Mejoras en la calidad de vida de pacientes con fibromialgia a través de la fisioterapia
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2024-05-09
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La fibromialgia es un síndrome caracterizado por dolor musculoesqulético generalizado crónico que puede ir asociado o no a rigidez muscular o articular, acompañado de otros síntomas como la fatiga, trastornos del sueño, ansiedad y depresión. Es una enfermedad muy común a nivel global, considerándose la tercera afección musculoesquelética en cuestiones de prevalencia por debajo de del dolor lumbar y la artrosis, es más frecuente en mujeres que en hombres y aunque puede aparecer a cualquier edad es más frecuente entre los treinta y treinta y cinco años. Aunque la fisiopatología y etiopatogenia continúan siendo desconocidas son tres los procesos subyacentes a la fibromialgia que se han investigado. Estos son la sensibilización central, relacionada con un aumento de la liberación de neurotransmisores tanto excitatorios como inhibitorios; la sensibilización periférica asociada a alteraciones en las señales de los nociceptores periféricos y los mecanismos de inflamación e inmunidad que se desarrollan de forma paralela a los dos procesos anteriores. Además, se ha determinado que en el desarrollo de esta patología pueden influir factores genéticos, endocrinos, psicológicos y trastornos del sueño. La fibromialgia sigue sin diagnosticarse de forma correcta ya que esta carece de biomarcadores diagnósticos específicos, que continúan investigándose. Aun así, la actuación diagnóstica de la patología ha ido evolucionando basándose en el uso de escalas y cuestionarios para la identificación del dolor. El desconocimiento asociado a esta patología hace complicado establecer un tratamiento único y efectivo. Por esto el tratamiento es multidisciplinar y se organiza en intervenciones farmacológicas y no farmacológicas que actúan sobre los síntomas disminuyéndolos. Los tratamientos no farmacológicos expuestos en esta revisión son los relacionados con la disciplina de fisioterapia. Se ha destacado la efectividad de la realización de ejercicio físico tanto en el medio terrestre como en el acuático; la aplicación de electroterapia asociada a terapia transcraneal y la terapia manual. Todo esto pretende mejorar la calidad de vida del paciente, que se altamente afectada por la fibromialgia.
Fibromyalgia is a syndrome characterized by chronic, widespread musculoskeletal pain that may or may not be associated with muscle or joint stiffness, accompanied by other symptoms such as fatigue, sleep disorders, anxiety, and depression. It is a very common disease globally, considered the third most prevalent musculoskeletal condition after lower back pain and osteoarthritis. It is more common in women than in men, and although it can appear at any age, it is most common between the ages of 30 and 35. Although the pathophysiology and etiopathogenesis remain unknown, three underlying processes of fibromyalgia have been investigated. These are central sensitization, related to an increased release of both excitatory and inhibitory neurotransmitters; peripheral sensitization, associated with alterations in the signaling of peripheral nociceptors; and the inflammatory and immune mechanisms that develop in parallel with the two previous processes. Furthermore, it has been determined that genetic, endocrine, psychological, and sleep disorder factors can influence the development of this condition. Fibromyalgia remains underdiagnosed due to the lack of specific diagnostic biomarkers, which are still being investigated. Even so, the diagnostic approach to the condition has evolved based on the use of scales and questionnaires for pain identification. The lack of knowledge surrounding this condition makes it difficult to establish a single, effective treatment. Therefore, treatment is multidisciplinary and is organized into pharmacological and non-pharmacological interventions that act on and reduce symptoms. The non-pharmacological treatments discussed in this review are those related to physiotherapy. The effectiveness of physical exercise, both on land and in water, has been highlighted, as well as the application of electrotherapy combined with transcranial therapy and manual therapy. All of these aim to improve the quality of life of patients, which is significantly affected by fibromyalgia.
Fibromyalgia is a syndrome characterized by chronic, widespread musculoskeletal pain that may or may not be associated with muscle or joint stiffness, accompanied by other symptoms such as fatigue, sleep disorders, anxiety, and depression. It is a very common disease globally, considered the third most prevalent musculoskeletal condition after lower back pain and osteoarthritis. It is more common in women than in men, and although it can appear at any age, it is most common between the ages of 30 and 35. Although the pathophysiology and etiopathogenesis remain unknown, three underlying processes of fibromyalgia have been investigated. These are central sensitization, related to an increased release of both excitatory and inhibitory neurotransmitters; peripheral sensitization, associated with alterations in the signaling of peripheral nociceptors; and the inflammatory and immune mechanisms that develop in parallel with the two previous processes. Furthermore, it has been determined that genetic, endocrine, psychological, and sleep disorder factors can influence the development of this condition. Fibromyalgia remains underdiagnosed due to the lack of specific diagnostic biomarkers, which are still being investigated. Even so, the diagnostic approach to the condition has evolved based on the use of scales and questionnaires for pain identification. The lack of knowledge surrounding this condition makes it difficult to establish a single, effective treatment. Therefore, treatment is multidisciplinary and is organized into pharmacological and non-pharmacological interventions that act on and reduce symptoms. The non-pharmacological treatments discussed in this review are those related to physiotherapy. The effectiveness of physical exercise, both on land and in water, has been highlighted, as well as the application of electrotherapy combined with transcranial therapy and manual therapy. All of these aim to improve the quality of life of patients, which is significantly affected by fibromyalgia.