos pero como ya sabes,no hay nada efectivo.Ahora tomo paracetamol de 1g.alternandolo ccon nolotil.Me gustaria saber si sabeis algo sobre la melatonina.

    Un saludo

  • Luis Morales dice:

    Hola a todos!

    Me llamo Luis Morales. Vivo en Boston. Padezco fibromialgia desde enero, el mes en que me lo diagnosticaron. Tomo diariamente los medicamentos siguientes para el dolor:

    Oxicontin
    Oxicodona
    Gabapentina

    El dolor me azota sin tregua; los medicamentos surten efecto, pero no lo alivian 100%. El dolor me ataca en todas partes. Aun el acostarme y el levantarme me resultan ser un suplicio. Uso a veces un bastón para desplazarme en mi hogar. Quisiera saber de otras personas como las que han dejado comentarios arriba de sus experiencias y de tratamientos, tanto medicinales como terapeúticos (por ejemplo, la acupuntura o la terapia acuática)que les han traído beneficios de alivio. La fibromialgia ha impuesto límites a mis actividades diarias tanto en mi hogar como fuera de él. Estaría agradecido por cualquier consejo de parte de gente que, como yo, sufre diariamente de esta enfermedad.

    Saludos cordiales,

    Luis Morales

  • Luis Morales dice:

    Tengo 51 años, graduado de la Inter-American University, San Juan, Puerto Rico

  • fran dice:

    Me parece que la fibromialgia es un sindrome y no una enfermedad, y os equivocais si tomais medicamentos estandar para su alivio, y menos gabapentina y otras similares, el problema radica en dos factores fundamentales que tienen que ver con el sistema nervioso, el primero con el sistema nervioso periferico y sus conexiones fundamentales, y el otro con las fases 3 y 4 no REM del sueño q son las que regeneran los musculos de la actividad diurna. LLevo 3 años estudiando la fibromialgia, soy médico y creo que si se invierte e investigación real (como pasó con el VIH) la enfermedad se erradicaria en 2 ó 3 años, pero aunque exixte gente brillante estudiandola faltan medios y falta algo esencial y es que los que padecemos o hemos padecido esta maldita “enfermedda” seamos capaces de transmitir a la sociedad sus terrorificas consecuencias, creo que me he curado o estoy en proceso de (de forma autodidacta) y os aseguro que la medicación es una maldita pamplinada, el paracetamol, los AINES y sus familiares nada hacen contra este sindrome, o si lo hacen son en forma de efctos secundarios. Aunque epidemiolgicamente parecen que la padecen muchos grupos, ¿existía esta enfermedad hace años cuando eramos unos niños??, existe en el tercer mundo??, porque sobre las mujeres es mas manifiesto, porque no la padecen quienes duermen bien, porque se solapa con otros sindromes parecidos, …….muy pronto hará una pagina web con estas preguntas, leere vuestros comentarios, un abrazo, no os desanimeis, confiemos en la investigación, desconfiar de los “remedios” “milagro”. Postdata: yo he mejorado muchisimo con ser “autodidacta”.

  • Olga dice:

    Hola Fran, como enferma de fibromialgia coincido con Usted, y sobre todo en lo que respecta a los medicamentos.
    Lo felicito que usted como medico la estudie porque los enfermos como yo tenemos que aleccionar a los profesionales que nos atienden, porque ni siquiera entienden el dolor que sentimos.

    Si hubiesen muchos medico como usted la fibromialgia y los enfermos tendriamos mejores condiciones de vida.

    le comento que todo articulo de fibromialgia que encuentro lo doy a conocer.

    Me gustaria que se comunique conmigo, yo no puedo hacerlo no hay direccion de correo electronico.

    olgabrasero@speedy.com.ar

    saludos a todos

  • fran dice:

    Estimada Olga, aunque mi especialidad queda alejada de la fibromialgia que tratan reumatólogos, internistas, medicos de familia, etc, he de decirle que tengo el pleno convencimiento tras estudiarla fibromialgia y sibdromes afines durante dos años y con una base como médico, que se trata de una enfermedad “facilmente” curable. Hace tan solo 20 años cuando yo era un Residente de un gran hospital en nuestro pais, no podia ni imaginar que en mi especialidad estuvieramos haciendo las “cosas” que hacemos hoy en día, y he vivido como pacientes que antes morian rapidamente hoy viven muchos años y con una excelente calidad de vida. Que pasó: que la inversion economica ha sido muy grande. Algo similar ha ocurrido con el sida, antes se morian todos (yo lo recuerdo como si fuera ayer, chico/ass jovenes caquécticos que morian sin remedio), hoy se ha convertido en una enfermedad cronica si me apura de carater “leve” y con excelente calidad de vida. Por tanto la inversion debe ser grande y en apenas unos años, pocos probablemente se solucionará esta terrorifica enfermedad que destruye la dignidad de todos los que la padecen o hemos padecido. Por tanto la union hace la fuerza y debemos conseguirlo. Un comentario adicional Estimada Olga, a veces los diagnosticos de fibromialgia (que te repito es un cajon de sastre de varias patologias) son incorrectos, hace tan solo unas pocas semanas una señora que vino a mi consulta por otro tema y desesperadamente me contó sus dolores, en una semana los dolores desaparecieron, simplemente estaba tomando una medicacion que le producia daño muscular, la “señora” piensa que soy “dios” tras tantos años de dolor, y solo soy un humilde especialista que estudia diariamente y que vive para sus pacientes y su familia. Por ultimo le aconsejo que se meta en internet y vea los videos de redes de Eduart Punset en lo que ghacen referencia al cerebro, emociones y dolor, son buenisimos y te abren la mente para conocer algo mas de esta “enfermedad” del siglo XXI, un abrazo, disculpa que no le de mi email, lo tengo tan saturado que se colapsa rapido (en pocas semaas saldrá la pagina web que le comenté en la que estoy colaborando)pero si le digo que le seguiré en este blog, Un abrazo y ánimo que seguró seguro que saldrá de esta situación.

  • Elizabeth dice:

    Hola amigos con Fibromialgia,

    Pues les cuento que fui diagnosticada en el 2003, y hasta la semana pasada no podia mas con el dolor. Un amigo me recomendo ver a un especialista en medicinas naturales y encontre mi salvacion. Porfavor buscar este producto para que vea el cambio que van a sentir. Full Life: Reuma-Art X-Stregth. No tienen que tomar mas medicinas que lo hagan sentir con sueno y sin animo. Ohgastar dinero en terapias que no ayudan nada.

    Tratenlo y me dejan saber si se sienten mejor de los dolores como me sinti yo.

    Espero que se mejoren.

  • isabel dice:

    yo tambien padezco fibromialgia tomo medicamentos , un antiidepresivo, muy de vez en cuandoun antiinflamtorio. A mi me ayudo mucho hacer gimnnasia en el agua tres veces por semana, acupuntura tambien he hecho y ha rendido sus frutos, ahora por recomendacion de mi medico hago reike y flores de bach , tambien con muy buenos resultados, hago fisiterapia 1 vez por semana y bueno trato de que el dolor no me gana , cuianto mas dolorida se estar , mas actividades hago y me olvido de lo que me pasa, es mas mi medico me comemto que no es partidario de tanto medicamento. no nos queda otra que saber sobrellevar nuestra enfermedad y es mu dificil pero no imposible
    yo creo que ya sea la medicina tradicional y la alternativa en conmjunto se pueden lograr buenas mejoras para la enfermedad. Yo no me quedo con una , pruebo con todo
    isabel

  • mariaN dice:

    Fan ,hace días que no leo comentarios tuyos en este blog pero hoy quisiera decirte, a raiz de un escrito tuyo, que desde el tiempo de los romanos ya se conocia una enfermedad que producia mucho cansancio y dolores musculares,pero como ves poco hemos avanzado en su conocimiento. Ojala podamos destinar un poco más a la investigación.

  • Florangel dice:

    por favor a cual medico debo ir para saber si tengo FM?seria un neurologo?

  • fibromed dice:

    Hola Florangel la fibromialgia ha sido descrita por la Organización Mundial de la Salud como enfermedad reumática crónica, así que debería ir a su medico de cabecera y después al reumatologo y si no le detectan la FM y esta seguro que padece vaya a otro y a los que haga falta hasta que le hagan caso.

  • Ana E. dice:

    Hola a todos amigos con fibromialgia, yo la sufro desde 1997 , he ido a muchos medicos pero realmente no saben que hacer,he tomado casi todas los antinflamatorios, relajante antidepresivos, suplementos de minerales etc; es una enfermedad muy compleja, que realmente cambia tu vida por completo, yo tomo pastillas para dormir hace mas de 10 años, y realmente el tener un sueño REM (profundo) por lo menos hace que tu cerebro descanse mejor y tu malestar no sea tan molesto, cuandro tengo dolores muy fuerte entonces tomo Tramal Long de 100 mg, en ocaciones cuando me han dado espasmos a nivel de la cintura he tenido que tomar otros medicamentos, tambien tengo un terapeuta que viene a mi casa una vez por semana. He empesado a hacer un poquito de ejercicios y me he sentido con mas energia, no se si a ustedes le pasa lo mismo, cuando estoy lista para dormir se me intensifican los dolores y es porque mi cuerpo esta relajado y el nivel de adrenalina baja, hace como unos 6 años yo tenia como 33 puntos gatillo incluyendo los dolores faciales, hoy en dia tengo muchos mas, eso quiere decir que la enfermedad empeora hagas lo que hagas,yo evito el estres totalmente y trato de llevar una vida tranquila. Bueno un abrazo y paciencia.

  • Esperanza Restrepo D dice:

    Hola a todos en especial a fran te cuento que mi vida se a combertido en un mismo infierno tengo solo un año que me diagnosticaron fibromialgia pero ya venia sufriendo desde hacen 4 años, te cuento que mi diagnosticaron primero una cantidad de enfermedades hasta que por fin dieron con la fibromialgia, no llevo ningún tratamiento porque creo que mas adelante estos mismos tratamientos terminaran mas con mi salud, solo tomo un relajante muscular llamado ciclorelax eso me ayuda un poquito mi pregunta es que tanto avanza esta enfermedad y si en un futuro ella podría controlar mis movimientos motrices en pocas palabras me dejaría esta en una silla o una cama.
    mi correo es espelinda16@hotmail.com porvafor escríbame no he querido aceptar mi realidad tampoco saber mucho de esta enfermedad pero estoy siendo sus estragos y eso me deprime mucho, bueno mil vendiones para todos y para usted doctor fran.

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