Dizziness, light-headedness and problems with balance are distressing, but can also cause major problems in everyday life, including nausea, problems with co-ordination and walking, and falls that are more frequent. Up to two-thirds of people with FM have problems with dizziness to some degree.1
In a study carried out in the USA and published in 2009, which compared people with and without FM, people with FM had worse balance that those without the disorder. They also had worse scores on ‘balance confidence’, and had many more falls – for example a 50-year old with FM had numbers of falls equivalent to a 70- or 80-year old without the disorder.
What Causes Balance Problems and Dizziness in FM?
It’s not completely clear what causes balance problems and dizziness in FM (just another symptom no-one is sure of with FM!). FM trigger points in the neck or jaw can cause a feeling of dizziness and imbalance. This may be because they affect the nerves that tell the brain where the body is in space, so if these signals do not match with the signals from the eyes, this could cause dizziness and disorientation.
Dizziness and light-headedness could also be caused by neurally-mediated hypotension (also known as the vaso-vagal reflex) – a drop in blood pressure and heart rate. It can also cause sweating, fainting and falls.
Neurally-mediated hypotension is most likely to happen:
- after standing for a while
- when in a warm place
- after exercise
- after an emotionally stressful event
- after a heavy meal.
There is a physical abnormality in the skull known as the Chiari malformation that puts pressure on a specific area of the brain. This can bring on symptoms of neurally-mediated hypotension, and in a study in the USA, it was seen in 60% of people with FM.
Some medications can cause light-headedness, dizziness and balance problems. People with FM tend to take more medications than the general population, and so it’s worth talking to a doctor or pharmacist to see if this might be the cause.
Coping With Balance Problems and Dizziness in FM
Make sure that the house and workplace is free of trip hazards, such as cables, rugs and obstructing pieces of furniture, and watch out for sharp objects and corners that could cause an injury after a fall.
Try not to stand up too quickly after sitting or lying down, or bending over, as this can cause the dizziness or make it worse.
Balance exercises can help with balance problems – try dance, yoga, Tai chi or Pilates, sit on an exercise ball, stand on a wobble cushion, walk a line heel to toe (and then backwards again if you can), or just try standing on one leg. The Alexander technique can also be helpful – it focuses on good posture and helps with balance and co-ordination. Exercise also helps with other symptoms of fibromyalgia syndrome.
People with problems with balance can sometimes find walking awkward, and find that they stumble more easily – try using a pair of walking poles, especially when it’s icy, or on days that dizziness is a particular problem. Stumbling and falls can also destroy confidence – using walking poles, even if not always needed, will give extra confidence, and provides a visual reminder to people that walking may be a bit of a problem.
1. This figure is from Balance Problems and Dizziness by Suzanne Elvidge BSc (hons), MSc at http://www.fibromyalgiasyndrome.co.uk/balance-problems-dizziness.html but:
- A 1996 study found a prevalence of vertigo and dizziness in 72% of the 168 patients studied (Rosenhall U, Johansson G, Orndahl G. Otoneurologic and audiologic findings in fibromyalgia. Sancd J Rehabil Med. 1996;28(4):225-232)
- A 2002 study assessed the ear-related symptoms in 24 female patients with FM and found that 50% of the patients had either dizziness, ringing in the ears, hearing loss, or vertigo (Bayazit YA, Gursoy S, Ozer E, Karakurum G, Madenci E. Neurotologic manifestations of the fibromyalgia syndrome. J Neurol Sci. 2002;196(1-2):77-80)
- A 2009 study evaluated the frequency of various neurological signs and symptoms in both FM patients and healthy control subjects. The researchers found that 30% of the 166 FM patients had vertigo versus only 1% of the 66 healthy control subjects (Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen RG. Neurological signs and symptoms in fibromyalgia. Arthritis Rheum. 2009;60(9):2839-2844)
- Ehealthme.com ran an internet survey where 9,796 patients were questioned. It was found that 9.73% of respondents suffered from vertigo.
Reblogged (with comments from me) from http://www.fibromyalgiasyndrome.co.uk/balance-problems-dizziness.html by Suzanne Elvidge BSc (hons), MSc