Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain and tenderness. While the most recognized symptoms involve pain and fatigue, the condition is complex and often includes non-pain-related issues. This systemic disorder affects how the brain and nervous system process various signals, leading to a wide range of physical complaints. The involvement of the nervous system explains why many individuals with fibromyalgia experience symptoms like dizziness and nausea.
Dizziness and Nausea as Core Fibromyalgia Symptoms
Fibromyalgia can directly cause dizziness and nausea, which are frequently reported non-pain symptoms. These sensations are not merely side effects of medication or fatigue but appear intrinsic to the disorder’s effect on the nervous system. Dizziness is a common complaint, with research suggesting that between 60% and 70% of patients experience this issue, ranging from mild lightheadedness to severe vertigo.
The dizziness is often described as unsteadiness, instability, or a sensation of spinning, known as vertigo. Nausea is also a frequent companion, sometimes occurring alongside dizziness but also independently. Some studies indicate that a significant percentage of patients experience chronic nausea or vomiting. The co-occurrence of these symptoms highlights the systemic nature of fibromyalgia, extending beyond muscle aches and pain.
The Neurological Basis for Dizziness and Nausea
The underlying cause of these symptoms is rooted in central sensitization, where the central nervous system processes sensory information abnormally. In fibromyalgia, the brain and spinal cord become hypersensitive, amplifying signals that would not typically cause distress. This neural over-reactivity extends beyond pain signals to include other sensory inputs, impacting the body’s balance and digestive control centers.
Central sensitization can lead to the brain misinterpreting signals related to spatial orientation and balance, contributing to instability and dizziness. The hyperexcitability means the brain can generate symptoms like constant dizziness or motion sickness even when the body is at rest. This sensory amplification also affects the digestive system, contributing to chronic nausea and other gastrointestinal issues.
Dysfunction of the Autonomic Nervous System (ANS), known as dysautonomia, is another mechanism linking fibromyalgia to these symptoms. The ANS regulates involuntary bodily functions, including heart rate, blood pressure, respiration, and bowel function. When the ANS malfunctions, it causes inefficient regulation of blood flow, especially when changing position.
This poor regulation often manifests as orthostatic intolerance, where the body struggles to maintain stable blood pressure and heart rate upon standing. The resulting temporary reduction of blood flow to the brain causes lightheadedness, dizziness, and sometimes a feeling of near-fainting. Furthermore, ANS dysfunction can affect the nerves controlling the digestive tract, leading to issues with gastric motility that trigger nausea.
Related Conditions That Mimic or Worsen These Symptoms
The experience of dizziness and nausea in fibromyalgia is complex because several co-occurring conditions frequently amplify or mimic these symptoms. Postural Orthostatic Tachycardia Syndrome (POTS) is closely linked to the dysautonomia seen in fibromyalgia. POTS is defined by an abnormal increase in heart rate upon standing, leading to severe orthostatic intolerance symptoms like chronic lightheadedness, dizziness, and fainting.
Vestibular issues and balance disorders are also common, often stemming from chronic musculoskeletal tension and altered gait associated with widespread pain. Chronic pain can alter posture, sending confusing signals to the brain about the body’s position in space. This can lead to a secondary balance problem, where the person perceives excessive wobbling or instability, further contributing to dizziness.
Fibromyalgia-related migraines, particularly vestibular migraines, represent a third overlap that intensifies dizziness and nausea. Vestibular migraines primarily cause severe dizziness, vertigo, and balance problems, often without a typical headache. Since migraines and fibromyalgia frequently co-exist, central nervous system sensitization is thought to play a role in both conditions, leading to a higher rate of intense episodes.
Managing Vertigo and Stomach Distress
Managing these non-pain symptoms requires a focused approach that addresses nervous system dysregulation. Non-pharmacological relief strategies are often the first line of defense, especially for nausea and dizziness related to blood flow. For nausea, eating small, frequent meals helps prevent the stomach from becoming overly full, and consistent hydration is important for blood volume regulation.
For dizziness, particularly orthostatic symptoms, patients should incorporate slow, deliberate changes in body position, avoiding rapid movements when standing. Lifestyle adjustments, such as pacing activities to avoid overexertion, are beneficial since fatigue can worsen both dizziness and nausea. Gentle, low-impact exercise, such as water aerobics or light walking, can improve overall physical conditioning and contribute to better ANS function.
Medical interventions can also target these specific non-pain symptoms, often using approaches distinct from standard pain management. Doctors may prescribe antiemetic medications to control chronic or severe nausea. For dysautonomia-related dizziness, certain medications regulate blood pressure and heart rate. Additionally, vestibular rehabilitation therapy (VRT), a specialized form of physical therapy, can be beneficial for those experiencing vertigo and balance problems, using exercises to help the brain better process balance signals.