En la fibromialgia, mareos, pérdida del equilibrio, y las caídas son quejas comunes. Para algunas personas, que son una molestia menor que surge de vez en cuando. En otros, puede ser muy debilitante y dar lugar a lesiones habituales.
La caída, y especialmente caer con frecuencia, es un problema serio. La última cosa que necesita cuando ya estás en el dolor constante es hacer daño a sí mismo todo el tiempo. caídas frecuentes o problemas de equilibrio también puede conducir a un miedo a caer.
Que el miedo puede, a su vez, hará miedo de permanecer activo, incluso dentro de sus límites. Según un estudio publicado en Clinical Rheumatology, 73 por ciento de las personas con fibromialgia tienen un miedo de la actividad física, y casi el 75 por ciento tiene problemas de equilibrio.
La caída es menos un síntoma y una consecuencia más de los síntomas de mareos y pérdida del equilibrio. En esta condición, las caídas y los problemas de equilibrio también pueden estar relacionados con cambios en la forma en que caminamos.
Entonces, ¿por qué la fibromialgia implican estos problemas? Y qué podemos hacer al respecto?
Fibromialgia y mareos
En la fibromialgia, mareos mayoría de las veces se enciende la primera vez que se levanta. Es similar a la sensación de una “fiebre cabeza” de cuando usted se levanta demasiado rápido, sólo que puede ocurrir en cualquier momento se pasa de estar tumbado o sentado a de pie. La aparición repentina de mareo puede hacer que usted domina en sus pies, escalonar, o incluso puede hacer que se caiga o se desmaya.
Mareos y desmayos en esta condición pueden estar vinculados a un subgrupo particular, de acuerdo con un estudio de 2017 publicado en el European Journal of Pain .
Además de mareos y desmayos, este subgrupo también tenía los más altos niveles de dolor, así como una variedad de síntomas y condiciones de solapamiento incluyendo la disfunción cognitiva ( “niebla fibro”), vejiga irritable, vulvodinia, y síndrome de piernas inquietas.
La investigación sugiere que este síntoma se debe a una disfunción del sistema nervioso autónomo (SNA), que se llama la disautonomía.
El SNA está involucrado con una gran cantidad de funciones críticas en su cuerpo, incluyendo la frecuencia cardíaca, la presión arterial, frecuencia respiratoria, temperatura corporal, el metabolismo y la digestión.
Mareos resultante de disautonomía puede ser llamado intolerancia ortostática, hipotensión mediada neuralmente, o síndrome de taquicardia ortostática postural (POTS). En esencia, estas cosas significan que el corazón y el cerebro no se comunican correctamente entre sí.
Lo que debería ocurrir es que cuando se pone de pie desde una posición acostada o sentada, la ANS aumenta su presión arterial con el fin de luchar contra la gravedad y mantener un suministro suficiente de sangre en el cerebro. Con la disautonomía, esto no sucede como debería. En lugar de ello, la presión de la sangre pueden hacer caer al ponerse de pie, y el resultado es el mareo o aturdimiento. En POTS, las velocidades de ritmo cardíaco como gotas para la presión arterial.
Mareos puede estar asociada con palpitaciones del corazón, visión borrosa, aumento de la frecuencia de pulso, dolor de pecho, y un tipo de desmayos llamado síncope vasovagal.
No todas las personas con vértigo asociado a fibromialgia se desmaya, sin embargo. En un estudio realizado en 2008, los investigadores dicen mareos y palpitaciones eran más comunes que desmayo. También dicen POTS fue uno de los síntomas más comunes de la fibromialgia se observaron durante la prueba de basculación, que miden su respuesta a los cambios de posición.
Equilibrio y problemas de la marcha en la fibromialgia
Agregando a la posibilidad de caídas, las investigaciones sugieren que las personas con fibromialgia a pie de manera diferente que las personas sanas. Un estudio de 2009 encontró que alrededor del 28 por ciento de las personas con esta enfermedad tienen una alteración de la marcha (forma de caminar).
En un estudio de 2017 de rendimiento funcional, los investigadores dijeron que la marcha y el equilibrio fueron seriamente perjudicados en esta condición. Las diferencias incluyen:
- significativamente más corta longitud de la zancada
- Paso lento
- la forma en que el cuerpo se inclina al caminar
Los investigadores observaron que la marcha y equilibrio diferencias fueron peores en las personas que tenían más dolor, rigidez, fatiga, ansiedad y depresión.
Se recomienda que los médicos evaluar la marcha y la postura de sus pacientes con fibromialgia con el fin de encontrar el mejor tipo de rehabilitación y prevención de caídas para ellos.
Este estudio es parte de un creciente cuerpo de literatura que demuestra el equilibrio científico y problemas de la marcha en esta condición que puede conducir a las caídas. Sin embargo, la evaluación y el tratamiento de estos síntomas puede no ser una alta prioridad para su médico. Si son preocupaciones para usted, asegúrese de criarlos en su próxima cita.
Los mareos y aliviar el riesgo de caídas en la fibromialgia
Cuanto más éxito está en el tratamiento de la fibromialgia, menos estos síntomas debería ser un problema. Sin embargo, si necesitan más atención o que han sido incapaces de encontrar tratamientos eficaces fibromialgia, tiene varias opciones.
Para el mareo de POTS, hipotensión ortostática o hipotensión de origen neurológico, el médico puede ser capaz de recomendar medicamentos que ayudan. Estos pueden incluir SSRI / SNRI, benzodiazepinas y bloqueadores beta. Algunos de estos medicamentos pueden ayudar a aliviar otros síntomas de la fibromialgia, así, los ISRS y los IRSN se prescriben comúnmente para esta enfermedad. El médico también puede recomendar cambios de estilo de vida.
Si usted fuma, la investigación publicada en la revista reumatológica articulaciones, huesos, columna vertebral sugiere que dejar de fumar puede ayudar a aliviar los desmayos y otros síntomas de la fibromialgia.
Cuando se trata de equilibrio y la marcha, la fisioterapia es un tratamiento común. También puede ser que desee preguntarle a su médico si algo como el yoga, el tai chi o qigong es seguro para usted.
Hasta encontrar maneras de mejorar estos síntomas, vale la pena tener cuidado. Los dispositivos de ayuda, como un bastón o un andador pueden ayudarle a mantenerse en sus pies. ejercicios sentado puede ser la opción más segura, y son sin duda una mejor opción que es menos activo de lo que puede ser.
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