Every one of us has experienced some sort of sensation in our lifetime that we would label as dizziness, light-headedness or a feeling of being off balance. But what really is dizziness? Is dizziness and vertigo the same thing? Why does it matter? How can we treat it?
Did you know?
- Dizziness and balance problems account for 5-10% of all doctor’s visits and is the #1 reason for physician visits by people over the age of 65
- Dizziness and balance problems affect approximately 50% of all adults at some time
- 1 in 5 persons older than 60 years of age have current dizziness that has led to significant disability, medical consultation or the use of medication
What is Dizziness?
The term dizziness is used to describe a variety of sensations which include: feeling unsteady, light-headedness, feeling like you are on-board a ship, floating or swimming inside your head etc. It is important that you clearly describe to your practitioner what you are feeling because this will help guide diagnosis and treatment.
Here are some examples of common complaints:
“I feel light-headed when sitting up from a lying position.”
This is usually a sign of decreased blood flow to the brain due to a sudden change in blood pressure. Treatment for this condition usually involves changing diet and lifestyle, and taking medication as necessary.
“I feel off balance and unsteady when standing or walking.”
This can be due to a variety of reasons which include: dysfunction of the inner ear or vision (or problems with integration of both), instability or weakness of certain joints of the lower extremity or core, dysfunction of the nerves that supply your lower extremity, fear of falling etc. A well rounded program that includes balance exercises, vestibular/visual rehabilitation and stability and strengthening exercises will be of benefit for those complaining of this sensation.
“I experience motion sickness very easily.”
This often indicates a mismatch between the feedback you are receiving from your eyes and your inner ear. Exercises that integrate these systems will be helpful.
What is Vertigo?
Vertigo is defined as the illusion of movement of self or environment – this can present itself in many ways (not just horizontally as a spinning type of motion). Vertigo is due to a miscommunication from the inner ear to the brain.
Common causes of vertigo include:
- Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. It due to an over-activation of one or more of the structures within the peripheral vestibular system
- Vestibular Neuritis/Labyrinthitis – is the second most common cause of vertigo. In most cases the cause is unknown, but there is evidence to support a viral infection
- Meniere’s Disease/Endolymphatic Hydrops – build up of fluid causing fluctuations in pressure within the inner ear fluid
- Migraine Associated Vertigo – episodic attacks of vertigo without any dysfunction found within the inner ear itself (therefore it may be more of an issue at the central/brain level). Other symptoms include light sensitivity, nausea and a headache. However, you do not require a headache to experience Migraine Associated Vertigo.
- Head Trauma (Labyrinthine Concussion) – head trauma causing injury to the nerve of the vestibular system
- Stroke – affecting specific arteries that nourish the vestibular system
Treatment for the above disorders may include any or all of the following: vestibular rehabilitation (by a physiotherapist trained in this speciality), neck treatment, lifestyle changes, diet changes and medication.
One of the difficulties in managing dizzy patients is that the term dizziness is used to describe a variety of sensations. When talking to your practitioner be sure to describe in detail the sensation you are experiencing so that they can provide you with the correct treatment or referral for your problem. Dizziness is not normal, or something you should have to put up with. Give us a call today to book in with a physiotherapist trained in vestibular rehabilitation!
Written by: Karen Boyle, Registered Physiotherapist