Bij fibromyalgie zijn duizeligheid, slechte balans en vallen veelvoorkomende klachten. Voor sommige mensen zijn ze een kleine ergernis die af en toe ontstaat. In andere landen kunnen ze ernstig verzwakken en leiden tot regelmatig letsel.
Vallen, en vooral vaak vallen, is een serieus probleem. Het laatste dat je nodig hebt als je al constant pijn hebt, is jezelf de hele tijd pijn doen. Frequente valpartijen of evenwichtsproblemen kunnen ook leiden tot valangst.
Die angst kan je op zijn beurt doen vrezen actief te zijn, zelfs binnen jouw grenzen. Volgens een studie in klinische reumatologie, is 73 procent van de mensen met fibromyalgie bang voor fysieke activiteit en bijna 75 procent heeft problemen met de balans.
De val is minder een symptoom en meer een gevolg van de symptomen van duizeligheid en een slecht evenwicht. In deze situatie kunnen vallen en evenwichtsproblemen ook verband houden met veranderingen in de manier waarop we lopen.
Dus, waarom brengt fibromyalgie deze problemen met zich mee? En wat kunnen we ermee doen?
Fibromyalgie en duizeligheid
Bij fibromyalgie verschijnt duizeligheid bijna altijd als je voor het eerst opstaat. Het is vergelijkbaar met het gevoel van een “hoofdrace” wanneer je te snel opstaat, het kan alleen gebeuren elke keer als je gaat liggen of zitten om rechtop te staan. Het plotselinge begin van duizeligheid kan ervoor zorgen dat hij op zijn voeten zwaait, wiebelt of zelfs laat vallen of flauwvallen.
Duizeligheid en flauwvallen in deze toestand kunnen worden gekoppeld aan een bepaalde subgroep, volgens een studie uit 2017, gepubliceerd in European Journal of Pain .
Naast duizeligheid en flauwvallen had deze subgroep ook de hoogste niveaus van pijn en een verscheidenheid aan overlappende symptomen en aandoeningen, waaronder cognitieve disfunctie (“fibrohumiditeit”), prikkelbare blaas, vulvodynie en rustelozebenensyndroom.
Onderzoek suggereert dat dit symptoom komt van autonome zenuwstelsel dysfunctie (SNA), die dysautonomia wordt genoemd.
De ANS is betrokken bij vele kritieke functies in uw lichaam, waaronder hartslag, bloeddruk, ademhalingssnelheid, lichaamstemperatuur, metabolisme en spijsvertering.
Duizeligheid als gevolg van dysautonomie kan orthostatische intolerantie, neuraal gemedieerde hypotensie of orthostatisch tachycardiesyndroom (POTS) worden genoemd. In wezen betekenen deze dingen dat het hart en de hersenen niet correct met elkaar communiceren.
Wat er moet gebeuren, is dat wanneer u opstaan vanuit een liggende of zittende positie, de ANS uw bloeddruk verhoogt om tegen de zwaartekracht in te vechten en een voldoende hoeveelheid bloed in uw hersenen behoudt. Bij dysautonomia gebeurt dit niet zoals het zou moeten. De bloeddruk kan daarentegen juist dalen als u stopt en het resultaat is duizeligheid of duizeligheid. In POTS versnelt de hartslag als de bloeddruk daalt.
Duizeligheid kan gepaard gaan met hartkloppingen, wazig zicht, verhoogde pols, pijn op de borst en een soort flauwvallen, genaamd vasovagale syncope.
Echter, niet alle mensen met duizeligheid gerelateerd aan fibromyalgie flauwvallen. In een onderzoek uit 2008 zeiden onderzoekers dat duizeligheid en hartkloppingen vaker voorkwamen dan flauwvallen. Ze zeggen ook dat POTS een van de meest voorkomende symptomen was van fibromyalgie die ze tijdens tafel tilt-testen waarnamen, die hun reactie op positieveranderingen meten.
Saldo- en loopproblemen bij fibromyalgie
Naast de mogelijkheid van vallen, suggereert onderzoek dat mensen met fibromyalgie anders lopen dan gezonde mensen. Een onderzoek uit 2009 wees uit dat ongeveer 28 procent van de mensen met deze ziekte een abnormale manier van lopen hebben.
In een onderzoek naar functionele prestaties uitgevoerd in 2017, zeiden de onderzoekers dat gang en evenwicht in deze toestand ernstig waren aangetast. Verschillen inbegrepen:
- Aanzienlijk kortere paslengte
- Trage stap
- de manier waarop het lichaam zwaait tijdens het lopen
De onderzoekers merkten op dat het loop- en evenwichtsverschil slechter was bij mensen die meer pijn, stijfheid, vermoeidheid, angst en depressie hadden.
Zij adviseerden artsen de voortgang en positie van hun patiënten met fibromyalgie te evalueren om het beste type revalidatie en preventie van vallen voor hen te vinden.
Deze studie maakt deel uit van een groeiend aantal wetenschappelijke literatuur die balansproblemen en wandelen in deze toestand aantoont die tot vallen kan leiden. Toch is het mogelijk dat het evalueren en behandelen van deze symptomen geen prioriteit is voor uw arts. Als u zich zorgen maakt, moet u ze vermelden op uw volgende afspraak.
Verlicht duizeligheid en het risico op vallen van fibromyalgie
Hoe succesvoller u bent bij het behandelen van uw fibromyalgie, deze symptomen zouden minder problematisch moeten zijn. Als u echter meer aandacht nodig heeft of als u geen effectieve behandelingen voor fibromyalgie heeft kunnen vinden, heeft u verschillende opties.
Voor duizeligheid veroorzaakt door POTS, orthostatische hypotensie of neuraal gemedieerde hypotensie, kan uw arts medicijnen aanbevelen om u te helpen. Deze kunnen SSRI / SNRI, benzodiazepines en bètablokkers omvatten. Sommige van deze medicijnen kunnen andere fibromyalgiesymptomen helpen verlichten, net zoals SSRI’s en SNRI’s vaak worden voorgeschreven voor deze ziekte. Uw arts kan ook veranderingen in de levensstijl aanbevelen.
Als je rookt, suggereert onderzoek, gepubliceerd in het gezamenlijkereumatologische tijdschrift Bone, Spine dat stoppen met roken kan helpen om flauwvallen en andere symptomen van fibromyalgie te verlichten.
Als het gaat om balans en gang, fysiotherapie is een veel voorkomende behandeling. U kunt ook uw arts vragen of iets als yoga, tai chi of Qigong veilig voor u is.
Totdat u manieren vindt om deze symptomen te verbeteren, is het de moeite waard voorzichtig te zijn. Hulpmiddelen zoals een stok of rollator kunnen u helpen te staan. Zittende oefeningen kunnen de veiligste optie zijn, en ze zijn zeker een betere optie dan minder actief te zijn dan je misschien bent.
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