Avaliado medicamente por Lindsey Marcellin, MD, MPH
Quando você tem fibromialgia, pode parecer que você simplesmente não consegue se libertar da dor – o que pode incluir dores nas costas. Até dois terços das pessoas com dor lombar crônica também têm fibromialgia. Olhando para os números da outra direção, até 49 por cento das pessoas com fibromialgia têm menor dor nas costas. Na verdade, a dor nas costas é tão prevalente entre as pessoas com fibromialgia que já foi um dos sintomas que os médicos procuraram para fazer um diagnóstico de fibromialgia.
Não há dúvida de que viver com fibromialgia é um desafio por si só, quanto mais quando você tem dores nas costas. Mas isso pode fazer você se sentir um pouco melhor ao saber que há uma explicação para a intensidade da dor que você está passando.
“Dor nas costas e fibromialgia pertencem a um grupo de distúrbios chamados síndromes centrais de hipersensibilidade”, diz Ronald Staud, MD, professor de medicina na Universidade da Flórida em Gainesville. Embora as raízes das duas condições sejam diferentes – por exemplo, a dor nas costas pode ser causada por um disco vertebral danificado – as experiências de dor das duas condições apresentam algumas semelhanças. Entre eles está a sensação de que essas condições de dor crônica fazem com que você esteja em uma situação de “alerta máximo” (os médicos chamam isso de hiperestimulação). E então, para completar, a dor te desgasta, causando fadiga, depressão e ansiedade que tornam a vida com fibromialgia e dor nas costas ainda mais drenante.
“A hiperatividade é realmente uma resposta normal”, diz o Dr. Staud. Normal, sim, mas lança uma chave de macaco para encontrar a combinação certa de tratamentos para aliviar dois problemas muito dolorosos.
Um essencial é obter um diagnóstico preciso da sua dor nas costas. De acordo com Staud, muitos médicos que tratam fibromialgia também podem avaliar as possíveis causas da dor nas costas. No entanto, peça um encaminhamento a um especialista em dor se tiver alguma dúvida sobre a capacidade do seu médico em analisar os fatores que contribuem para a sua dor nas costas e prescrever o tratamento médico apropriado.
Tratar fibromialgia e dor nas costas
A medicação para a dor geralmente faz parte da prescrição para sintomas de fibromialgia, mas geralmente não é suficiente para a maioria das pessoas, especialmente se uma condição de coluna estiver envolvida. Montar um plano de dor multipartes é uma obrigação, diz Staud. Isto é ainda mais verdadeiro se você precisar de terapia específica para suas costas. Considere estas ideias adicionais para criar uma estratégia de tratamento abrangente que possa combinar abordagens tradicionais e alternativas:
- Mudancas de estilo de vida. A dor nas costas e os sintomas da fibromialgia podem melhorar à medida que você trabalha em um estilo de vida mais saudável – ajustando sua dieta, aumentando o exercício e perdendo peso, se necessário.
- Tratamento de saúde mental. Ansiedade, depressão e problemas para dormir podem fazer a dor piorar. Estratégias abrangentes de tratamento podem incluir terapia e medicação direcionada para depressão e ansiedade, diz Staud.
- Fisioterapia. “A dor nas costas é a base dos fisioterapeutas”, diz Staud. Fisioterapeutas podem ensinar-lhe como se mover através do seu dia de forma mais eficaz e mostrar-lhe alongamentos para aliviar a dor nas costas e, talvez, facilitar a vida com fibromialgia.
- Abordagens de tratamento alternativo. Acupuntura, biofeedback e musicoterapia podem ajudar a aliviar a dor nas costas. De acordo com Staud, os especialistas em gerenciamento da dor são bem versados na complexidade do tratamento da dor e estarão abertos a qualquer dúvida que você possa ter sobre abordagens alternativas. Conversar com sua equipe sobre as opções que você está considerando também ajudará a evitar interações entre tratamentos alternativos e medicamentos prescritos.
- Educação. Finalmente, um pouco de conhecimento pode ajudar muito a aliviar um pouco da ansiedade que você pode estar sentindo. Converse com sua equipe médica sobre a fisiologia da dor e os fatores complexos que influenciam sua percepção da dor quando você está enfrentando condições relacionadas à hipersensibilização.
Quando você está lutando com dor lombar e fibromialgia, você pode se sentir como se estivesse lutando em duas batalhas. Mas uma combinação de terapias – algumas voltadas para a fibromialgia, algumas voltadas para a dor nas costas, e algumas voltadas para ambas – têm maior probabilidade de trazer alívio para os sintomas.
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