Yrsel, balans och fall under fibromyalgifläckar

I fibromyalgi är yrsel, dålig balans och faller vanliga klagomål. För vissa människor är de en liten irritation som uppstår ibland. I andra kan de vara allvarligt försvagande och leda till regelbundna skador.

Att falla, och speciellt faller ofta, är ett allvarligt problem. Det sista du behöver när du redan har konstant smärta är att skada dig hela tiden. Frekventa fall eller balansproblem kan också leda till rädsla för att falla.

Den rädslan kan i sin tur göra dig rädd att vara aktiv, även inom dina gränser. Enligt en studie i   klinisk reumatologi är  73 procent av personer med fibromyalgi rädda för fysisk aktivitet och nästan 75 procent har problem med balans.

Fallet är mindre ett symptom och mer en följd av symptomen på yrsel och dålig balans. I detta tillstånd kan fall och balansproblem också relateras till förändringar i hur vi går.

Så, varför involverar fibromyalgi dessa problem? Och vad kan vi göra med dem?

Fibromyalgi och yrsel

I fibromyalgi visas nästan alltid alltid yrsel när du går upp för första gången. Det liknar känslan av en “head race” när du står upp för fort, det kan bara hända varje gång du går från att ligga eller sitta för att stå upp. Den plötsliga uppkomsten av yrsel kan få honom att sväva på fötterna, vippa eller till och med få honom att falla eller svimma.

Yrsel och svimning i detta tillstånd kan kopplas till en viss undergrupp, enligt till en 2017 studie publicerad i   European Journal of Pain  .

Förutom yrsel och svimning, denna undergrupp hade också de högsta nivåerna av smärta och en mängd olika symptom och överlappande tillstånd inklusive kognitiv dysfunktion ( “fibrohumedad”), irriterad urinblåsa, vulvodynia och restless leg syndrome.

Forskning tyder på att detta symptom kommer från dysfunktion av det autonoma nervsystemet (ANS), kallas dysautonomi.

ANS är involverad i många kritiska funktioner i din kropp, inklusive hjärtfrekvens, blodtryck, andningsfrekvens, kroppstemperatur, metabolism och matsmältning.

Yrsel som härrör från dysautonomi kan kallas ortostatisk intolerans, neuralt medierad hypotoni eller posturalt ortostatiskt takykardi syndrom (POTS). I huvudsak innebär dessa saker att hjärtat och hjärnan inte kommunicerar korrekt med varandra.

Vad som ska hända är att när du stiger upp från en liggande eller sittande position ökar ANS ditt blodtryck för att bekämpa gravitationen och upprätthålla en tillräcklig blodtillförsel i din hjärna. Med dysautonomi sker detta inte som det borde. Däremot kan blodtrycket faktiskt minska när du slutar, och resultatet är yrsel eller ljushårighet. I POTS accelererar hjärtfrekvensen då blodtrycket minskar.

Yrsel kan vara associerad med hjärtklappning, suddig syn, ökad puls, bröstsmärta och en typ av besvär som kallas vasovagal synkope.

Men inte alla personer med yrsel i samband med fibromyalgi svimmade. I en studie från 2008 sa forskare att yrsel och hjärtklappning var vanligare än svimning. De säger också att POTS var ett av de vanligaste symptomen på fibromyalgi som de observerade under bordslingstest, vilket mäter deras svar på förändringar i position.

Balans och gångproblem i fibromyalgi

Förutom möjligheten till fall, tyder forskning på att personer med fibromyalgi går annorlunda än friska människor. En studie från 2009 visade att cirka 28 procent av personer med denna sjukdom har en onormal gång (sätt att gå).

I en studie av funktionell prestation som genomfördes 2017, sa forskarna att gång och balans påverkades allvarligt i detta tillstånd. Skillnaderna ingår:

  • Betydande kortare stridlängd
  • Långsamt steg
  • hur kroppen svävar när man går

Forskarna noterade att gång- och balansskillnader var värre hos personer som hade mer smärta, stelhet, trötthet, ångest och depression.

De rekommenderade att läkare utvärderar deras patients utveckling och position med fibromyalgi för att hitta den bästa typen av rehabilitering och förebyggande av fall för dem.

Denna studie är en del av en växande kropp vetenskaplig litteratur som visar balansproblem och går i detta tillstånd som kan leda till fall. Det kan dock inte vara en prioritet för din läkare att utvärdera och behandla dessa symtom. Om du är orolig, var noga med att nämna dem vid nästa möte.

Lindra yrsel och risk för fall i fibromyalgi

Ju mer framgångsrik du är i behandling av din fibromyalgi, dessa symtom borde vara mindre problematiska. Men om du behöver mer uppmärksamhet eller om du inte har kunnat hitta effektiva behandlingar för fibromyalgi, har du flera alternativ.

För yrsel orsakad av POTS, ortostatisk hypotension eller neuralt medierad hypotension, kan din läkare rekommendera mediciner för att hjälpa dig. Dessa kan inkludera SSRI / SNRI, bensodiazepiner och beta-blockerare. Några av dessa läkemedel kan hjälpa till att lindra andra fibromyalgi symptom, precis som SSRI och SNRI är vanligtvis ordinerad för denna sjukdom. Din läkare kan också rekommendera förändringar i livsstil.

Om du röker,  föreslår forskning som publiceras i den gemensamma reumatologiska tidningen   Bone, Spine att sluta röka kan hjälpa till att lindra svimning och andra symptom på fibromyalgi.

När det gäller balans och gång är fysioterapi en vanlig behandling. Du kan också vilja fråga din läkare om något som yoga, tai chi eller qigong är säkert för dig.

Innan du hittar sätt att förbättra dessa symtom är det värt att vara försiktig. Hjälpanordningar som en käpp eller vandrare kan hjälpa dig att stå. Sittande övningar kan vara det säkraste alternativet, och de är säkert ett bättre alternativ än att vara mindre aktiv än du kanske är.

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