Feeling dizzy, off-balance or having vertigo?

By Marjolein Groenevelt

Dizziness and vertigo are extremely common, affecting 15 to 20 per cent of adults each year. These feelings can range from severe but short episodes lasting hours or days to longer lasting but milder feelings of unsteadiness. There may be a spinning sensation.

The Vestibular Disorder Association (VeDA) is an extremely informative and helpful organization for people with balance issues. Every year, they promote Balance Awareness Week this year, it runs from September 18 to 24.

The vestibular system is mainly defined as the inner ear and the vestibular nerve. The other main contributors to balance are our eyes and our proprioceptive system, meaning our muscles and joints telling our brain where we are in space. There are other lesser contributors, but these are the three main ones that should all agree. When there is mismatching input from one or both inner ears, the brain will try to reconcile the input from the eyes and the body.

There are many causes of vestibular problems. Inner ear infections and Ménière’s disease will cause significant mismatch and spinning. Another condition called Benign Paroxysmal Positional Vertigo (BPPV) is becoming more well-known. BPPV occurs when debris, sometimes called rocks or crystals, leaves its home base and gets stuck in one of the inner ear semi-circular canals. When the head moves in a particular direction, the heavy debris signals movement which is incorrect. The eyes try to rectify the problem and flick in one direction, known as nystagmus. When the debris settles, commonly around 30 seconds, the feeling of motion goes away until the next time the movement occurs. This commonly occurs when looking up or lying down in bed especially on one side. Maneuvers such as the Epley maneuver can guide the debris back where it belongs.

There are many other causes of dizziness and vertigo. A medical doctor can help you with spinning and vertigo diagnosis and treatment. If appropriate, the next step would be a vestibular physiotherapist. A detailed evaluation will review the many possible causes and outline a good treatment plan. If the symptoms have been present for weeks or months, evaluation should include the use of infrared goggles. Putting these goggles on eliminates room light, so that only the inner ear and not the eyes can detect the movement. The infrared camera allows the physiotherapist to see what the eyes are doing.

If you are living with balance issues, spend some time on the VeDA website. Learn about your own symptoms and talk to a doctor and a vestibular physiotherapist.

Marjolein Groenevelt is a physiotherapist at Glebe Physiotherapy and Sport Medicine at Lansdowne who, along with her colleague Michael Seto, has worked with vestibular clients of all ages.

Dizziness and vertigo are common conditions that can be helped with therapy. Balance Awareness Week is September 18 to 24.

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