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Out of Balance

Posted 6/6/2018 by UHBlog

If dizziness and vertigo are getting you down, vestibular therapy can help. Ask us how.

Sad senior man sitting on bed contemplating

Ever get up from a chair and the room starts to spin? It’s no fun being dizzy. Often dizziness, vertigo or imbalance is the result of a disorder of the vestibular (inner ear balance) system and can be corrected with vestibular therapy.

“Vestibular therapy is an exercise-based program, designed by a specialized vestibular therapist to improve balance and reduce problems related to dizziness,” says Amy McMillin, MSPT, a physical therapist and neurovestibular clinical specialist at University Hospitals Warrensville Outpatient and Neuro Rehab Center. “This therapy involves specific head, body and eye exercises designed to stimulate and retrain the vestibular system.”

According to McMillin, vestibular problems can affect people at any age, but the chances of getting the disorder increases with age.

“Sometimes a sense of dizziness or a loss of balance can come on suddenly, or it can be progressive, with a series of falls due to unsteadiness,” McMillin says. “Falling can be dangerous as it can lead to hospitalizations, pain and life-threatening orthopedic fractures.”

To determine if patients suffering from balance issues are good candidates for vestibular therapy, they are assessed for:

  • Their balance
  • Their gait (i.e., how they walk)
  • Their neck motion
  • Their visual stability

According to McMillin, the people who might benefit from vestibular rehabilitation include those diagnosed with conditions such as:

  • Benign paroxysmal positional vertigo (BPPV)
  • Brain injury
  • Inner ear infection
  • Imbalance
  • Migraine
  • Stroke
  • Vertigo/dizziness

The most common cause of dizziness is an inner ear problem that can be corrected by a maneuver called the canalith repositioning procedure (CRP). This procedure is used when small crystals of calcium carbonate – called otoconia – become loose in the inner ear due to trauma, infection or simple aging. A person experiences dizziness and vertigo when simple head movements shift the crystals and stimulate the sensitive nerve hairs in the inner ear and send false signals to the brain. CRP moves the displaced crystals so they stop sending these debilitating signals to the brain.

“Think of the inner ear as a labyrinth,” says McMillin. “In a CRP treatment, we move the head in a particular pattern so the otoconia are placed into a location where they no longer cause vertigo. Usually patients only require one or two treatments to alleviate their symptoms.”

Taking care of vestibular problems is a team approach at UH, says McMillin.

“Our physical therapy department works closely with the UH ear, nose and throat group and UH neurologists, ensuring patients get the right practitioner and treatment for vertigo or dizziness,” she says. “Sometimes the correct treatment might be medication or it could be vestibular therapy – and our team can figure that out.”

The good news, she says, is people don't have to suffer from vestibular problems in silence.

“I see about 100 patients a month for vertigo and concussion-related dizziness and 90 percent of my patients see improvement,” she says.

People can have vestibular therapy at any age. That’s why McMillin encourages seniors over 65 to see a vestibular therapist if their balance issues cause them to have trouble walking, or if they have a fear of falling or can't get out of a chair without using their arms.

“There is no age limit when it comes to relief, especially if there is an easy treatment available that can help you prevent a hip fracture or other fatal fall,” she says.

Amy McMillin, MSPT, is a physical therapist and neurovestibular clinical specialist at University Hospitals Warrensville Outpatient and Neuro Rehab Center. You can request an appointment with McMillin or any other healthcare provider online.

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