Consciencia y Dolor: una mirada desde la Fisioterapia (I): Las Teorías de la Consciencia y el problema real del paciente con dolor
Resumen
Objetivos: Si el dolor es una sensación (relacionado con perturbaciones corporales) o una percepción (relacionado con las diferentes evaluaciones del paciente) es una pregunta que, en principio, la Fisioterapia no tiene la responsabilidad de responder, como tampoco lo es resolver el problema de la consciencia. Sin embargo, el dolor es un fenómeno consciente y esto tiene unas implicaciones científicas y clínicas importantes que no podemos seguir soslayando durante más tiempo, ni en la consulta ni en el laboratorio. Nos preguntamos entonces qué luz puede arrojar el estudio de las Teorías de la Consciencia y del dolor para aproximarnos al problema real del paciente con dolor de una manera rigurosa y ética.
Métodos: Se realizó una revisión crítica de la neurociencia de la consciencia y del dolor y de la filosofía de la mente y del dolor, tomando la estructura del superventas Being You: A new science of consciousness (Seth, 2021), en relación con el marco teórico de la Fisioterapia y su aplicación en la práctica clínica y la investigación.
Resultados: La HOT se relaciona con el evaluativismo y la Educación en Neurociencia del Dolor. El imperativismo y la Teoría Corporal guardan relación con la GNWT. Desde la IIT se propone un marco de tipo pluralista para disolver las aporías y paradojas que se presentan en el campo del dolor, así como para delimitar el alcance de nuestras intervenciones.
Conclusiones: Con el cuerpo de conocimiento actual, científico y filosófico, no se puede estudiar seriamente el dolor dejando de lado sistemáticamente el asunto de la consciencia. Las Teorías de la Consciencia, desde una perspectiva pluralista, pueden arrojar luz sobre problemas acuciantes en el campo, tanto a nivel clínico como investigador. Quizá no para obtener respuestas, pero sin duda para ayudar plantear las preguntas correctas.
Cómo citar
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