Vertiges, équilibre et chutes lors d’épidémies de fibromyalgie

Dans la fibromyalgie, les vertiges, le manque d’équilibre et les chutes sont des problèmes fréquents. Pour certaines personnes, il s’agit parfois d’un désagrément mineur. Dans d’autres, ils peuvent être gravement débilitants et causer des blessures régulières.

La chute, et surtout la chute fréquente, est un problème grave. La dernière chose dont vous avez besoin lorsque vous avez déjà une douleur constante est de vous faire mal tout le temps. Des chutes fréquentes ou des problèmes d’équilibre peuvent également faire craindre une chute.

Cette peur peut à son tour vous faire craindre de rester actif, même dans vos limites. Selon une étude en   rhumatologie clinique,   73% des personnes atteintes de fibromyalgie ont peur de l’activité physique et près de 75% ont des problèmes d’équilibre.

La chute est moins un symptôme et davantage une conséquence des symptômes de vertige et de manque d’équilibre. Dans cette situation, les problèmes d’équilibre et de chute peuvent également être liés à des changements dans notre façon de marcher.

Alors, pourquoi la fibromyalgie implique-t-elle ces problèmes? Et que pouvons-nous faire à ce sujet?

Fibromyalgie et vertiges

Dans la fibromyalgie, les vertiges sont plus fréquents lorsque vous vous levez pour la première fois. C’est comme si vous vous sentiez trop pressé lorsque vous vous levez trop vite. Cela ne peut se produire que lorsque vous vous allongez ou que vous vous levez. L’apparition soudaine de vertiges peut le faire basculer, vaciller ou même le faire tomber ou l’évanouir.

Selon une étude de 2017 publiée dans le European Journal of Pain, lesétourdissements et les évanouissements peuvent être liés à un sous-groupe particulier    .

En plus des vertiges et des évanouissements, ce sous-groupe présentait également les niveaux de douleur les plus élevés, ainsi que divers symptômes et affections qui se chevauchaient, notamment un dysfonctionnement cognitif (“fibro-brouillard”), une vessie irritable, une vulvodynie et un syndrome des jambes. agité

Les recherches suggèrent que ce symptôme est dû à un dysfonctionnement du système nerveux autonome (SNA), appelé dysautonomie.

Le SNA est impliqué dans de nombreuses fonctions essentielles de votre corps, notamment la fréquence cardiaque, la pression artérielle, la fréquence respiratoire, la température corporelle, le métabolisme et la digestion.

Les étourdissements provoqués par la dysautonomie peuvent être appelés intolérance orthostatique, hypotension à médiation neurale ou syndrome de tachycardie orthostatique posturale (POTS). Essentiellement, cela signifie que le cœur et le cerveau ne communiquent pas correctement l’un avec l’autre.

Ce qui devrait arriver, c’est que lorsque vous vous levez d’une position allongée ou assise, le SNA augmente votre tension artérielle pour lutter contre la gravité et maintenir un apport sanguin suffisant dans votre cerveau. Avec la dysautonomie, cela ne se produit pas comme il se doit. Au lieu de cela, la tension artérielle peut réellement baisser en position debout et provoquer des vertiges ou des étourdissements. Dans les POTS, la fréquence cardiaque s’accélère à mesure que la pression artérielle baisse.

Les étourdissements peuvent être associés à des palpitations cardiaques, une vision floue, une fréquence cardiaque accélérée, des douleurs à la poitrine et un type d’évanouissement appelé syncope vaso-vagale.

Cependant, toutes les personnes qui ont des vertiges associés à la fibromyalgie ne s’évanouissent pas. Dans une étude de 2008, des chercheurs ont déclaré que les vertiges et les palpitations étaient plus fréquents que les évanouissements. Ils disent également que le POTS était l’un des symptômes les plus courants de la fibromyalgie observés lors des tests sur table inclinée, qui mesurent leur réponse aux changements de position.

Problèmes d’équilibre et de démarche dans la fibromyalgie

En plus de la possibilité de chutes, les recherches suggèrent que les personnes atteintes de fibromyalgie marchent différemment des personnes en bonne santé. Une étude de 2009 a révélé qu’environ 28% des personnes atteintes de cette maladie ont une démarche anormale (mode de marche).

Dans une étude de performance fonctionnelle de 2017, les chercheurs ont déclaré que la marche et l’équilibre étaient gravement endommagés dans cette condition. Les différences incluent:

  • Longueur de foulée considérablement plus courte
  • Pas lent
  • la façon dont le corps se balance en marchant

Les chercheurs ont observé que les différences de démarche et d’équilibre étaient plus graves chez les personnes souffrant davantage de douleur, de raideur, de fatigue, d’anxiété et de dépression.

Ils ont recommandé aux médecins d’évaluer les progrès et la position de leurs patients atteints de fibromyalgie afin de trouver le meilleur type de rééducation et de prévention des chutes.

Cette étude fait partie d’un nombre croissant de publications scientifiques qui démontrent des problèmes d’équilibre et de démarche dans cette condition pouvant entraîner des chutes. Cependant, l’évaluation et le traitement de ces symptômes peuvent ne pas être une priorité pour votre médecin. Si vous êtes concerné, assurez-vous de les mentionner lors de votre prochain rendez-vous.

Soulager les vertiges et le risque de chutes dans la fibromyalgie

Plus vous réussissez dans le traitement de votre fibromyalgie, moins ces symptômes devraient poser de problèmes. Cependant, si vous avez besoin de plus d’attention ou si vous n’avez pas été en mesure de trouver un traitement efficace pour la fibromyalgie, vous avez plusieurs options.

En cas d’étourdissements, d’hypotension orthostatique ou d’hypotension cérébrale, votre médecin peut vous recommander des médicaments efficaces. Ceux-ci peuvent inclure les ISRS / IRSN, les benzodiazépines et les bêta-bloquants. Certains de ces médicaments peuvent également aider à soulager d’autres symptômes de la fibromyalgie: les ISRS et les IRSN sont couramment prescrits pour cette maladie. Votre médecin peut également recommander des changements de mode de vie.

Si vous fumez, une étude publiée dans le journal de rhumatologie   , Bone, Spine,suggère que cesser de fumer peut aider à soulager l’évanouissement et d’autres symptômes de la fibromyalgie.

En matière d’équilibre et de démarche, la thérapie physique est un traitement courant. Vous pouvez également demander à votre médecin si quelque chose comme le yoga, le tai-chi ou le qigong est sans danger pour vous.

En attendant que vous trouviez le moyen d’améliorer ces symptômes, faites-le avec prudence. Des appareils et accessoires fonctionnels, comme une canne ou un déambulateur, peuvent vous aider à rester debout. Les exercices assis peuvent être l’option la plus sûre, et ils sont certainement une meilleure option que d’être moins actif que vous ne pouvez l’être.

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