{"id":2769,"date":"2021-06-01T10:36:51","date_gmt":"2021-06-01T08:36:51","guid":{"rendered":"https:\/\/crarbcn.com\/?p=2769"},"modified":"2021-06-10T22:42:02","modified_gmt":"2021-06-10T20:42:02","slug":"manejo-multimodal-del-dolor-cronico","status":"publish","type":"post","link":"https:\/\/crarbcn.com\/es\/manejo-multimodal-del-dolor-cronico\/","title":{"rendered":"Manejo multimodal del dolor cr\u00f3nico"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\"><strong><span style=\"color:#34575b\" class=\"has-inline-color\">Caso realizado por Marina Gonzalo, veterinaria rehabilitadora de CRAR<\/span><\/strong><\/h4>\n\n<hr class=\"wp-block-separator\"\/>\n\n<p class=\"wp-block-paragraph\"><strong>Hoy en el blog de CRAR &#8211; Centre de Rehabilitaci\u00f3 Animal de Refer\u00e8ncia, especialistas en fisioterapia veterinaria en Barcelona, queremos compartir el caso de Shiva, una perra que sufre dolor cr\u00f3nic debido a osteoartrosis severa de cadera y luxaci\u00f3n luxaci\u00f3 vertebral L5-L6.<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">El caso de Shiva no es especial, muchos de los pacientes que se visitan en las cl\u00ednicas veterinaries sufren <strong>dolor cr\u00f3nico<\/strong>, por eso es tan importante realizar un <strong>buen protocolo de manejo del dolor.<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Nuestros compa\u00f1eros del<strong><a href=\"https:\/\/hvmolins.com\/\">Hospital Veterinari Molins<\/a><\/strong> lo saben muy bien y cuando atendieron a Shiva en su unidad del dolor quisieron complementar los tratamientos m\u00e9dicos con rehabilitaci\u00f3n.<\/p>\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><strong><em> Para mejorar el dolor de nuestros pacientes, sobre todo los que sufren dolor cr\u00f3nico, debemos llevar a cabo una evaluaci\u00f3n global del paciente: dieta, actividad f\u00edsica, medicamentos, rehabilitaci\u00f3n&#8230;<\/em><\/strong><\/p><p><strong><em>Seg\u00fan la WSAVA, el enfoque multimodal , como el que usamos en el cas de Shiva, es la mejor opci\u00f3n para tratar el dolor<\/em><\/strong>,<strong><em>y as\u00ed lo recoge en sus<a href=\"https:\/\/wsava.org\/global-guidelines\/global-pain-council-guidelines\/\">gu\u00edas de reconocimiento, asesoramiento y tratamiento del dolor<\/a><\/em><\/strong>. <\/p><\/blockquote>\n\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Historia cl\u00ednica<\/span><\/h2>\n\n<p class=\"wp-block-paragraph\">Shiva, una perra mestiza de 10 a\u00f1os, fue rescatada hace a\u00f1os en un hospital de Eslovaquia. La encontraron apalizada y con una <strong>luxaci\u00f3n vertebral L5-L6 muy grave<\/strong>.<br\/><br\/>Ya desde entonces la <strong><a href=\"https:\/\/crarbcn.com\/es\/blog\/la-importancia-de-la-fisioterapia-veterinaria\/\">rehabilitaci\u00f3n<\/a><\/strong> e <a href=\"https:\/\/crarbcn.com\/es\/blog\/la-hidroterapia-en-el-crar\/\"><strong>hidroterapia<\/strong><\/a> fueron implementadas por el equipo veterinario, y con gran dedicaci\u00f3n de la familia que finalmente la adopt\u00f3, lograron que volvieran a caminar<br\/><br\/>En el<strong>Hospital Veterinari Molins<\/strong> le detectaron una <strong>displasia de cadera bilateral severa<\/strong>, que juntamente a la p\u00e9rdida de actividad debida al confinamiento, le provocaba mucho <strong>dolor<\/strong>.<br\/><br\/>Va ser referida al nostre centre per fer una<strong> ter\u00e0pia analg\u00e8sica multimodal juntament amb el tractament farmacol\u00f2gic<\/strong> ja instaurat.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/Shiva_osteoartrosis_dolor_rehabilitacion-1024x577.jpg\" alt=\"\" class=\"wp-image-2765\"\/><figcaption>Shiva, perra con dolor cr\u00f3nico por osteoartrosis.<\/figcaption><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Valoraci\u00f3n funcional inicial<\/span><\/h2>\n\n<ul class=\"wp-block-list\"><li><strong>Incapacidad<\/strong> para subir y bajar del coche y el sof\u00e1.<\/li><li>Condici\u00f3n corporal 6\/9 y <strong>atrofia muscular marcada<\/strong><\/li><li><strong>D\u00e9ficits propioceptivos<\/strong> y <strong>disminuci\u00f3n de los reflejos<\/strong> en ambas extremidades posteriores.<\/li><li><strong>Dolor<\/strong> moderado a la palpaci\u00f3n lumbar y a la movilizaci\u00f3n de la cadera derecha<\/li><\/ul>\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Objetivos<\/span><\/h2>\n\n<ul class=\"wp-block-list\"><li>Control del dolor<\/li><li>Mejorar rango de movimiento (ROM) del paciente.<\/li><li>Aumentar la calidad de vida y su bienestar.<\/li><\/ul>\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Plan de rehabilitaci\u00f3n<\/span><\/h2>\n\n<p class=\"wp-block-paragraph\">En el caso de Shiva realizamos 8 <strong>sesiones<\/strong> <strong>semanales<\/strong> de las siguientes terapias de rehabilitaci\u00f3n veterinaria:<\/p>\n\n<ul class=\"wp-block-list\"><li><strong><a href=\"https:\/\/crarbcn.com\/es\/blog\/la-hidroterapia-en-el-crar\/\">Hidroterapia<\/a><\/strong> en cinta subacu\u00e1tica.<\/li><li><strong><a href=\"https:\/\/crarbcn.com\/es\/blog\/terapia-laser-el-paso-a-paso-de-su-uso-en-veterinaria\/\">L\u00e1ser<\/a><\/strong><\/li><li><strong>Campos magn\u00e9tics puls\u00e1tiles<\/strong>.<\/li><li><strong><a href=\"https:\/\/crarbcn.com\/es\/blog\/electroacupuntura-en-medicina-veterinaria\/\">Acupuntura<\/a><\/strong>.<\/li><\/ul>\n<figure class=\"wp-block-gallery columns-3 is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\"><ul class=\"blocks-gallery-grid\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/hidroterapia_rehabilitacion_veterinaria_osteoartrosis.jpg\" alt=\"\" data-id=\"2757\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/hidroterapia_rehabilitacion_veterinaria_osteoartrosis.jpg\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=2757\" class=\"wp-image-2759\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/hidroterapia_rehabilitacion_veterinaria_osteoartrosis.jpg 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/hidroterapia_rehabilitacion_veterinaria_osteoartrosis-150x150.jpg 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_fisioterapia_veterinaria.jpg\" alt=\"\" data-id=\"2748\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_fisioterapia_veterinaria.jpg\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=2748\" class=\"wp-image-2750\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_fisioterapia_veterinaria.jpg 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_fisioterapia_veterinaria-150x150.jpg 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_laser_rehabilitacion_veterinaria.jpg\" alt=\"\" data-id=\"2751\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_laser_rehabilitacion_veterinaria.jpg\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=2751\" class=\"wp-image-2753\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_laser_rehabilitacion_veterinaria.jpg 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/dolor_cronico_osteoartrosis_laser_rehabilitacion_veterinaria-150x150.jpg 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><\/ul><figcaption class=\"blocks-gallery-caption\">Tratamiento multimodal del dolor cr\u00f3nico: hidroterapia, circuito de cinesiterapia activa, l\u00e1ser.<\/figcaption><\/figure>\n<p class=\"wp-block-paragraph\">Se instauraron rutinas para casa de <strong>termoterapia diaria, masajes<\/strong>, control de la actividad, y se recomendaron <strong>modificaciones del ambiente<\/strong> para mejorar la movilidad en el hogar.<\/p>\n\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Evoluci\u00f3n<\/span><\/h2>\n\n<p class=\"wp-block-paragraph\">En el seguiente video podeis ver la evoluci\u00f3n de Shiva durante sus sesions de fisioterapia veterinaria:<\/p>\n\n<figure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Manejo del dolor en un pastor checo con artrosis de cadera grave | CRAR BCN\" width=\"1080\" height=\"608\" src=\"https:\/\/www.youtube.com\/embed\/9CP7mSgBxg8?feature=oembed\"  allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<p class=\"wp-block-paragraph\">Despu\u00e9s de 8 sesions de rehabilitaci\u00f3n:<\/p>\n\n<ul class=\"wp-block-list\"><li>Tolera paseos de m\u00e1s de 1 hora y ya se sube f\u00e1cilmente a los sitios.<\/li><li><strong>Aumento del trofismo muscular<\/strong> y condici\u00f3n corporal de 5\/9.<\/li><li><strong>Aumento del ROM<\/strong> en cadera bilateral.<\/li><li>Reacciones posturales presentes y s\u00f3lo una leve parestesia en la extremidad posterior derecha, con reflejos mantenidos.<\/li><li><strong>No muestra dolor<\/strong> a la palpaci\u00f3n.<\/li><\/ul>\n<p class=\"wp-block-paragraph\">Para mantener el efecto analg\u00e9sico de las terapias implementadas se recomienda continuar realizando sesiones de mantenimiento.<\/p>\n\n<hr class=\"wp-block-separator\"\/>\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><strong><em>El 30% de los perros y gatos podr\u00edan clasificarse como seniors. Este tipo de paciente tiene una alta prevalencia de dolor cr\u00f3nico, sin embargo, a menudo se subdiagnostica y se confunde con el propio proceso de envejecimiento. <\/em><\/strong><\/p><\/blockquote>\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><strong><em>Los veterinarios, como garantes de la salud y el bienestar de nuestros pacientes, tenemos la obligaci\u00f3n de diagnosticar y clasificar el dolor. Adem\u00e1s, llevar a cabo un protocolo adecuado para el manejo del dolor de nuestro paciente y ofrecer a sus familias todas las opciones terap\u00e9uticas que puedan mejorar su bienestar.<\/em><\/strong><\/p><\/blockquote>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/crarbcn.com\/#referidors\"><span style=\"color:#4ab69f\" class=\"has-inline-color\"><strong>\u00bfQuieres referirnos un caso?<\/strong><\/span><\/a><\/div>\n<\/div>\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Queremos compartir el caso de Shiva, una perra que sufre dolor cr\u00f3nico debido a osteoartrosis severa de cadera y luxaci\u00f3n vertebral L5-L6. En este caso os ense\u00f1aremos la importancia de un enfoque multimodal en el tratamiento del dolor.<\/p>\n","protected":false},"author":2,"featured_media":2823,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","_joinchat":[],"footnotes":""},"categories":[44],"tags":[139,140],"class_list":["post-2769","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-es","tag-dolor-es","tag-rehabilitacion-es"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Manejo multimodal del dolor cr\u00f3nico - CRAR BCN<\/title>\n<meta name=\"description\" content=\"Queremos compartir el caso de Shiva, una perra que sufre dolor cr\u00f3nico debido a osteoartrosis severa de cadera y luxaci\u00f3n vertebral L5-L6.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crarbcn.com\/es\/manejo-multimodal-del-dolor-cronico\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Manejo multimodal del dolor cr\u00f3nico - 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