By Andy Parsons, PT, DPT, Board-Certified Orthopedic Specialist, Vestibular Rehab Certified
When you look up into the cupboard, wash your hair, roll over in bed, or bend to look into a low cupboard does your world spin around you? Do you feel more unsteady with walking, or do you feel like you're being pushed over? Is it difficult for you to walk down the aisle of the supermarket? Do you feel like you're intoxicated even though you haven't had any alcohol? If you had any or some of these experiences, then you might be suffering from an inner ear problem. Dizziness often comes from a portion of the inner ear called the vestibular system. Issues in this area of the ear can cause the above symptoms or many other problems.
In fact, 35% of people forty and older have experienced a vestibular problem at some point in their lives. Luckily, there are good treatment options for folks that are having inner ear dysfunction. The most common type of inner ear dizziness called benign paroxysmal positional vertigo (BPPV) creates a sensation of spinning when moving from sitting to lying, rolling over, or looking up for example. Some people complain of unsteadiness with this condition as well. One out of ten people 75 years and older have this problem. The gold standard treatment for this condition is a series of specific physical positions that reposition loose calcium particles in the inner ear. Studies report success rates between 75-90% for this type of treatment. Medication is not generally helpful for this condition. This treatment is supported by the American Neurotology Association, the American Academy of Family Physicians, and the American Physical Therapy Association among others. Physical therapists with additional training often perform these positioning treatments for people with dizziness. This is generally accomplished in between 2-4 sessions.
Alternatively, the inner ear system can lose function from a variety of issues like infections, viruses, or diseases specific to the inner ear. People with these class of conditions may complain of increased unsteadiness, bouncing vision, falls, and slower walking. Vestibular rehabilitation can be very effective for these people to increase balance and stability with walking by training the brain to compensate for the inner ear problem. Guidelines recommend around 6-8 weeks of treatment for this type of vestibular problem.
Dizziness is a complex subject. Not all dizziness comes from the inner ear. Lightheadedness is the most common issue that is generally not responsive to physical therapy. Talk to your doctor or physical therapist about whether or not this type of treatment would be appropriate for you.
Andy Parsons is a physical therapist at ProMedica Defiance Total Rehab at ProMedica Defiance Regional Hospital. He is certified in Vestibular Rehabilitation and has nearly 9 years of experience working with “dizzy” patients. You can call 419-783-6943 for more information.
BPPV: Experts Update Best Practices for Diagnosis and Treatment. Am. Academy of Otolaryngolgy- Head and Neck Surgery. https://www.entnet.org/content/bppv-experts-update-best-practices-diagnosis-and-treatment
Image source: Pixabay via Kalhh. https://pixabay.com/photos/trees-away-nature-eddy-turn-dizzy-358418/