Bij fibromyalgie zijn duizeligheid, gebrek aan evenwicht en vallen veel voorkomende klachten. Voor sommige mensen zijn ze een kleine ergernis die zich af en toe voordoet. In andere gevallen kunnen ze ernstig verzwakken en regelmatig letsel veroorzaken.
De val, en vooral de frequente val, is een serieus probleem. Het laatste dat je nodig hebt als je al een constante 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 weer bang maken om actief te blijven, zelfs binnen jouw grenzen. Volgens een studie in Clinical Rheumatology, 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 gebrek aan 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 eraan doen?
Fibromyalgie en duizeligheid
Bij fibromyalgie treedt duizeligheid vaker op als je voor het eerst opstaan. Het lijkt op het gevoel van “head rushing” wanneer je te snel opstaat, het kan alleen gebeuren als je gaat liggen of liggen. Het plotselinge begin van duizeligheid kan ervoor zorgen dat hij op zijn benen slingert, schommelt of zelfs laat vallen of flauwvallen.
Duizeligheid en flauwvallen in deze toestand kunnen verband houden met een bepaalde subgroep, volgens een studie uit 2017, gepubliceerd in European Journal of Pain .
Naast duizeligheid en flauwvallen, deze subgroep had ook de hoogste niveaus van pijn en een verscheidenheid van symptomen en aandoeningen die elkaar overlappen, waaronder cognitieve disfunctie ( “fibro fog”), prikkelbare blaas, vulvodynia en benensyndroom rusteloos.
Onderzoek suggereert dat dit symptoom te wijten is aan autonome stoornissen van het zenuwstelsel (SNA), dat dysautonomia wordt genoemd.
Het SNA is betrokken bij vele kritieke functies in uw lichaam, waaronder hartslag, bloeddruk, ademhalingssnelheid, lichaamstemperatuur, metabolisme en spijsvertering.
Duizeligheid veroorzaakt door dysautonomia orthostatische intolerantie, neuraal gemedieerde hypotensie posturale orthostatische tachycardie of (POTS) syndroom genoemd. In wezen, deze dingen betekenen dat het hart en de hersenen niet goed met elkaar communiceren.
Wat moet er gebeuren is dat wanneer je opstaat vanuit een liggende of zittende houding, de SNA verhoogt je bloeddruk de zwaartekracht tegen te gaan en een voldoende bloedtoevoer naar zijn hersenen te handhaven. Bij dysautonomia gebeurt dit niet zoals het zou moeten. In plaats daarvan kan de bloeddruk ook daadwerkelijk te gaan naar beneden bij het staan, en het resultaat is duizeligheid of licht in het hoofd. In POTS versnelt de hartslag als de bloeddruk daalt.
Duizeligheid kan gepaard gaan met hartkloppingen, wazig zicht, verhoogde hartslag, pijn op de borst en een soort flauwvallen, genaamd vasovagale syncope.
Echter, niet iedereen die duizeligheid heeft geassocieerd met fibromyalgie valt flauw. 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 de tests met hellende tafels 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 functioneel prestatieonderzoek van 2017 zeiden de onderzoekers dat gang en evenwicht in deze toestand ernstig waren beschadigd. De verschillen omvatten:
- Aanzienlijk kortere paslengte
- Trage stap
- de manier waarop het lichaam zwaait tijdens het lopen
De onderzoekers merkten op dat verschillen in gang en evenwicht erger waren 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 evenwichts- en loopproblemen in deze toestand aantoont die tot vallen kunnen leiden. Het evalueren en behandelen van deze symptomen heeft echter mogelijk geen hoge prioriteit 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, hoe minder deze symptomen een probleem zouden 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 POTS duizeligheid, orthostatische hypotensie of hersen-gemedieerde hypotensie, kan uw arts medicijnen aanbevelen die helpen. Deze kunnen SSRI / SNRI, benzodiazepinen en bètablokkers omvatten. Sommige van deze medicijnen kunnen ook helpen bij het verlichten van andere symptomen van fibromyalgie: SSRI’s en SNRI’s worden vaak voorgeschreven voor deze ziekte. Uw arts kan ook veranderingen in de levensstijl aanbevelen.
Als je rookt, suggereert onderzoek, gepubliceerd in het gezamenlijke reumatologische 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, is fysiotherapie 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 wandelstok of een wandelstok, 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 zou kunnen zijn.
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