Young woman with fibromyalgia syndrome presented with significant postural hypotension and severe intractable headache and anxiety.
i think postural hypotension correction will help alot
A common cause of debilitating headaches is a forward head position that results in increased tonicity in the small occipital (neck) muscles. The occipital nerve is compressed, headaches result (e.g., Greater Occipital Nerve Syndrome).
If your patient has a forward head position, provide a treatment regimen that reverses the FHP. This will, many cases, eliminate the headaches.
http://rothbartsfoot.es/Headaches.html
Would suggest strongly to try Yoga Practice from a professional teacher along with the other treatment.It could definitely bring about a change gradually.
Further added a guided frame work
Simple analgesics such as paracetamol and other weak opioids can be considered in the treatment of fibromyalgia. (Corticosteroids and strong opioids are not recommended.). These drugs are designed to take the edge off less severe pain or to combat flare ups. If paracetamol is not effective in easing the pain, the GP, or healthcare professional, may prescribe a stronger painkiller, such as codeine or tramadol, or one called nefopam. Both of these painkillers have been found to be effective in treating pain that is caused by fibromyalgia and act like synthetic codeine. In some cases, in addition to the main painkiller, a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen can be added. However, NSAIDs should be avoided if the patient have asthma, high blood pressure, or kidney, or heart, problems
We observe that many cases of headache in fibromyalgia patients are caused by the presence of tender points in the fascial region, particularly in cheek, orbital, and occipital region. These tender points often mimic "true" migraine pain. In such cases medical massage performer by experienced in fibromyalgia physiotherapist may markedly improve symptoms. In our opinion in the localization of tender points thermography can be helpful, as it indicates "cold regions". Complementary measures include: cold avoidance and warm (sometimes sleeping in cap may be helpful).
as you mention the postural hypotension I would recommend working with the young woman´s posture maybe in combination with massage . We use the Mensendieck postural training for patients with postural problems, and from learning a new way of postural tension we try to help the person find new ways of using the body in Daily activites.
Fibromyalgia patients often has a headache. But if she is severe it is important make an evaluation the cervical spine to verify that does not have disc herniation or significant increase in cervical curve or rectification.
Please check
"""The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine."""(Clin Rheumatol. 2013 Jul;32(7):983-90. doi: 10.1007/s10067-013-2218-2. Epub 2013 Feb 27.)
It will be profitble for for you.
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