Dizziness is one of the most common reasons that people seek medical attention. It is such a common symptom because so many things can cause you to feel dizzy.
The term dizziness itself is ambiguous. Dizzy means different things to different people.
Common descriptions of dizziness include; light-headedness, imbalance, spinning, motion sensitivity and often an accompanying sense of nausea. Inner ear problems can cause these types of symptoms. However, it is important to seek medical attention if you have a sudden onset of severe dizziness to ensure that there aren’t any serious medical concerns causing your symptoms.
The inner ear is a structure located inside the head just behind the eardrum and middle ear. It has two main functions: hearing, and balance. As the two functions are closely related there can frequently be both hearing and balance issues present when there is a problem with this structure. Although, this does not have to be the case and these symptoms can occur independently of each other.
There are two very common issues that can affect the inner ear and cause dizziness. The first is called benign paroxysmal positional vertigo (BPPV). This is very common and tends to happen more frequently as we age. It is a condition where small calcium carbonate crystals that are supposed to be in one chamber of the inner ear get loose and end up in the semi-circular canals. When they end up in this part of the inner ear, they cause a strong sense of spinning with head movement. Usually, keeping the head level and moving slowly helps to decrease the spinning. This is the most common cause of the sensation of true vertigo.
Treatment for this condition includes identifying which canal the crystals are trapped in by doing various movement tests, then performing a maneuver to get them back into the chamber they belong in.
The most common maneuver for this is called the Epley maneuver, however, there are lots of different maneuvers that can be done depending on where the crystals have ended up. Usually, one to three treatments are sufficient to treat this condition but sometimes it can be a bit more stubborn.
The second most common vestibular condition is a vestibular hypofunction or loss. This can occur in one or both inner ears. While motion makes the symptoms worse, with this condition there is also a constant level of dizziness present even when not moving. Hearing changes or feelings of fullness in the ear can also be present.
The damage to the vestibular system can happen as the result of a viral infection or other injury. Sometimes there is a known incident that triggers the dizziness, but often the symptoms come on suddenly “out of the blue”. Symptoms often start first thing in the morning and can initially be very intense and accompanied by nausea and vomiting. Many people are in bed for a few days when this first hits. After the initial acute stage some people’s symptoms completely resolve but for others, there is a lingering sense of being off balance and sensitivity to movement.
Another common symptom is problems with activities such as reading, looking at screens, scrolling or visually busy environments. Our tracking reflex connects the inner ear with our eyes and allows use to keep objects in motion in focus. This reflex can be affected by the injury to the vestibular system.
If the virus has left behind some damage to the vestibular system this can take a while to improve. Vestibular rehabilitation can help with the process of “compensation” whereby your brain learns to cover these symptoms. Most people can get back to their normal lives with the help of their physiotherapist.
If you or someone you know is suffering from a vestibular issue there are lots of ways a physiotherapist trained in vestibular rehab can help. To find a therapist in your area and to research further into these conditions you can go to www.vestibular.org.
I am also happy to help you out and have appointments open in the new year.
