Submitted by Poonam McAllister, Physical Therapist, Central Illinois Institute of Balance
Imagine reaching for something on a grocery store shelf and suddenly feeling unsteady or looking over your shoulder to back up the car and having things start whirling around you. Most people feel dizzy now and then. If that feeling persists or interferes with your daily life, it could be a sign of a balance disorder.
A balance disorder makes you feel as if you’re moving, spinning, or floating, even though you’re quite still. More than four in 10 Americans will experience an episode of dizziness sometime during their lives that’s significant enough to send them to a doctor.
Dizziness can range from feeling lightheaded to woozy to disoriented. Feeling that you or your surroundings are spinning is called vertigo. Any of these sensations can be extremely distressing.
“Balance is a multisystem function,” explains National Institute of Health (NIH) hearing and balance expert Dr. Daniel Sklare. It begins with a series of signals within the tiny balance organs of the inner ear. These organs work with your brain’s visual system to give you a sense of your body’s position. They also keep objects from blurring when your head moves. Sense receptors in skin, joints, and muscles also send balance-related signals to the brain. The brain receives and coordinates information from all these different body systems. Balance disorders can arise when any of these signals malfunction.
Because balance is so complex, it can be hard to figure out the underlying cause of certain problems. Some balance disorders can begin suddenly. They might arise from an ear infection, a head injury or certain medications. Low blood pressure can lead to dizziness when you stand up quickly. Disorders related to vision, muscles, bones or joints can also contribute to balance problems.
“As America gets older, many people with imbalance have a collection of these problems,” says Dr. Gordon Hughes, NIH clinical trials Director for hearing and balance. “They might have aging of the ear, aging of vision, cataracts, or muscle weakness from losing some muscle mass or arthritis in the hips, plus other problems like diabetes.”
Researchers have identified more than a dozen different balance disorders. The most common is a sudden, often harmless burst of vertigo that might arise with an abrupt change in the position of the head, like when you roll in bed or bend over to tie your shoes. Technically known as benign paroxysmal positional vertigo (BPPV), this condition can result from a head injury or simply from getting older. However younger people under 65 years of age also experience BPPV symptoms. BPPV occurs when tiny calcium crystals in the inner ear become displaced. In that case, your vestibular specialist physical therapist can treat BPPV by carefully moving the head and body to reposition these particles. An NIH-supported clinical trial showed that this treatment works well for BPPV.
Another common balance disorder is known as Ménière’s disease. It can develop at any age, but most often strikes adults between 40 and 60 years of age. Symptoms include intense vertigo, hearing loss, nausea, tinnitus (a ringing or buzzing in the ear), and a feeling of fullness in the ear. Ménière’s disease usually affects only one ear.
Some people with Ménière’s disease have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some affected people have vertigo so extreme that they lose their balance and fall. These episodes are called “drop attacks.”
An attack of Ménière’s symptoms, while not life-threatening, can feel completely overwhelming. The symptoms arise because of a change in fluid volume within the inner ear, but its underlying cause remains unknown.
If you think you may have a balance disorder, talk with your health care provider. Your doctor can assess whether your symptoms might be caused by a serious disorder, such as a heart or blood condition. If an inner-ear balance disorder is likely, you should see a professional who specializes in balance disorders. A specialized therapist can give you a set of head, body and eye exercises to help reduce dizziness and nausea. Additional balance therapy may be needed with your physical therapist to restore everyday walking and to decrease your risk of falling.
“The key for people looking for treatment is to go to the best team of clinical experts that they can gain access to,” says Dr. Sklare. “It’s very important to get that level of assessment.”
For more information on problems with balance or dizziness, contact Poonam McAllister at Central Illinois Institute of Balance, 309-663-4900 or www.dizzyil.com. Poonam is specially trained in the evaluation and treatment of balance disorders using a comprehensive approach that looks at the complexities of balance problems in the context of the total patient. Her office is located at 211 Landmark Dr, Suite E-3 in Normal.