Medical Review by Andrea Chadwick, M.D., M.Sc., FASA | Last Updated: January 2026
Dizziness is an often overlooked symptom in fibromyalgia, but many people with fibro report episodes of lightheadedness, imbalance, unsteadiness, or true vertigo. These experiences can be distressing, disabling, and confusing, especially when standard medical tests appear “normal.”
In this article, we explain why fibromyalgia may cause dizziness, what types of dizziness are not directly caused by fibromyalgia, and when to consider other diagnoses.
Understanding Fibromyalgia and Its Symptoms
Fibromyalgia is a chronic pain condition that affects how the brain and nervous system process signals from the body. Rather than being caused by tissue damage or inflammation, fibromyalgia is linked to an overly sensitive nervous system.
- Widespread musculoskeletal pain
- Fatigue
- Sleep disturbance
- Cognitive dysfunction (“fibro fog”)
- Sensory symptoms
These sensory symptoms can include increased sensitivity to light, sound, touch, and internal body sensations. Because balance depends on how the brain processes sensory information, these changes may help explain why fibro and dizziness often occur together, even when there’s no clear inner ear problem. [1]
How Fibromyalgia May Cause Dizziness
1. Central Sensitization and Sensory Amplification
Fibromyalgia is closely associated with central sensitization, a phenomenon in which the nervous system is overly responsive to normal sensory input. This hypersensitivity contributes to fibromyalgia, and can extend beyond pain to brain fog and fatigue.
A 2024 evidence review published in Rheumatology and Therapy indicates that sensory inputs from vision, proprioception (your sense of body position), and inner ear vestibular signals may also processed differently under central sensitization, leading to a perception of imbalance or dizziness, even if the organs in your inner ear are functioning normally. [2]
2. Impaired Balance and Postural Control
Studies have shown that people with fibromyalgia score higher on balance dysfunction questionnaires and experience more episodes of instability than people without fibro.[3] Because of the difficulty in mobility, fibromyalgia patients may have low confidence in their balance, or find that the combination of chronic pain, fatigue, and altered sensory processing can disrupt their interpretation of balance information.
3. Influence of Pain, Stress, and Mood
Dizziness in fibromyalgia often correlates with other symptom severity indices, including pain levels, mood disorders, and fatigue. [4] Anxiety, depression, and chronic stress — common in fibromyalgia — can make dizziness worse or more noticeable.
How Is Fibro with Dizziness Described?
Studies show that up to 80-87% of fibromyalgia patients report vestibular symptoms, including dizziness and balance problems. [5]
People with fibromyalgia commonly report:
- Feeling unsteady or off-balance. A sense of rocking, swaying, or instability without the room spinning. This is the most common type of dizziness in fibromyalgia, and can be related to how the brain processes sensory information.
- Lightheadedness or feeling faint. A floating or woozy sensation, especially when standing up or moving, which may be linked to nervous system regulation issues that often occur alongside fibromyalgia.
- Visually triggered dizziness. Symptoms brought on by busy visual environments—such as grocery stores, crowds, or scrolling screens—reflecting increased sensitivity to sensory input.
What Kind of Dizziness Is Not Typically Caused by Fibromyalgia
While fibromyalgia can contribute to a sense of dizziness or imbalance, positional vertigo (where the world seems to spin), severe vertigo attacks, and dizziness associated with clear vestibular test abnormalities may indicate another condition. These include:
- Benign Paroxysmal Positional Vertigo (BPPV): Brief episodes of spinning triggered by turning the head or rolling over in bed.
- Vestibular Migraine: Episodes of dizziness or vertigo that may occur with or without a headache, often alongside light or sound sensitivity.
- Ménière’s Disease: A condition of the inner ear that causes vertigo, hearing loss, ringing in the ears, and a feeling of ear fullness.
- Inner Ear Infections or Inflammation, such as labyrinthitis or vestibular neuritis, which typically cause sudden, intense vertigo.
- Blood Pressure–Related Dizziness: Feeling lightheaded due to drops in blood pressure when standing up (orthostatic hypotension).
- Neurological Conditions: Conditions like stroke or multiple sclerosis can cause dizziness along with other neurological symptoms.
When to Consider Other Diagnoses
Always talk with your doctor about dizziness—especially if it:
- Comes in sudden, intense spinning episodes Is accompanied by hearing loss or ringing in the ears
- Causes fainting or heart palpitations
- Occurs with symptoms like double vision, weakness, or numbness
- Continues to worsen even when fibromyalgia symptoms are otherwise stable
Conditions like these often require targeted treatment and should be evaluated by a specialist.
Finding Relief: Strategies for Fibromyalgia-Related Dizziness
Managing dizziness related to fibromyalgia often requires a whole-person approach. Because symptoms usually stem from how the nervous system processes information, rather than from a single inner ear problem, relief may come from combining physical, medical, and lifestyle strategies over time.
1. Balance and Movement Therapy
Balance-focused physical therapy can be especially helpful for people with fibromyalgia-related dizziness. This type of therapy goes beyond general exercise and is designed to help the brain better integrate signals from the eyes, inner ear, and body.
A physical therapist may:
- Use gentle balance and coordination exercises to improve stability
- Gradually expose you to movements or positions that trigger dizziness, helping the nervous system adapt
- Work on core strength and walking patterns to reduce strain and instability
Over time, this approach can improve balance confidence, reduce fear of movement, and help the brain respond more calmly to everyday motion.
2. Medication-Based Fibromyalgia Treatment
Some medications commonly used to treat fibromyalgia may also reduce dizziness by calming an over-reactive nervous system. These medications don’t treat dizziness directly, but they may lower the overall “volume knob” of sensory signals that contribute to feeling off-balance.
Examples include:
- Certain antidepressants (such as SNRIs), which can help regulate pain and sensory processing
- Nerve-targeting medications that reduce nerve signal amplification
Medication decisions should always be individualized and discussed with a healthcare provider, especially since dizziness can sometimes be a side effect of medications rather than a symptom of fibromyalgia itself.
3. Behavioral Approaches and Lifestyle Strategies
Cognitive and behavioral therapies, which have been regularly shown to improve fibromyalgia symptoms overall, may also help with dizziness by reducing anxiety around symptoms and improving confidence in daily activities. Because stress and sensory overload can worsen symptoms, approaches that support nervous system regulation are especially helpful.
Everyday habits and coping strategies also can make a meaningful difference in managing fibro-related dizziness. Helpful strategies may include:
- Staying well hydrated, especially if lightheadedness occurs when standing
- Rising slowly from sitting or lying positions to avoid sudden drops in blood pressure
- Taking breaks in visually busy environments, such as stores or crowded spaces
- Using grounding techniques when dizziness starts—such as focusing on a stable object, placing your feet firmly on the floor, or using slow, steady breathing
4. Treating Related or Underlying Conditions
If migraines, blood pressure issues, or autonomic nervous system problems are also present, addressing those conditions can significantly improve dizziness symptoms.
Summary
Fibromyalgia and dizziness are often connected in patient reports, and central sensitization can give us clues about why that’s the case, even when vestibular organs are normal. However, severe or episodic vertigo, hearing symptoms, or neurological deficits point toward other diagnoses that require specialist care. Comprehensive evaluation and multimodal management may help people with fibromyalgia and dizziness find relief and improve daily functioning.
Sources
- Skare TL, de Carvalho JF. Ear Complaints in Fibromyalgia: A Narrative Review. Rheumatol Ther. 2024 Oct;11(5):1085-1099. doi: 10.1007/s40744-024-00701-1. Epub 2024 Aug 3. PMID: 39096417; PMCID: PMC11422319.
- Skare TL et al, ibid.
- Peinado-Rubia A, Osuna-Pérez MC, Rodríguez-Almagro D, Zagalaz-Anula N, López-Ruiz MC, Lomas-Vega R. Impaired Balance in Patients with Fibromyalgia Syndrome: Predictors of the Impact of This Disorder and Balance Confidence. Int J Environ Res Public Health. 2020 May 1;17(9):3160. doi: 10.3390/ijerph17093160. PMID: 32370043; PMCID: PMC7246608.
- Mucci V, Demori I, Rapallo F, Molinari E, Losacco S, Marinelli L, Browne CJ, Burlando B. Vestibular Disability/Handicap in Fibromyalgia: A Questionnaire Study. J Clin Med. 2022 Jul 11;11(14):4017. doi: 10.3390/jcm11144017. PMID: 35887781; PMCID: PMC9315683.
- Skare TL et al, ibid.
