Dizziness and fibromyalgia

Dizziness is a symptom that is often attributed to fibromyalgia but it is a complex symptom because it can have so many causes. It is also a symptom that may be overlooked, or not even mentioned to the doctor, because pain and stiffness and fatigue are just so much more demanding of our attention. 

I've collected information here on dizziness from a variety of sources including people who have fibromyalgia. 

DIZZINESS AND FIBROMYALGIA STATISTICS

Many people quote the statistic that 70% of people who have fibromyalgia have dizziness but they do not say where this statistic comes from. As far as I can work out it came from a study into 168 fibromyalgia patients that was done in 1996 at the Department of Audiology Karolinska Hospital, Sweden. Vertigo/dizziness was reported by 72% of these patients. The results of this study indicated "that central nervous system (CNS) dysfunction frequently occurs in patients with fibromyalgia, although proprioceptive disturbances might also explain some of the abnormalities observed."

CAUSES OF DIZZINESS IN FIBROMYALGIA

Celeste Cooper is a Registered Nurse, hospital educator, and nurse paralegal who has been living with fibromyalgia who has important recommendations for the symptom of dizziness:  

• Report this to your doctor and discuss the possibilities of the presence of these conditions, there are tests that can be done. 
• You must find out what is causing your dizziness. Dizziness is a symptom and can be caused by many conditions, but in FM the major culprits are hypothyroidism, Neurally Mediated Hypotension (NMH) or Postural Orthostatic Tachycardia (POTS). The presence of myofascial trigger points, causing chronic myofascial pain, located in muscles next to vital organs and blood vessels can also cause dizziness.
• Identify the cause of your dizziness to know how it is best treated. The treatment for all of the disorders is different. 
• Rule out other conditions such as hypoglycemia (low blood sugar), insulin resistance, impending stroke, etc.
• Once any life-threatening cause has been ruled out, be sure to check for myofascial trigger points in the area. They can be easily felt by a trained examiner, and treated. Myofascial Pain is present in most if not all FM patients. 

NEURALLY MEDIATED HYPOTENSION (NMH) IN FIBROMYALGIA

Dr Oz says One potential side effect of fibromyalgia is a problem called neurally mediated hypotension. It simply means that your blood pressure is a bit too low. If you stand for a long time, your head may start spinning.

The best way to avoid dizziness that comes from this problem is to avoid standing for long periods, if possible. When you can't avoid standing, walk around as much as you can. You can also try wearing compression stockings, which help to relieve hypotension.

POSTURAL ORTHOSTATIC TACHYCARDIA (POTS)

PoTS UK says that this condition is due to an abnormal response by the autonomic nervous system and is characterised by orthostatic intolerance (the development of symptoms when upright that are mostly relieved by lying down). These symptoms include lightheadedness, fatigue, and fainting.

STEROCLEIDOMASTOID TRIGGER POINTS

These are trigger points in the neck that can cause dizziness, vertigo and imbalance. They can also cause hearing loss and tinnitus. They are created by postures that cause the neck muscle to contract such as forward head posture. These trigger points can be released by specific massage techniques. You may be able to find a Myofascial Trigger Point Therapist near you through this database.

POSTURE AND DIZZINESS

Having poor posture and weak muscles can mean that when people with fibromyalgia do many daily activities such as driving or working on a computer they can cause the creation of the trigger points mentioned above. If your neck is tight or sore it may indicate you have these issues. A trained physical therapist can help diagnose and treat these issues and will usually give you exercises to improve your posture.

MEDICATIONS FOR FIBROMYALGIA MAY CAUSE DIZZINESS

According to Dr. Congdon, “Many fibromyalgia medications have dizziness – and sometimes loss of balance – as a common side effect. That’s why it is important to talk to your doctor if you are experiencing dizziness or balance trouble to see if one of your medications could be contributing.”

Specifically, she mentioned pregabalin (eg, Lyrica), gabapentin (eg, Neurontin), and zolpidem (eg, Ambien), which helps with sleep and may cause next-day dizziness. If you are taking any of these medications and experiencing issues with balance, talk with your doctor about possible alternatives. FROM PRACTICAL PAIN MANAGEMENT ARTICLE

RESEARCH INTO FIBROMYALGIA AND DIZZINESS

A 2019 study into Impaired Balance in Patients with Fibromyalgia Syndrome found that many of the participants experienced dizziness in their daily life. This impacted their balance confidence as they were scared of falling over. 

To evaluate disability due to vertigo the dizziness handicap inventory (DHI) was used. This is a useful multi-dimensional tool for quantifying self-perceived disability in patients with vertigo, dizziness, or instability, and its impact on activities of daily living. It contains 25 self-administered questions, with a total range of 0 to 100 points. A higher score indicates a greater degree of disability due to the vertiginous symptoms.

A 2002 study found that dizziness was the most common complaint of the patients in the study and that they had symptoms of vestibular ear disorders even though they did not have any clinically or audiologically detectable ear disease. 

OTHER DIZZINESS RELATED CONDITIONS

Pituitary Adenoma ~ What is Your Fibromyalgia Hiding?

One of the symptoms of having a pituitary adenoma is dizziness. Find out more about this condition and read Suzanne's story with it from diagnosis to treatment.  

Vestibular migraine is a nervous system problem that causes repeated dizziness (or vertigo) in people who have a history of migraine symptoms.

A day in the life with vestibular migraine.

Symptoms of vestibular migraine can differ slightly amongst those with the condition. Two of the most common are dizziness, which VeDA describes as ‘a sensation of lightheadedness, faintness, or unsteadiness’, and imbalance, which is ‘unsteadiness or loss of equilibrium that is often accompanied by spatial disorientation’.

Other symptoms of vestibular migraine in particular, and those that affect me, are motion intolerance (can’t stand being on a bus), vertigo attacks (which I am thankful to have few of nowadays), and issues with heights or simply looking at tall buildings. Cobblestone streets and uneven ground throw out my balance, and you will never catch me going on a rollercoaster! Claire describes her day with this condition. 

Meniere's disease is an inner ear disorder probably caused by a fluid buildup and a feeling of fullness and pressure in the ear. The symptoms include episodes of vertigo, hearing loss, and tinnitus (ringing in the ears). 

Recurrent positional vertigo is most often caused by benign paroxysmal positional vertigo (BPPV). BPPV has the sudden sensation that you're spinning or that the inside of your head is spinning. BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed. (MAYO CLINIC) 

If this is the cause of your dizziness your doctor can guide you through some exercises that are called the canalith repositioning procedure.

Multiple Chemical Sensitivity (MCS)

MCS is something that many people with fibromyalgia have and one of the symptoms is dizziness. this is usually brought on by strong smells such as household cleaners, perfumes and petrol fumes encountered when pumping petrol to your car. 

LIVING WITH DIZZINESS

STAY HYDRATED

This can seem a bit simplistic but being dehydrated can cause dizziness and lightheadedness. Naturopath Janet McKenzie gives us a guide on how to determine how much water we should be drinking. 

EXERCISE

Dizziness is something many of us who live with fibromyalgia struggle with, but it can also be a symptom of other medical issues. As it affects our balance, exercising while we’re dizzy can throw us off balance and result in falls and injury. Terri talks about this and how to determine if we should exercise on any particular day. 

TIPS FOR SHOWERING WHEN WE ARE DIZZY

Showering can be difficult when we have fibromyalgia for a variety of reasons including dizziness. Shelley talks about the reasons why showering is a complex issue and some suggestions for what to do to prevent dizziness and other showering issues here.

THE RIGHT PILLOW MAY HELP PREVENT DIZZINESS

For years Bethan would experience vertigo, a feeling of spinning if her head fell off her pillow while sleeping. Now she has found the perfect pillow for her to prevent this.

10 TIPS TO STOP DIZZINESS

Sue has some helpful tips including home remedies and trigger point massage that you can try yourself. She also recommends finding out what kind of dizziness you are experiencing so you know which treatments may help.

WHAT DOCTOR SHOULD I SEE FOR DIZZINESS?

A specialist is needed to diagnose these issues. The following specialist's may be able to help:

• Audiologist
• An ear nose and throat specialist (otolaryngologist)
• Neurologist

ARTICLES IN SPANISH ABOUT FIBROMIALGIA  AND DIZZINESS

Mareos, falta de equilibrio y caídas durante los episodios agudos de Fibromialgia

Falta de equilibrio y Fibromialgia, un estudio demostró que las mujeres son más propensas a sufrirlo

Fibromialgia: averigua como prevenir y evitar los mareos, vértigo, caídas, caminar inestable