Douleur chronique de la mâchoire et ostéopathie
FIBROMYALGIA
DEFINITION
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas of the body. While the exact cause is unknown, research suggests several factors may contribute to its development:
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Genetic Predisposition: Genetics may play a role, as fibromyalgia tends to run in families. Certain genetic mutations may increase sensitivity to pain.
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Abnormal Pain Processing: People with fibromyalgia have a heightened sensitivity to pain. Their central nervous system may amplify pain signals, causing normal sensations to be perceived as painful.
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Infections or Illnesses: Certain infections or illnesses have been linked to triggering or exacerbating fibromyalgia symptoms.
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Physical or Emotional Trauma: Physical injuries, surgeries, or significant emotional stress may act as a trigger for the onset of fibromyalgia.
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Hormonal Imbalances: Fibromyalgia may be related to imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine, which are involved in pain regulation, sleep, and mood.
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Symptoms:
Fibromyalgia presents with a range of symptoms that can vary in intensity. The most common include:
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Widespread Pain: The hallmark symptom is pain throughout the body, often described as a dull ache that persists for three months or more. It typically occurs above and below the waist and on both sides of the body.
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Fatigue: Despite getting sufficient sleep, individuals with fibromyalgia often feel fatigued. Sleep is frequently disrupted by pain or other sleep disorders, such as restless leg syndrome or sleep apnea.
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Cognitive Difficulties: Often referred to as "fibro fog," this includes problems with memory, focus, and concentration.
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Sleep Disturbances: Many individuals with fibromyalgia have trouble falling asleep or staying asleep due to pain or other related conditions.
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Tender Points: Specific areas of the body, such as the neck, shoulders, back, and hips, may be especially tender to touch.
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Other Symptoms: Headaches, irritable bowel syndrome (IBS), anxiety, and depression are commonly associated with fibromyalgia.
Recommendations de prise en charge des douleurs chroniques de la mâchoire
Les dernières recommendations de traitement publiée par un comité d’expert dans le BMJ en décembre 2023.
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Douleur chronique de l'ATM:
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Douleur modérée de l’articulation ATM: EVA 4-6 / 10 depuis au moins 3 mois.
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Douleur associée avec une dysfonction de l’articulation ATM.
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Fortes recommendations en faveur:
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Thérapie comportementale et cognitive (TCC)
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Mobilisations passives de l’articulation.
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Exercices de posture.
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Exercices et étirements des muscles de l’articulation ATM.
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Traitements des points gâchettes (trigger points therapy).
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Soins habituels.
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Recommendations en faveur sous conditions:
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Manipulation
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Anti-inflammatoires non stéroidiens + TCC
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Acupuncture.
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Exercices + mobilisations de l’articulation.
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Apport de l'ostéopathie et de la thérapie manuelle dans les douleurs chroniques de la mâchoire
L'ostéopathie et la thérapie manuelle sont des approches qui ont scientifiquement démontré leurs indications dans la prise en charge des douleurs chroniques de la mâchoire, et ont montré une réduction significative de la douleur et une amélioration de la qualité de vie des patients. Les techniques ostéopathiques incluent des techniques manuelles spécifiques et sans danger pour relâcher les muscles de la l'articulaire temporo=mandibulaire mais aussi du cou.
Mr Charbel Kortbawi DO, MSc, ostéopathe spécialisé dans la gestion de la douleur prend en charge dans son cabinet situé à Paris 16, les douleurs aigues et chroniques de l'articulation temporo-mandibulaire.
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