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Abstract(s)
A fibromialgia (FM) é uma condição de dor crónica, generalizada e de difí-cil tratamento, com importante prevalência na população em geral. A fibromialgia é mais do que um estado de dor músculo-esquelética crónica, porque a maioria destes pacientes também refere fadiga, distúrbios do sono, dor visceral, intole-rância ao exercício e queixas neurológicas. É uma síndrome caracterizada mais por sintomas, sofrimento e incapacidades do que por alterações orgânicas estru-turais demonstráveis, podendo fazer parte do grupo de síndromes funcionais. Muitas tentativas para elucidar a patogenia orgânica da FM, como pesquisas em genética, aminas biogénicas, neurotransmissores, hormonas do eixo hipotálamo-hipófise-supra-renal, stress oxidativo, mecanismos de modulação da dor, sensibi-lização central e função autonómica na FM, revelam várias anormalidades, indi-cando que múltiplos factores e mecanismos podem estar envolvidos na sua pato-génese.
A fibromialgia continua a ser um conceito controverso em medicina. Esta revisão crítica considera importantes contributos para as “guerras da fibromialgia”, ao longo da história mais recente, sublinhando alguns dados relevantes da inves-tigação biológica, psicológica e social. Não obstante os putativos mecanismos fisiopatológicos que determinam a sua génese ou acompanham a sua evolução temporal, a fibromialgia pode ser compreendida à luz de fenómenos psicológicos e sociais que caracterizam os processos de somatização e comportamentos de doença, como um idioma de mal-estar ou sofrimento que desafia as conjecturas comuns da nossa prática clínica. O tratamento da FM consiste em medidas edu-cacionais, exercício aeróbico, terapia cognitivo-comportamental e tratamento farmacológico (antidepressivos, analgésicos).
Fibromyalgia is a chronic, widespread pain condition and difficult to treat, that has important prevalence in general population. Despite the musculoskeletal pain, the majority of people with FM also experience fatigue, sleep disorders, visceral pain, exercise intolerance and neurological symptoms. This syndrome is considered a functional syndrome because it is better characterized by its symptoms, suffering and disability rather than well seen organic structure impairment. A substantial literature has been produced in order to explain the pathophysiology of FM: researches on genetics, biogenic amines, neurotransmitter, hypothalamic-pituitary-adrenal axis hormones, oxidative stress, mechanisms of pain modulation, central sensitization and autonomic function in FM revealed various abnormalities indicating that multiple factors and mechanisms may be involved in the pathogenesis of FM. Fibromyalgia remains a controversial topic in clinical medicine. This paper considers some of the most significant contributions to the “fibromyalgia wars”, in recent times, emphasizing relevant data from biological, psychological and a social research. FM, regardless of the putative physiopathological mechanisms which determine its genesis or accompany its progression, can then be understood in the light of the social and psychological processes which characterize the phenomena of somatization and illness behaviour, as an idiom of distress and suffering which challenges the tenets of current clinical practice. The treatment of fybromyalgia consists of education, aerobic exercise, cognitive-behavioural therapy and medications (antidepressives, analgesics).
Fibromyalgia is a chronic, widespread pain condition and difficult to treat, that has important prevalence in general population. Despite the musculoskeletal pain, the majority of people with FM also experience fatigue, sleep disorders, visceral pain, exercise intolerance and neurological symptoms. This syndrome is considered a functional syndrome because it is better characterized by its symptoms, suffering and disability rather than well seen organic structure impairment. A substantial literature has been produced in order to explain the pathophysiology of FM: researches on genetics, biogenic amines, neurotransmitter, hypothalamic-pituitary-adrenal axis hormones, oxidative stress, mechanisms of pain modulation, central sensitization and autonomic function in FM revealed various abnormalities indicating that multiple factors and mechanisms may be involved in the pathogenesis of FM. Fibromyalgia remains a controversial topic in clinical medicine. This paper considers some of the most significant contributions to the “fibromyalgia wars”, in recent times, emphasizing relevant data from biological, psychological and a social research. FM, regardless of the putative physiopathological mechanisms which determine its genesis or accompany its progression, can then be understood in the light of the social and psychological processes which characterize the phenomena of somatization and illness behaviour, as an idiom of distress and suffering which challenges the tenets of current clinical practice. The treatment of fybromyalgia consists of education, aerobic exercise, cognitive-behavioural therapy and medications (antidepressives, analgesics).
Description
Keywords
Fibromialgia Dor Sistema nociceptivo Fibromialgia - Diagnóstico Fibromialgia - Prevenção Fibromialgia - Qualidade de vida
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior