Fibromyalgia is a chronic condition characterized by widespread pain, profound fatigue, sleep disturbances, and cognitive difficulties, often called “fibro fog.” This article explores the connection between fibromyalgia and dizziness, explaining why this symptom occurs and how it can be managed.
Is Dizziness a Fibromyalgia Symptom?
Dizziness is a recognized symptom for many with fibromyalgia. Research indicates that approximately 60% to 70% of those diagnosed report experiencing it. This sensation can manifest as lightheadedness, a feeling of being off-balance, or true vertigo, where the world feels like it is spinning.
The intensity and frequency of dizziness vary considerably among individuals. Some feel mild unsteadiness, while others experience severe episodes that disrupt daily activities and increase fall risk. This symptom can also occur alongside nausea, vomiting, or visual disturbances like blurry vision or light sensitivity.
Why Fibromyalgia Can Cause Dizziness
Several factors contribute to dizziness in fibromyalgia. A significant contributor is autonomic nervous system dysfunction, or dysautonomia, which regulates involuntary bodily functions like heart rate and blood pressure.
Dysregulation can lead to orthostatic hypotension (a sudden drop in blood pressure upon standing) or Postural Orthostatic Tachycardia Syndrome (POTS), where heart rate increases significantly when upright. Both reduce blood flow to the brain, causing lightheadedness or faintness. Fibromyalgia can also alter central nervous system processing, impairing the brain’s ability to integrate sensory signals for balance and spatial orientation.
Medications for fibromyalgia can also cause dizziness. Antidepressants (e.g., duloxetine, milnacipran) and anticonvulsants (e.g., pregabalin), used to manage pain, often list dizziness as a potential side effect. Muscle relaxants can also contribute to dizziness and drowsiness.
Chronic sleep disturbances, prevalent in fibromyalgia, can worsen dizziness. Poor sleep quality increases fatigue and affects cognitive function and balance. Co-occurring conditions like migraines, anxiety, chronic fatigue syndrome, or restless legs syndrome can also contribute to dizziness.
Other Reasons for Dizziness
Dizziness is a common symptom with many potential causes beyond fibromyalgia. Inner ear problems, such as Benign Paroxysmal Positional Vertigo (BPPV) or Meniere’s disease, directly affect balance and can cause vertigo. Dehydration and low blood pressure, even without a POTS diagnosis, also reduce blood flow to the brain.
Vision problems, including uncorrected refractive errors or eye strain, can lead to unsteadiness. Anxiety and panic attacks can trigger dizziness, as can certain neurological conditions or other medication side effects unrelated to fibromyalgia. A thorough medical evaluation is necessary to determine the specific cause of dizziness.
When to Seek Medical Help and Management
Seek medical attention for dizziness if it is recurrent, sudden, severe, disrupts daily life, or has no clear cause. Immediate medical evaluation is necessary if dizziness accompanies concerning symptoms like chest pain, sudden severe headache, numbness or weakness in limbs, slurred speech, vision changes, or fainting.
Diagnosing dizziness typically involves a detailed medical history and physical examination. Doctors may perform tests to rule out other conditions, including blood tests, imaging scans, or specialized balance assessments. This approach helps pinpoint whether dizziness relates to fibromyalgia or another underlying issue.
Management strategies for fibromyalgia-related dizziness involve a multi-faceted approach. Lifestyle adjustments include making slow position changes to avoid sudden blood pressure drops, staying hydrated, and incorporating gentle exercise. Stress management and improved sleep hygiene are also important, as fatigue and stress can worsen dizziness.
A review of current medications may be necessary to adjust any drugs contributing to dizziness. Physical therapy, especially vestibular rehabilitation, can improve balance and reduce dizziness by retraining the brain to process balance signals. Addressing co-occurring conditions like anxiety or sleep disorders can also alleviate dizziness.