Dizziness is the second most common complaint heard in the doctor’s office, and the number one malady of people older than 70. In the past, those with dizziness or balance problems had nowhere to turn; there simply were no effective treatments. If you suffered from dizziness, you were probably told, “You’ll have to live with it.”
That’s not the case today. An alternate form of therapy, vestibular rehabilitation, can help you overcome dizziness and the helpless feelings associated with it.
But before we discuss the treatment, let’s examine how the balance system works. Three sensory systems gather information regarding your body’s position and movement in space: the visual, vestibular (semicircular canals and otoliths), and somatosensory (touch, joint and muscle receptors) systems. These systems transmit information to your brain’s central processor, the cerebellum.
The balance response is carried out by the motor system located here – the right and left vestibular systems, which are key to maintaining balance because they provide the brain with information about your head movement and position. Disease in one vestibular system will send erroneous information to your brain and cause vertigo or imbalance.
Vision helps orient the body in space by referencing vertical and horizontal axes of objects around you. The somatosensory system gives your brain information regarding support surfaces and the motion of your body’s parts in relation to one another.
Balance can be maintained if you suffer a loss of one of these three sensory systems, but when more than one system is lost balance difficulties like dizziness occur. And this is where vestibular rehabilitation comes in.
How does vestibular rehabilitation work?
There are three methods of vestibular rehabilitation. The first is habituation, which means that by continually repeating the actions that bring on dizziness or vertigo you will eventually accustom your body to those actions. The second process involves balance retraining exercises that help reduce unsteadiness and imbalance. The third aspect deals with head-eye coordination exercises that help reduce gaze-induced dizziness.
Specific exercises customized to your particular needs will help decrease dizziness and increase balance function, and may also increase your general activity levels.
Diagnosing vestibular disorders
A physician will diagnose your particular problem by performing a complete medical history, a neurotologic examination, and tests of hearing and balance function. Blood tests for allergies, autoimmune inner ear disease (allergies to your own ear tissue), or hormonal imbalance may also be necessary. In addition, an ultrasound test which evaluates the blood circulation around the brain and/or imaging studies with CT or MRI and a consultation with a neurologist or cardiologist might be indicated. Once a diagnosis is made, the physician (neurotologist) will be able to determine if vestibular rehabilitation therapy will benefit you. In some cases, this can be used as an alternative to medication or surgery. Results have been rewarding, even in the elderly.
The vestibular rehabilitation therapist
A vestibular rehabilitation therapist with create a therapy program specifically for you. First he ro she will discuss your symptoms, and then assess your musculoskeletal system by testing the strength, coordination, and range of movement in your arms and legs. Your balance and gait are also evaluated by observing if you need to touch objects, fix your eyes on stationary objects, and what hip and ankle strategy you use to maintain your balance.
After careful analysis, the vestibular rehabilitation therapist designs a specific home exercise program suited to your particular needs. You will keep a weekly log of your progress, which is evaluated by the physician and the vestibular rehabilitation therapist. You will meet with the therapist once or twice a week for several months, all the while continuing the exercises at home.
It is important for you to understand that your symptoms may become worse before they improve. Even so, therapy should continue in order to overcome the problems.
Benefits of vestibular rehabilitation therapy
The benefits of vestibular rehabilitation vary depending on the cause of your problem and how well your central nervous system compensates. If your condition does not improve within three months, the therapy is usually discontinued.
Vestibular rehabilitation has helped many people overcome the physical sensations and discomfort associated with dizziness and vertigo. But its psychological benefits are perhaps the most rewarding. Returning to a normal lifestyle, no longer afraid of falling, and taking control of your body is worth more than words can say.