Yrsel, balans och fall under fibromyalgiutbrott

I fibromyalgi är yrsel, brist på balans och faller vanliga klagomål. För vissa människor är de en mindre irritation som uppstår ibland. I andra kan de vara allvarligt försvagande och orsaka regelbundna skador.

Fallet, och särskilt det vanliga fallet, 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 för 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 symtom på yrsel och brist på 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 åt det?

Fibromyalgi och yrsel

I fibromyalgi uppträder yrsel oftare när du stiger upp. Det liknar känslan av “head rushing” när du står upp för fort, det kan bara hända varje gång du lägger dig ner eller står upp. Den plötsliga uppkomsten av yrsel kan leda till att han svävar på fötterna, vinklar eller till och med får honom att falla eller svimma.

Yrsel och svimning i detta tillstånd kan relateras till en viss undergrupp, enligt en studie från 2017 som publicerades i   European Journal of Pain  .

Förutom yrsel och svimning, denna undergrupp hade också de högsta nivåerna av smärta och en mängd olika symptom och tillstånd som överlappar, inklusive kognitiv dysfunktion ( “fibro dimma”), irriterad urinblåsa, vulvodynia och legs syndrome rastlös.

Forskning tyder på att detta symptom beror på autonomt nervsystemet dysfunktion (SNA), som kallas dysautonomi.

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

Yrsel som orsakas av dysautonomi kallas ortostatisk intolerans, neural-medierad hypotoni postural ortostatisk takykardi eller (POTS) syndrom. I huvudsak dessa saker gör att hjärtat och hjärnan inte kommunicera ordentligt med varandra.

Vad ska hända är att när du går upp från liggande eller sittande ställning, ökar SNA ditt blodtryck mot gravitationen och upprätthålla en tillräcklig blodtillförsel till hjärnan. Med dysautonomi sker detta inte som det borde. Istället kan blodtrycket faktiskt gå ner när man står, och resultatet är yrsel eller yrsel. I POTS accelererar hjärtfrekvensen som blodtrycksdroppar.

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

Men inte alla som har yrsel i samband med fibromyalgifainter. I en studie 2008 säger forskare att yrsel och hjärtklappning var vanligare än svimning. De säger också att POTS var ett av de vanligaste symptomen på fibromyalgi de observerade under de lutande bordsförsöken, vilka mäter deras svar på förändringar i position.

Balans och gångproblem i fibromyalgi

Förutom möjligheten till fall, föreslår forskning 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 funktionell prestationsstudie av 2017 sa forskarna att gång och balans var allvarligt skadade i detta tillstånd. Skillnaderna är:

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

Forskarna observerade att skillnader i gång och balans 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 balans och gångproblem i detta tillstånd som kan leda till fall. Men utvärdering och behandling av dessa symtom kanske inte har hög prioritet för din läkare. 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, desto mindre skulle dessa symtom vara ett problem. Men om du behöver mer uppmärksamhet eller om du inte har kunnat hitta effektiva behandlingar för fibromyalgi, har du flera alternativ.

För POTS-yrsel, ortostatisk hypotension eller hjärnmedierad hypotension, kan din läkare rekommendera mediciner som hjälper. Dessa kan inkludera SSRI / SNRI, bensodiazepiner och betablockerare. Några av dessa läkemedel kan också hjälpa till att lindra andra symptom på fibromyalgi: 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 fysisk terapi en vanlig behandling. Du kan också fråga din läkare om något som yoga, tai chi eller qigong är säkert för dig.

Innan du hittar sätt att förbättra dessa symptom, är det värt att vara försiktig. Hjälpmedel, som en käpp eller rullator, 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 kan vara.

108 thoughts on “Yrsel, balans och fall under fibromyalgiutbrott

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