Dizziness, balance, and falls during fibromyalgia outbreaks

Fibromyalgia, dizziness, lack of balance and waterfalls are common complaints. For some people, they are a little annoyance that comes up at the time. In other cases, they can be severely debilitating and lead to regular injuries.

Falling and especially falling often is a serious problem. The last thing you need when you are in constant pain is getting hurt all the time. Frequent falls or problems with balance can also cause fear of falling.

This fear can, in turn, frighten you into staying active even within your limits. According to a study in    Clinical Rheumatology,    73% of people with fibromyalgia are afraid of physical activity and almost 75% have problems with balance.

Falling is not so much a symptom and more a result of the symptoms of dizziness and a bad balance. In this situation, the problems of falling and balance may also be related to changes in the way we walk.

So why does fibromyalgia involve these problems? And what can we do about it?

Fibromyalgia and dizziness

In fibromyalgia, dizziness usually occurs when you get up. It is similar to the feeling of a “head race” from the moment you get up too fast, it can only happen every time you lie down or sit down. The sudden onset of dizziness can sway in your feet, stagger or may even fall or faint.

Dizziness and fainting in this state may be linked to a certain subgroup, according to a 2017 study published in the    European Journal of Pain   .

Image result for the old lady falling on the floor

In addition to dizziness and fainting, this subgroup also had the highest levels of pain, as well as various symptoms and conditions, including fibro fog, irritable bladder, vulvodynia, and restless leg syndrome.

Research suggests that this phenomenon stems from dysfunction of the autonomic nervous system (AZS), which is called dysautonomia.

SNA is involved with many critical functions in your body including heart rate, blood pressure, respiratory rate, body temperature, metabolism, and digestion.

Dizziness caused by dysautonomia may be called orthostatic intolerance, mediated neural hypotension, or postural orthostatic tachycardia syndrome (POTS). In essence, these things mean that the heart and brain do not communicate well with each other.

What needs to be done is that when you get up from a lying or sitting position, SNA increases your blood pressure to fight against gravity and keep enough blood supply in your brain. With dysautonomia, this does not happen as it should. Instead, your blood pressure may actually drop when you are standing up, and the result is dizziness or lightheadedness. In POTS, the heart rate accelerates when blood pressure drops.

Dizziness may be associated with palpitations, blurred vision, increased heart rate, chest pain, and a kind of fainting call called vasovagal syncope.

Not everyone fainting with fibromyalgia-related dizziness, though. In a 2008 study, the researchers said that dizziness and palpitations were more frequent than fainting. They also say that POTS was one of the most common fibromyalgia symptoms they observed during tilt tests, which measure their response to changes in position.

Balance and gait problems in fibromyalgia

Adding the possibility of fall, research suggests that people with fibromyalgia perform differently than healthy people. A 2009 study found that about 28 percent of people with this disease have an abnormal gait (gait).

In a functional performance study of 2017, the researchers said gait and balance were severely affected in this condition. Differences included:

  • significant klter paslengte
  • trager time
  • the way the body shakes as it walks

The researchers observed that gait and balance differences were worse in people who had more pain, stiffness, fatigue, anxiety and depression.

She recommended that doctors evaluate the gait and posture of their fibromyalgia patients to find the best type of rehab and fall prevention for them.

This study is part of a growing body of scientific literature to balance and perform problems in this condition that can lead to falls. However, assessing and treating these symptoms may not be a high priority for your doctor. If they take care of you, be sure to bring them to your next appointment.

Relieving dizziness and risk of fall in fibromyalgia

The more successful you are treating your fibromyalgia, the less these symptoms would be a problem. However, if they need more attention or you have not been able to find effective fibromyalgia treatments, you have several options.

For POTS dizziness, orthostatic hypotension, or mediated neural hypotension, your doctor may recommend medications to help you. These may consist of SSRI / SNRIs, benzodiazepines and beta-blockers. Some of these drugs may help alleviate other fibromyalgia symptoms, just as the SSRIs and SNRIs are often prescribed for this disease. Your doctor can also change your lifestyle.

If you smoke, research published in the journal Rheumatology    Joint, Bone, Spine suggests that stopping smoking may help relieve fainting and some other symptoms of fibromyalgia.

When it comes to balance and walking, physical therapy is a very 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 pays to be careful. Tools such as cane or walker can help keep you standing. Session exercises can be the safest option, and they are certainly a better choice than less active than you can be.


ID Costa, Gamundi A, Miranda JG, Changed 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 functions in fibromyalgia. Articulation, leg, back. May 2011; 78 (3): 259-65.

Staud R. autonomic dysfunction in fibromyalgia syndrome: orthostatic postural tachycardia. Reports of current rheumatology. December 2008; 10 (6): 463-6.

Russek L, Gardner S, Maguire K, et al An evaluation of the evaluation causes locomotor devices to be fearful in people with fibromyalgia. Clinical Rheumatology. 2015 june; 34 (6): 1109-19.

Watson NF, Buchwalk D, Goldberg J., and others Neurological signs and symptoms in fibromyalgia Arthritis and rheumatism. September 2009; 60 (9): 2839-44.

Yim YR, Lee KE, DJ Park, Identify subgroups of fibromyalgia using cluster analysis: the relationship with clinical variables. European Journal of Pain. February 2017; 21 (2): 374-384.

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