In fibromyalgia, dizziness, balance problems, and falls are common complaints. For some people, they are a minor nuisance that comes back to the occasion. In others, they can be very disabling and lead to regular injuries.
Falling, and especially falling often, is a serious problem. The last thing you need when you are already in constant pain is to hurt yourself all the time. Frequent falls or balance problems can also lead to a fear of falling.
This fear can, in turn, scare you to stay active, even within your limits. According to a study in clinical rheumatology, 73 percent of people with fibromyalgia are afraid of physical activity, and nearly 75 percent have balance problems.
The fall is less a symptom and more a consequence of the symptoms of vertigo and a bad balance. In this condition, falls and balance problems can also be related to changes in the way we walk.
So, why does fibromyalgia involve these problems? And what can we do about them?
Fibromyalgia and Dizziness
In fibromyalgia, dizziness comes most often when you get up. It is similar to the feeling of a “rush to the head” of when you get up too fast, that it can happen at any time to go from lying down to sitting up. The sudden onset of dizziness can make you swing on your feet, staggering, or it can even make you fall or weak.
Dizziness and fainting in this condition may be related to a particular subgroup, according to a 2017 study published in the European Journal of Pain .
In addition to dizziness and fainting, this subgroup also had higher pain levels, as well as a variety of overlapping symptoms and conditions, including cognitive dysfunction (“fibro fog”), bladder irritable, vulvodynia, and restless legs syndrome.
Research suggests that this symptom results from a dysfunction of the autonomic nervous system (ANS), which is called autonomic dysfunction.
The SNA is involved with a lot of vital functions in your body, including heart rate, blood pressure, respiratory rate, body temperature, metabolism, and digestion.
Dizziness resulting from dysautonomia can be called orthostatic intolerance, neural hypotension, or postural orthostatic tachycardia syndrome (POTS). Essentially, these things mean that the heart and the brain do not communicate well with each other.
What is needed when you get up from a supine or sitting position, the SNA raises your blood pressure to fight the gravity and keep a sufficient amount of blood in your brain. With dysautonomia, this does not happen as it should. Instead, the blood pressure can actually fall when you stand, and the result is dizziness or lightheadedness. In POTS, heart rate speeds in the form of drops blood pressure.
Dizziness may be associated with heart palpitations, blurred vision, increased pulse rate, chest pain, and a type of fainting called vasovagal.
Not everyone with fibromyalgia-related vertigo fails, though. In a 2008 study, researchers say that dizziness and palpitations were more common than fainting. They also say POTS has been one of the most common fibromyalgia symptoms they have seen in table tilt tests, which measure your response to changes in position.
Balance and Posture Problems in Fibromyalgia
Adding the possibility of falls, research suggests that people with fibromyalgia walk differently than healthy people. A 2009 study found that about 28 percent of people with this disease have abnormal gait (walking).
In a 2017 study of functional performance, the researchers said that gait and balance were severely compromised in this condition. Differences included:
- significantly shorter stride length
- slower pace
- the way the body waves when walking
The researchers noted that gait differences and balance were worse in people who had more pain, stiffness, fatigue, anxiety, and depression.
They recommended that doctors evaluate the gait and posture of their fibromyalgia patients to find the best type of rehabilitation and fall prevention for them.
This study is part of a growing number of equilibrium scientific literature demonstrating and gait problems in this condition can lead to falls. However, the evaluation and treatment of these symptoms may not be a priority for your doctor. If they are concerns for you, be sure to put them on your next appointment.
Risk and Dizziness Mitigating Autumn in Fibromyalgia
The more you have managed to treat your fibromyalgia, the less these symptoms should be a problem. However, if they need more attention or you have been unable to find effective treatments for fibromyalgia, you have several options.
For POTS vertigo, orthostatic hypotension, hypotension, or neural damage, your doctor may be able to recommend medications that help. These may include SSRI / SNRI, benzodiazepines and beta-blockers. Some of these medications may help relieve other symptoms of fibromyalgia, as well as SSRI and SNRI are commonly prescribed for this condition. Your doctor may also recommend lifestyle changes.
If you smoke, research published in rheumatoid joints, bone, spine review suggests that quitting smoking can help relieve the loss of consciousness and several other symptoms of fibromyalgia.
With regard to balance and walking, physical therapy is a common treatment. You can also ask your doctor if something like yoga, tai chi, or qigong is safe for you.
Until you find ways to improve these symptoms, it is better to be careful. assistive devices such as a cane or walker can help you stay on your feet. Exercises may be sitting the safest option, and they are definitely a better choice than being less active than you can be.
Costa ID, Gamundi A, Miranda JG, et al. Altered functional performance in patients with fibromyalgia. Frontiers in human neuroscience. January 26, 2017; 11:14
Lee SS, Kim SH, Nah SS, et al. Smoking habits influence pain and functional and psychiatric features in fibromyalgia. Joints, bones, spine. May 2011; 78 (3): 259-65.
Staud R. dysfunction in Autonomic fibromyalgia syndrome: postural tachycardia.Current rheumatologists postural reports. Dec 2008; 10 (6): 463-6.
Russian L Gardner S, Maguire K, et al. A cross-sectional assessment of sources of fear related movement in people with fibromyalgia syndrome. Clinical rheumatology. June 2015; 34 (6): 1109-1119.
Watson NF, Buchwalk D, J Goldberg, et al. neurological signs and symptoms in fibromyalgia.Arthritis and rheumatism. Sep 2009; 60 (9): 2839-44.
Yim YR, Lee KE, DJ Park, et al. Identification of subgroups of fibromyalgia using cluster analysis: relationships with clinical variables. European Journal of Pain. February 2017; 21 (2): 374-384.