Do you experience dizzy spells, or often feel off balance? Have you stopped participating in some of your favourite activities for fear of falling? Does the room spin on you when you roll over in bed or get up too fast? If you answered yes to any of these questions you are not alone. It’s estimated that as many as 35% of adults over the age of 40 and 80% of adults over the age of 65 experience dizziness. While dizziness can be the result of many different problems such as a cardiovascular or neurological problem, and a person should consult their doctor if they begin to experience dizziness, the most common cause of dizziness is vestibular dysfunction. The good news is that vestibular dysfunction can often be easily identified and a person’s quality of life can be restored with simple treatment.
Before we get into how it is treated let’s discuss what vestibular dysfunction is and how it causes dizziness. Vestibular dysfunction is a form of miscommunication between the vestibular apparatus located in your inner ear and your brain. This miscommunication can create a sense of dizziness (light headedness, swaying, disorientation) or vertigo. Even people without vestibular dysfunction can feel symptoms of a mismatch. For example, motion sickness is caused when information from the vestibular system tells your brain that you are moving, but the information from your eyes and body tell your brain that you are not moving.
Vertigo is a distinct form of vestibular dysfunction that can be very uncomfortable, or even disabling for those who suffer from it. The sensation of vertigo can be compared to the feeling of the room spinning when you lie down after enjoying too much great Okanagan wine. One of the most common causes of vertigo is a condition called benign paroxysmal positional vertigo (BPPV) a condition that is not dangerous, but can very scary when it first happens, and can interfere with quality of life. BPPV is when a person experiences a sensation of vertigo when they move their head, and is most commonly experienced when rolling over in bed. When it first happens people may also experience nausea and feel unwilling to move. The good news about BPPV is that it can be diagnosed and treated in 1 or 2 appointments with a physiotherapist trained in vestibular rehab. BPPV is the result of small naturally occurring crystals in your inner ear that have become dislodged and migrated into the semi circular canals of the inner ear creating an improper signal from your ear telling you that you are moving your head even though you aren’t. By repositioning the client in a series of specific positions a physiotherapist is able to move the loose crystals back to the correct spot in the inner ear. Once the crystals are back where they belong there is no longer any symptoms.
If you’re not experiencing vertigo, but rather just dizziness or a feeling of instability, a vestibular trained physiotherapist can also to help reduce the symptoms and improve your quality of life. While treating theses conditions is not as quick as treating BPPV it is still possible to reduce the feelings of dizziness and nausea and improve overall quality of life. After an assessment your therapist should be able to provide you with specific exercises designed to help your brain recognize the mismatch and adapt, and get back to enjoying the activities that you love.
Demian Carson is a registered physiotherapist at Spine and Sports South End and is trained in vestibular rehabilitation.