Balance and Vertigo

Dizziness and imbalance are common complaints heard by family doctors.  Sometimes dizziness and imbalance are caused by disease or injury affecting the inner ear and/or its connections to the brain.  Some physiotherapists, including two providing services through Panther clinics, have taken training in Vestibular Rehabilitation. The “Vestibular System” is that part of your inner ear and its connections to the brain which register movement of our bodies in space. It is involved in keeping us upright and balanced, and able to move.

Vestibular Rehabilitation can help 4 categories of patients with dizziness and imbalance:

                 1) People with a condition called Benign Paroxysmal Positional Vertigo (BPPV).  This is believed to be a mechanical problem where “crystals” distort the normal flow of fluid in the canals of the inner ear.  This causes faulty messages about movement to be transmitted to the brain, making the person feel dizzy when they change position.  BPPV can usually be cured within a couple of treatments using a procedure designed to flush the crystals out of the inner ear, called the “Epley maneuver”.

                 2) People with vestibular loss. Typically, this means one inner ear (or inner ear nerve) has been damaged resulting in insufficient information about movement getting to the brain. Since most people in this category will still have one inner ear that is capable of transmitting correct information, treatment involves helping their brain “re-calibrate” so it can make sense of the differing amounts of information received from each inner ear. This is done through specific eye and head movements and balance exercises.

                 3) People with “multisensory” deficits. The body utilizes three kinds of sensory information in helping us keep our balance: vestibular, vision, and somatosensory  (sensation from our neck, trunk, lower limbs and feet on the ground).  As we age or experience diseases that affect the acuity of our senses, we may find our balance deteriorates. We may become too reliant on information from one sensory system.  Vestibular rehabilitation can help us fine-tune our balance by optimizing our use of all sensory information available to us.

                 4)   People who have central nervous system problems which interfere with the brain’s ability to interpret the information it receives from the vestibular and other sensory systems.  This may be caused by head trauma, stroke, tumors or diseases such as multiple sclerosis. Vestibular exercises may form part of a full rehabilitation program designed to help the person regain as much function as possible.

 Vestibular Rehabilitation can include any combination of the following types of procedures or exercises:

                a)  Canal repositioning maneuvers such as the Epley maneuver.

                b)  Habituation exercises to desensitize the individual to vertigo-inducing situations or positions.

                c)  Adaptation exercises to help the brain re-calibrate.

                d)  Compensation strategies to substitute for lost abilities and prevent falls.

 If you experience dizziness or imbalance, check with your Doctor to see if vestibular rehabilitation at a Panther clinic could help you.