When Balance Starts to Slip
Do you frequently feel unsteady or light, as if your head is spinning or whirling, making you wobbly when standing still, lying down, or changing positions? If so, you may be at risk of a balance disorder. Good balance is often taken for granted, people generally don't consider it serious until they've already experienced real damage to their health.
Balance is achieved and maintained by a complex set of sensorimotor control systems that include sensory input from vision, proprioception (touch), and the vestibular system (motion, equilibrium, and spatial orientation). Among these, imbalance is most often tied to vestibular system malfunction, the vestibular system acts as the tie-breaker between conflicting forms of sensory information, and when it malfunctions, it can no longer resolve moments of sensory conflict, resulting in symptoms like dizziness, vertigo, and disequilibrium. That's why we offer different vestibular therapy programs to help patients maintain good balance.
Common Symptoms Vestibular Therapy Can Help
Dizziness, a sensation of lightheadedness, faintness, or unsteadiness. Vertigo, the perception of movement or whirling, either of the self or surrounding objects. Spatial disorientation, a sensation of not knowing where one's body is in relation to the vertical and horizontal planes. Disequilibrium, unsteadiness, imbalance, or loss of equilibrium, often accompanied by spatial disorientation. Vision disturbance, trouble focusing or tracking objects, with text or objects appearing to jump, bounce, float, blur, or double. Hearing changes, hearing loss, distorted or fluctuating hearing, or sensitivity to loud noises or environments.
What Causes Balance Problems
Balance problems are caused by numerous factors, including injury, disease, certain drugs, the aging process, or other psychological factors. Migraine can bring on dizziness and sensitivity to motion, known as vestibular migraine, and is a common cause of dizziness in general. Benign paroxysmal positional vertigo (BPPV) occurs when calcium crystals in the inner ear, which help control balance, become dislodged and move elsewhere in the inner ear, it's the most common cause of vertigo in adults, often producing a spinning sensation when turning in bed or tilting the head back.
Psychogenic vertigo affects patients with panic disorder and other anxiety disorders who often seek treatment for ill-defined vestibular symptoms. Head injury can cause significant disability due to vestibular symptoms, often involving both cognitive and central vestibular components along with a peripheral one. Meniere's disease can cause fluctuating hearing loss along with buzzing, ringing, or a feeling of fullness in the ear; its cause isn't fully known, and it's rare, typically developing in people between the ages of 20 and 40.
Evaluation and Assessment
Vestibular therapy is an exercise-based treatment program designed by a specialty-trained vestibular physical therapist to improve balance and reduce dizziness-related problems. The therapist evaluates your symptoms, reviews your medical history, and assesses your condition across several areas: balance and leg strength and flexibility, gait (how you walk), visual stability and mobility, neck mobility and neck and arm strength, and positional testing, including an inner ear exam.
Programs to Treat Impaired Balance
Vestibular rehabilitation therapy (VRT) uses specific head, body, and eye exercises designed to retrain the brain to recognize and process signals from the vestibular system and coordinate them with vision and proprioception; the exact exercises differ from person to person, with the goals of enhancing gaze stability, enhancing postural stability, improving vertigo, and improving activities of daily living.
Canalith repositioning maneuvers, such as the Epley maneuver, are a specialized form of VRT used to treat BPPV, involving a series of specifically patterned head and trunk movements that move tiny displaced otoliths to a place in the inner ear where they no longer cause symptoms.
Home-based exercise is often a vital part of treatment, with appropriate VRT exercises assigned by the physical or occupational therapist to be performed at a prescribed pace, along with a progressive fitness program to increase energy and reduce stress.
Dietary adjustments can help many people with Meniere's disease, secondary endolymphatic hydrops, and migraine-associated dizziness, along with avoiding non-dietary substances such as nicotine and certain medications. Talk therapy counseling can also help, since symptoms from vestibular disorders are invisible and unpredictable and often carry psychological weight; support and counseling can help patients cope with lifestyle changes, depression, guilt, and grief. Medication may be used depending on whether the dysfunction is in an initial, acute phase or an ongoing, chronic one, and surgery may be considered when medical treatment isn't effective in controlling vertigo and other symptoms, with the type of surgery depending on each individual's diagnosis and physical condition.
You Don't Have to Manage It Alone
Living with a vestibular disorder can affect a person's life in many ways, and balance problems are often difficult to address alone because they can be caused by numerous factors. That's why having a specialty-trained vestibular physical therapist evaluate and guide your treatment makes such a difference.