Dolor Neuropático periférico en neuropatías por atrapamiento: fisiopatología y manejo de fisioterapia.
Resumen
La prevalencia exacta del dolor neuropático periférico es desconocida. La complejidad y las múltiples presentaciones clínicas dificultan su abordaje. Por ello, se antoja necesario conocer los mecanismos patobiológicos que acontecen en los pacientes con este tipo de afección. La fisioterapia ha emergido en los últimos años como una alternativa o complemento a los tratamientos médicos convencionales. En este trabajo, se introducen aspectos fundamentales del dolor neuropático y las neuropatías por atrapamiento, y se revisa el conocimiento relacionado con los mecanismos de acción de las distintas técnicas de fisioterapia sobre el dolor neuropático y el proceso fisiopatológico de las neuropatías por atrapamiento.
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Referencias
Akyuz G, Kenis O. Physical therapy modalities and rehabilitation techniques in the management of neuropathic pain. Am J Phys Med Rehabil. 2014;93(3):253–259. DOI:https://doi.org/10.1097/PHM.0000000000000037. DOI: https://doi.org/10.1097/PHM.0000000000000037
Ando Y. [Experimental study on chronic entrapment neuropathy]. Nihon Seikeigeka Gakkai Zasshi. 1990;64(7):633–647.
Armstrong BD, Hu Z, Abad C, Yamamoto M, Rodriguez WI, Cheng J, Lee M, Chhith S, Gomariz RP, Waschek JA. Induction of neuropeptide gene expression and blockade of retrograde transport in facial motor neurons following local peripheral nerve inflammation in severe combined immunodeficiency and BALB/C mice. Neuroscience. 2004;129(1):93–99. DOI:https://doi.org/10.1016/j.neuroscience.2004.06.085. DOI: https://doi.org/10.1016/j.neuroscience.2004.06.085
Austin PJ, Moalem-Taylor G. The neuro-immune balance in neuropathic pain: Involvement of inflammatory immune cells, immune-like glial cells and cytokines. J Neuroimmunol. 2010;229(1–2):26–50. DOI:https://doi.org/10.1016/j.jneuroim.2010.08.013. DOI: https://doi.org/10.1016/j.jneuroim.2010.08.013
Basson CA, Stewart A, Mudzi W, Musenge E. Effect of Neural Mobilization on Nerve-Related Neck and Arm Pain: A Randomized Controlled Trial. Physiotherapy Canada. 2019;72(4):408–419. DOI:https://doi.org/10.3138/ptc-2018-0056. DOI: https://doi.org/10.3138/ptc-2018-0056
Bialosky Joel E, Bishop MD, Price DD, Robinson ME, Vincent KR, George SZ. A Randomized Sham-Controlled Trial of a Neurodynamic Technique in the Treatment of Carpal Tunnel Syndrome. Journal of Orthopaedic & Sports Physical Therapy. 2009;39(10):709–723. DOI:https://doi.org/10.2519/jospt.2009.3117. DOI: https://doi.org/10.2519/jospt.2009.3117
Bialosky Joel E., Bishop MD, Robinson ME, Zeppieri G, George SZ. Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: A randomized controlled trial. Phys Ther. 2009;89(12):1292–1303. DOI:https://doi.org/10.2522/ptj.20090058. DOI: https://doi.org/10.2522/ptj.20090058
Boudier-Revéret M, Gilbert KK, Allégue DR, Moussadyk M, Brismée JM, Sizer PS, Feipel V, Dugailly PM, Sobczak S. Effect of neurodynamic mobilization on fluid dispersion in median nerve at the level of the carpal tunnel: A cadaveric study. Musculoskelet Sci Pract. 2017;31:45–51. DOI:https://doi.org/10.1016/j.msksp.2017.07.004. DOI: https://doi.org/10.1016/j.msksp.2017.07.004
Cleland JA, Childs JD, Palmer JA, Eberhart S. Slump stretching in the management of non-radicular low back pain: A pilot clinical trial. Man Ther. 2006;11(4):279–286. DOI:https://doi.org/10.1016/j.math.2005.07.002. DOI: https://doi.org/10.1016/j.math.2005.07.002
Colloca L, Ludman T, Bouhassira D, Baron R, Dickenson AH, Yarnitsky D, Freeman R, Truini A, Attal N, Finnerup NB, Eccleston C, Kalso E, Bennett DL, Dworkin RH, Raja SN. Neuropathic pain. Nat Rev Dis Primers. 2017;3:1–20. DOI:https://doi.org/10.1038/nrdp.2017.2. DOI: https://doi.org/10.1038/nrdp.2017.2
Dieleman JP, Kerklaan J, Huygen FJPM, Bouma PAD, Sturkenboom MCJM. Incidence rates and treatment of neuropathic pain conditions in the general population. Pain. 2008;137(3):681–688. DOI:https://doi.org/10.1016/j.pain.2008.03.002. DOI: https://doi.org/10.1016/j.pain.2008.03.002
Dilley A, Bove GM. Disruption of axoplasmic transport induces mechanical sensitivity in intact rat C-fibre nociceptor axons. J Physiol. 2008;586(2):593–604. DOI:https://doi.org/10.1113/jphysiol.2007.144105. DOI: https://doi.org/10.1113/jphysiol.2007.144105
Fernández-de-las Peñas C, Ortega-Santiago R, de la Llave-Rincón AI, Martínez-Perez A, Fahandezh-Saddi Díaz H, Martínez-Martín J, Pareja JA, Cuadrado-Pérez ML. Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial. J Pain. 2015;16(11):1087–1094. DOI:https://doi.org/https://doi.org/10.1016/j.jpain.2015.07.012. DOI: https://doi.org/10.1016/j.jpain.2015.07.012
Fernández-de-las-Peñas C, Cleland J, Palacios-Ceña M, Fuensalida-Novo S, Pareja JA, Alonso-Blanco C. The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(3):151–161. DOI:https://doi.org/10.2519/jospt.2017.7090. DOI: https://doi.org/10.2519/jospt.2017.7090
Fernández-de-las-Peñas C, Ortega-Santiago R, De-la-Llave-Rincón AI, Cleland JA, Pareja JA, Fahandezh-Saddi-Díaz H, Arias-Buría JL. Ultrasound-guided percutaneous electrical nerve stimulation versus surgery for women with unilateral carpal tunnel syndrome: A randomized parallel-group trial. European Journal of Pain. 2023;n/a(n/a). DOI:https://doi.org/https://doi.org/10.1002/ejp.2117. DOI: https://doi.org/10.1002/ejp.2117
Finnerup NB, Haroutounian S, Baron R, Dworkin RH, Gilron I, Haanpaa M, Jensen TS, Kamerman PR, Mcnicol E, Moore A, Raja SN, Andersen NT, Sena ES, Smith BH, Rice ASC. Neuropathic pain clinical trials: factors associated with decreases in estimated drug efficacy. Pain. 2018;159(July 2015):2339–2346. DOI:https://doi.org/10.1097/j.pain.0000000000001340.Neuropathic. DOI: https://doi.org/10.1097/j.pain.0000000000001340
Finnerup NB, Haroutounian S, Kamerman P, Baron R, Bennett DLH, Bouhassira D, Cruccu G, Freeman R, Hansson P, Nurmikko T, Raja SN, Rice ASC, Serra J, Smith BH, Treede R-D, Jensen TS. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016;157(8):1599–1606. DOI:https://doi.org/10.1097/j.pain.0000000000000492. DOI: https://doi.org/10.1097/j.pain.0000000000000492
Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150(3):573–581. DOI:https://doi.org/10.1016/j.pain.2010.06.019. DOI: https://doi.org/10.1016/j.pain.2010.06.019
Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH. The carpal tunnel syndrome. A study of carpal canal pressures. J Bone Joint Surg Am. 1981;63(3):380–383. Available at: http://europepmc.org/abstract/MED/7204435. DOI: https://doi.org/10.2106/00004623-198163030-00009
Gibson W, Wand BM, O’Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2017;2017(9). DOI:https://doi.org/10.1002/14651858.CD011976.pub2. DOI: https://doi.org/10.1002/14651858.CD011976.pub2
Guo JB, Chen BL, Wang Y, Zhu Y, Song G, Yang Z, Zheng YL, Wang XQ, Chen PJ. Meta-analysis of the effect of exercise on neuropathic pain induced by peripheral nerve injury in rat models. Front Neurol. 2019;10(JUN):1–12. DOI:https://doi.org/10.3389/fneur.2019.00636. DOI: https://doi.org/10.3389/fneur.2019.00636
Haanpää ML, Backonja M-M, Bennett MI, Bouhassira D, Cruccu G, Hansson PT, Jensen TS, Kauppila T, Rice ASC, Smith BH, Treede R-D, Baron R. Assessment of Neuropathic Pain in Primary Care. Am J Med. 2009;122(10):S13–S21. DOI:https://doi.org/10.1016/j.amjmed.2009.04.006. DOI: https://doi.org/10.1016/j.amjmed.2009.04.006
Hansford HJ, Wewege MA, Cashin AG, Hagstrom AD, Clifford BK, McAuley JH, Jones MD. If exercise is medicine, why don’t we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease. Br J Sports Med. 2022:bjsports-2021-104977. DOI:https://doi.org/10.1136/bjsports-2021-104977. DOI: https://doi.org/10.1136/bjsports-2021-104977
Van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: A systematic review of epidemiological studies". Pain. 2014;155(4):654–662. DOI:https://doi.org/10.1016/j.pain.2014.06.006. DOI: https://doi.org/10.1016/j.pain.2013.11.013
von Hehn CA, Baron R, Woolf CJ. Deconstructing the Neuropathic Pain Phenotype to Reveal Neural Mechanisms. Neuron. 2012;73(4):638–652. DOI:https://doi.org/10.1016/j.neuron.2012.02.008. DOI: https://doi.org/10.1016/j.neuron.2012.02.008
Held M, Karl F, Vlckova E, Rajdova A, Escolano-Lozano F, Stetter C, Bharti R, Förstner KU, Leinders M, Dušek L, Birklein F, Bednarik J, Sommer C, Üçeyler N. Sensory profiles and immune-related expression patterns of patients with and without neuropathic pain after peripheral nerve lesion. Pain. 2019;160(10):2316–2327. DOI:https://doi.org/10.1097/j.pain.0000000000001623. DOI: https://doi.org/10.1097/j.pain.0000000000001623
Hu P, McLachlan EM. Macrophage and lymphocyte invasion of dorsal root ganglia after peripheral nerve lesions in the rat. Neuroscience. 2002;112(1):23–38. DOI:https://doi.org/10.1016/S0306-4522(02)00065-9. DOI: https://doi.org/10.1016/S0306-4522(02)00065-9
Jensen TS, Baron R, Haanpää M, Kalso E, Loeser JD, Rice ASC, Treede RD. A new definition of neuropathic pain. Pain. 2011;152(10):2204–2205. DOI:https://doi.org/10.1016/j.pain.2011.06.017. DOI: https://doi.org/10.1016/j.pain.2011.06.017
Jesson T, Runge N, Schmid AB. Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety. Pain Rep. 2020;5(5):1-e834. DOI:https://doi.org/10.1097/pr9.0000000000000834. DOI: https://doi.org/10.1097/PR9.0000000000000834
Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618–1625. DOI:https://doi.org/10.1016/s0140-6736(06)68700-x. DOI: https://doi.org/10.1016/S0140-6736(06)68700-X
Kozak A, Schedlbauer G, Wirth T, Euler U, Westermann C, Nienhaus A. Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research. BMC Musculoskelet Disord. 2015;16:231. DOI:https://doi.org/10.1186/s12891-015-0685-0. DOI: https://doi.org/10.1186/s12891-015-0685-0
Lemmelä S, Solovieva S, Shiri R, Benner C, Heliövaara M, Kettunen J, Anttila V, Ripatti S, Perola M, Seppälä I, Juonala M, Kähönen M, Salomaa V, Viikari J, Raitakari OT, Lehtimäki T, Palotie A, Viikari-Juntura E, Husgafvel-Pursiainen K. Genome-Wide Meta-Analysis of Sciatica in Finnish Population. PLoS One. 2016;11(10):e0163877. DOI:https://doi.org/10.1371/journal.pone.0163877. DOI: https://doi.org/10.1371/journal.pone.0163877
Loprinzi CL, Lacchetti C, Bleeker J, Cavaletti G, Chauhan C, Hertz DL, Kelley MR, Lavino A, Lustberg MB, Paice JA, Schneider BP, Lavoie Smith EM, Smith M Lou, Smith TJ, Wagner-Johnston N, Hershman DL. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update. Journal of Clinical Oncology . 2020;38(28):3325–3348. DOI:https://doi.org/10.1200/JCO.20.01399. DOI: https://doi.org/10.1200/JCO.20.01399
Matesanz-García L, Billerot C, Fundaun J, Schmid AB. Effect of Type and Dose of Exercise on Neuropathic Pain After Experimental Sciatic Nerve Injury: A Preclinical Systematic Review and Meta-Analysis. J Pain. 2023. DOI:https://doi.org/10.1016/j.jpain.2023.01.011. DOI: https://doi.org/10.1016/j.jpain.2023.01.011
Matesanz-García L, Schmid AB, Cáceres-Pajuelo JE, Cuenca-Martínez F, Arribas-Romano A, González-Zamorano Y, Goicoechea-García C, Fernández-Carnero J. Effect of Physiotherapeutic Interventions on Biomarkers of Neuropathic Pain: A Systematic Review of Preclinical Literature. J Pain. 2022;23(11):1833–1855. DOI:https://doi.org/https://doi.org/10.1016/j.jpain.2022.06.007. DOI: https://doi.org/10.1016/j.jpain.2022.06.007
Michael Costigan, Joachim Scholz and CJW. Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage. Annu Rev Neurosci. 2009;32:1–32. DOI:https://doi.org/10.1146/annurev.neuro.051508.135531.Neuropathic. DOI: https://doi.org/10.1146/annurev.neuro.051508.135531
Moalem G, Tracey DJ. Immune and inflammatory mechanisms in neuropathic pain. Brain Res Rev. 2006;51(2):240–264. DOI:https://doi.org/10.1016/j.brainresrev.2005.11.004. DOI: https://doi.org/10.1016/j.brainresrev.2005.11.004
Moalem G, Xu K, Yu L. T lymphocytes play a role in neuropathic pain following peripheral nerve injury in rats. Neuroscience. 2004;129(3):767–777. DOI:https://doi.org/10.1016/J.NEUROSCIENCE.2004.08.035. DOI: https://doi.org/10.1016/j.neuroscience.2004.08.035
National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). Nice. 2016;(November 2016):1–18.
Parreira P, Maher CG, Steffens D, Hancock MJ, Ferreira ML. Risk factors for low back pain and sciatica: an umbrella review. Spine J. 2018;18(9):1715–1721. DOI:https://doi.org/10.1016/j.spinee.2018.05.018. DOI: https://doi.org/10.1016/j.spinee.2018.05.018
Penza P, Bricchi M, Scola A, Campanella A, Lauria G. Electroacupuncture Is Not Effective in Chronic Painful Neuropathies. Pain Medicine. 2011;12(12):1819–1823. DOI:https://doi.org/10.1111/j.1526-4637.2011.01230.x. DOI: https://doi.org/10.1111/j.1526-4637.2011.01230.x
Pourmemari MH, Shiri R. Diabetes as a risk factor for carpal tunnel syndrome: a systematic review and meta-analysis. Diabet Med. 2016;33(1):10–16. DOI:https://doi.org/10.1111/dme.12855. DOI: https://doi.org/10.1111/dme.12855
Rydevik B, Lundborg G, Bagge U. Effects of graded compression on intraneural blood blow. An in vivo study on rabbit tibial nerve. J Hand Surg Am. 1981;6(1):3–12. DOI:https://doi.org/10.1016/s0363-5023(81)80003-2. DOI: https://doi.org/10.1016/S0363-5023(81)80003-2
Santos FM, Silva JT, Rocha IRC, Martins DO, Chacur M. Non-pharmacological treatment affects neuropeptide expression in neuropathic pain model. Brain Res. 2018;1687:60–65. DOI:https://doi.org/10.1016/j.brainres.2018.02.034. DOI: https://doi.org/10.1016/j.brainres.2018.02.034
Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther. 2008;13(5):387–396. DOI:https://doi.org/10.1016/j.math.2007.12.007. DOI: https://doi.org/10.1016/j.math.2007.12.007
Schmid AB, Elliott JM, Strudwick MW, Little M, Coppieters MW. Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome-an MRI study to reveal therapeutic mechanisms. Journal of Orthopaedic Research. 2012;30(8):1343–1350. DOI:https://doi.org/10.1002/jor.22064. DOI: https://doi.org/10.1002/jor.22064
Schmid AB, Fundaun J, Tampin B. Entrapment neuropathies: A contemporary approach to pathophysiology, clinical assessment, and management. Pain Rep. 2020;5(4). DOI:https://doi.org/10.1097/PR9.0000000000000829. DOI: https://doi.org/10.1097/PR9.0000000000000829
Sleijser-Koehorst MLS, Koop MA, Coppieters MW, Lutke Schipholt IJ, Radisic N, Hooijmans CR, Scholten-Peeters GGM. The effects of aerobic exercise on neuroimmune responses in animals with traumatic peripheral nerve injury: a systematic review with meta-analyses. J Neuroinflammation. 2023;20(1):104. DOI:https://doi.org/10.1186/s12974-023-02777-y. DOI: https://doi.org/10.1186/s12974-023-02777-y
Song SJ, Min J, Suh SY, Jung SH, Hahn HJ, Im SA, Lee JY. Incidence of taxane-induced peripheral neuropathy receiving treatment and prescription patterns in patients with breast cancer. Supportive Care in Cancer. 2017;25(7):2241–2248. DOI:https://doi.org/10.1007/s00520-017-3631-x. DOI: https://doi.org/10.1007/s00520-017-3631-x
Sorkin LS, Xiao WH, Wagner R, Myers RR. Tumour necrosis factor-α induces ectopic activity in nociceptive primary afferent fibres. Neuroscience. 1997;81(1):255–262. DOI:https://doi.org/10.1016/S0306-4522(97)00147-4. DOI: https://doi.org/10.1016/S0306-4522(97)00147-4
Wiberg A, Ng M, Schmid AB, Smillie RW, Baskozos G, Holmes M V, Künnapuu K, Mägi R, Bennett DL, Furniss D. A genome-wide association analysis identifies 16 novel susceptibility loci for carpal tunnel syndrome. Nat Commun. 2019;10(1):1030. DOI:https://doi.org/10.1038/s41467-019-08993-6. DOI: https://doi.org/10.1038/s41467-019-08993-6
Williams TM, Mackinnon SE, Novak CB, McCabe S, Kelly Luise. Verification of the Pressure Provocative Test in Carpal Tunnel Syndrome. Ann Plast Surg. 1992;29(1):8–11. DOI: https://doi.org/10.1097/00000637-199207000-00003
Zhang Y-H, Hu H-Y, Xiong Y-C, Peng C, Hu L, Kong Y-Z, Wang Y-L, Guo J-B, Bi S, Li T-S, Ao L-J, Wang C-H, Bai Y-L, Fang L, Ma C, Liao L-R, Liu H, Zhu Y, Zhang Z-J, Liu C-L, Fang G-E, Wang X-Q. Exercise for Neuropathic Pain: A Systematic Review and Expert Consensus. Front Med (Lausanne). 2021;8(November):1–16. DOI:https://doi.org/10.3389/fmed.2021.756940. https://doi.org/10.22201/ceiich.24485691e.2014.12.49710 DOI: https://doi.org/10.3389/fmed.2021.756940