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Il dolore notturno è una condizione che deve preoccupare? - IlSipontino.net [esi adrotate group="1" cache="public" ttl="0"]
Dolore notturno
Il dolore notturno è una condizione che deve preoccupare?
Risposta breve: Si! Ma in realtà in fondamentale fare delle considerazioni importanti Il dolore notturno, o un peggioramento del dolore durante le ore notturne, è un campanello per problematiche di competenza medica. Ne sono un esempio l’infezione spinale o le neoplasie (Verhagen A.P., 2016). Non tutti i dolori notturni devono insospettire il clinico! Ecco perché: In pazienti con quadri specifici appartenenti al distretto lombare (quadri di competenza fisioterapica come stenosi e sindromi radicolari) potrebbero manifestarsi anche con dolore notturno. Allo stesso tempo questo potrebbe essere il sintomo più severo.
Ma perché questo avviene? Secondo lo studio di Segal J.P. et al il pattern di manifestazione del dolore infiammatorio (es. patologie infiammatorie in ambito reumatico) e neuropatico sono inversi tra loro. Lo schema del dolore infiammatorio peggiora le prime ore del mattino. Lo schema del dolore neuropatico peggiora durante le ore notturne.
Perché il dolore neuropatico peggiora di notte? Ecco 3 brevi motivi 1) Riduzione significativa dell’apporto di sangue a livello del tessuto nervoso. 2) Attivazione delle cellule della microglia e astrociti che potrebbero promuovere la produzione di chemochine, citochine pro-infiammatorie, cellule immunitarie (macrofagi, neuroglia e cellule T) che hanno un proprio ritmo circadiano. 3) Fluttuazione del livello di oppioidi (nell’arco delle 24 ore).
Per concludere rivolgetevi ad un professionista del settore per avere le risposte idonee nella gestione del dolore muscolo-scheletriche.
Dott. Ciro Pio Cunto – Fisioterapista Centro Rehab Medicina e Riabilitazione – Piazzale Niccolò Perotto, 1
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