Cambio de paradigma hacia el modelo biopsicosocial en el abordaje de la persona con dolor de hombro: un llamamiento a la comunidad de la Fisioterapia
Resumen
El dolor de hombro es una causa frecuente de dolor musculoesquelético con una prevalencia estimada del 66,7%. Más del 50% de estos pacientes siguen experimentando dolor tras 6 meses, lo que impacta significativamente en la calidad de vida y en el uso de recursos sanitarios. El abordaje del dolor de hombro sigue predominantemente un modelo biomédico que no refleja adecuadamente la naturaleza y amplia heterogeneidad de la presentación clínica de estos pacientes. Se ha señalado que este modelo muestra limitaciones para: (1) confirmar una relación de causalidad entre los hallazgos patobiológicos y el dolor o discapacidad presente en estos pacientes; (2) explicar la individualidad y globalidad de la experiencia de dolor de la persona que sufre dolor de hombro; (3) ofrecer etiquetas diagnósticas que capturen la complejidad y heterogeneidad de las presentaciones clínicas del dolor de hombro; (4) mostrar una superioridad en las intervenciones enfocadas en la resolución del “daño” tisular. Del mismo modo, los hallazgos científicos reportan la influencia de la visión biomédica en las creencias, expectativas y toma de decisiones tanto de los pacientes como de los fisioterapeutas. Por tanto, permanecer en un modelo enfocado únicamente en aspectos mecánicos y estructurales, contribuye a una visión reduccionista en el diagnóstico e intervenciones en Fisioterapia. El dolor de hombro debe considerarse un fenómeno multidimensional, en el cual factores biológicos, tanto locales como sistémicos, y factores psicológicos y sociales se interrelacionan entre sí, de una manera indivisible. Esta naturaleza biopsicosocial del dolor de hombro influye en el pronóstico, diagnóstico y tratamiento de las personas que lo sufren. Nuestro abordaje debe orientarse hacia estrategias que mejoren la funcionalidad y autonomía como el ejercicio terapéutico. Por todo ello, es necesario un cambio de paradigma en el abordaje de personas que sufren dolor de hombro hacia una visión biopsicosocial.
Cómo citar
Referencias
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