Low Blood Pressure And Dizziness

The number of symptoms and health complications that can occur with a diagnosis of fibromyalgia often seems overwhelming. Besides all the chronic physical pain and inability to sleep and the fibro fog cognitive problems, people may also experience a range of additional health risks. Two commonly noted health issues with fibromyalgia including feelings of dizziness and lack of balance as well as low blood pressure.

Dizziness

Dizziness for people with fibromyalgia is often more than just a momentary issue that happens if you stand up suddenly or move suddenly. This type of dizziness may last hours or days and may result in feeling nausea, headaches and even result in passing out for seconds to minutes or longer. Dizziness is most commonly related to a change in blood pressure, limiting the flow of blood to the brain and causing short to longer term inability of the brain to correctly process sensory information needed to maintain balance. Although not always reported by patients, medical professionals that specialize in working with individuals with fibromyalgia believe that as many as two thirds to three quarters of all people with the syndrome will experience some episodes of dizziness and low blood pressure.

Hypotension

Low blood pressure, also known as hypotension, occurs because the heart rate does not increase to compensate to the demand for blood in the lower parts of the body, particularly when going from a seated to standing position. This is not because of a problem with the heart or circulatory system, rather it is because the messages to and from the heart and the brain to regulate blood pressure are not being interpreted correctly. To distinguish this type of hypotension from other types, it is medically known as neutrally mediated hypotension. Like the accompanying dizziness, low blood pressure is directly a cause of a dysfunction in the messaging of the autonomic nervous system and may also include changes in respiration and heart rate.

Another name for this condition is near-syncope or near fainting. Individuals with this type of dizziness will feel fuzzy and weak and seem unsteady when they move from a resting position to a standing position even if they do it relatively slowly. Fainting does not occur but the symptoms may last for several minutes. Often the medications used to lower pain, treat depression or relax muscles can contribute to the low blood pressure and the changes of developing near-syncope.

One common test for autonomic nervous system dysfunction in patients with fibromyalgia is to test their heart rate when on a head-up tilt table. This provides a safe and secure way to change the position of the patient from a reclining position to an upright position and also monitor the heart rate and blood pressure. If the heart speeds up more than 30 beats for minute after more than 3 minutes in the upright position a diagnosis of postural orthostatic tachycardia syndrome is possible. This syndrome leads to dizziness and a racing heart that further creates disturbances in the normal blood pressure of the body.

How Dizziness And Hypotension Impacts Daily Life

In a national survey of 1,735 women diagnosed with fibromyalgia researchers used a self-reporting survey to determine the types of symptoms the participants experienced. This survey was done online and the women that participated reported their age to be between 31-78 years of age. The majority of women, over 60%, reported difficulty with household tasks, walking ½ mile and carrying more than 10 pounds. Over 90% reported problems with doing heavy household tasks, strenuous activities or lifting more than 25 pounds. The lower the report of functioning for each of these issue the higher women rated their levels of pain, dizziness, balance problems, fear of falling, spasticity, restless legs and bladder problems. The average score from these women was comparable to non-fibromyalgia females in their 80’s.2

Dizziness caused by hypotension affects all aspects of life. It can make it difficult to drive a vehicle, work in an office where you are constantly going from sitting to standing or move about without a fear of falling, losing balance or fainting. The more significant the dizziness is, which is often a factor of other conditions such as other illnesses, levels of pain experienced, blood sugar levels and concurrent circulation problems, the more debilitating it becomes.

Vertigo, or the feeling of spinning or tilting in space, is extremely difficult to live with. Often vertigo symptoms are present for several days or longer and may be accompanied by mild to severe nausea and headache.

Treatment For Dizziness and Hypotension with Fibromyalgia

As with most of the symptoms of fibromyalgia, dizziness and low blood pressure can be improved through the use of regular, low impact and low intensity types of exercises. It is important for the medical team to assess balance concerns, risks of falling, level of dizziness and blood pressure changes to ensure that the exercise prescribed is safe and effective based on the individual patient.

There are some over-the-counter medications that may help with some people. The motion sickness medications that are often prescribed before flying may be helpful to some individuals. However, these medications may cause you to feel tired and groggy and may also conflict with some pain medications. It is essential to check with your doctor before using any of these types of medications. Beta blockers may also be effective in some people to stabilize blood pressure and prevent the sudden drop that triggers feelings of dizziness.

It is important for your medical health professional to rule out inner ear infections and problems as the cause of the dizziness or vertigo. Often inner ear infections can become chronic and, with the headaches and pain associated with fibromyalgia, they may be misdiagnosed or overlooked.

Compression socks can be helpful to decrease the amount of blood that can rush to your legs when changing positions from sitting to standing. In addition remaining properly hydrated and learning to stand slowly are seen as effective non-medical management strategies.

References

1 Staud, R. (2008). Autonomic dysfunction in fibromyalgia syndrome: Postural orthostatic tachycardia. Currrent Rheumatology Reports , 463-466.

2 Jones, J., Rutledge, D. N., Dupree Jones, K., et al. (2008). Self-Assessed Physical Function Levels Of Women with Fibromyalgia: A National Survey. Women’s Health Issues , 406-412.

3 Jones, K. D., & Liptan, G. L. (2009). Exercise Intervention in Firbromyalgia: Clinical Applications from the Evidence. Rhuematic Disease Clinics of North America, 373-391.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015