Revisión narrativa Sensibilización espinal segmentaria: un síndrome doloroso neuromusculoesquelético desconcertante

Autores/as

  • Tomas Nakazato Nakamine Médico Fisiatra. Director Médico de CEDOMUH: Clínica Especializada en Dolor Muscular y del Hueso, Lima, Perú. Jefe de la Cátedra de Medicina Física y Rehabilitación, Facultad de Medicina Humana de la Universidad de Piura, Lima, Perú. https://orcid.org/0000-0002-3771-8249
  • Pedro Romero Ventosill Médico Fisiatra. Director Médico del Centro de Terapia de Dolor y Rehabilitación Integral, Lima, Perú. https://orcid.org/0000-0002-6880-4502

Palabras clave:

Sensibilización del sistema nervioso central, dolor crónico, dolor musculoesquelético, síndromes del dolor miofascial,, fisiatría

Resumen

El síndrome de sensibilización espinal segmentaria es un cuadro clínico de dolor regional crónico muy frecuente en la consulta fisiátrica cotidiana. Se caracteriza por la presencia de fenómenos de sensibilización periférica y central las cuales son producidas por el bombardeo persistente de impulsos nociceptivos que provienen de una articulación inestable y/o una lesión de los tejidos, e involucran a uno o más segmentos adyacentes de la columna vertebral, sus correspondientes nervios espinales (raíces nerviosas) y a todas las metámeras que estas inervan, con predominio de los sistemas tegumentario y musculoesquelético. musculoesquelético. Este cuadro clínico, que tiene características de un dolor mixto (nociceptivo y nociplástico), causa desconcierto en la mayoría de médicos porque corresponde a una disfunción neuromusculoesquelética que se presenta sin una lesión definida (no se aprecia en los estudios de imágenes ni de electromiografía), o cuando la hay, esta no es proporcional al dolor que manifiesta el paciente. En este sentido, la compresión de su neurofisiopatología es fundamental para establecer un diagnóstico oportuno e iniciar un tratamiento de rehabilitación adecuado, lo cual beneficiará a un gran número de pacientes que sufren de dolor crónico discapacitante a causa de esta condición.

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1.
Nakazato Nakamine T, Romero Ventosill P. Revisión narrativa Sensibilización espinal segmentaria: un síndrome doloroso neuromusculoesquelético desconcertante. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 20 de noviembre de 2023 [citado 30 de noviembre de 2023];33(2). Disponible en: https://revistacmfr.org/index.php/rcmfr/article/view/393

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