Fundamentos y evidencias de los antidepresivos y anticonvulsivos en el dolor reumático

[Myofascial pain syndrome]

Myosfascial pain syndrome is characterized by regional pain originating in muscle groups or a single muscle, with a tense band of increased consistency and painful to the touch, in which center a trigger point (TP) is found and generates referred pain, spontaneous pain or pain upon palpation. Causes are related to biomechanical over weight factors or muscle over usage and repetitive microtrauma. Its physiopathology is unknown but it is thought to be due to a dysfunction of the neuromotor plate due to excessive acetylcholine liberation. Clinical history, examination and an adequate review of the TG are fundamental to diagnosis. Treatment requires a multidimensional approach. Eliminating the perpetuating factors, patient education and a home-based exercise program are the cornerstone of patient treatment. Physiotherapy, pharmacotherapy and several behavioral treatments are employed in an individualized manner. In treatment resistant cases, infiltration of TP ("dry" puncture, local anesthetics, steroids or botulinic toxin), performed by an experienced physician, has been efficacious.