Physical Therapy

Our balance system helps us walk, run, and move without falling. Balance is controlled through signals to the brain
from your eyes, the inner ear (vestibular system), and the sensory systems of the body (such as the skin, muscles,
and joints).

What should I do if I have a problem with balance or dizziness?

It is important to see your doctor if you have unexplained dizziness or balance issues. If you have any of the following other symptoms, be sure to seek emergency medical care:

• Chest pains
• Numbness or tingling
• Falling or problems walking
• Weakness in the legs or arms
• Blurred vision
• Slurred speech
• Sudden hearing loss
• Severe neck stiffness
• Head trauma or injury
• High fever

Dizziness and balance difficulties are symptoms of another problem. The first thing you should do is try to find out
the underlying cause. You should have a medical examination with special attention given to checking for problems
that can be associated with balance difficulties. Unfortunately, in many cases, the dizziness and balance
difficulties cannot be treated medically or surgically. In these cases, the balance problem itself may need to be
treated through balance rehabilitation.

What is dizziness?

If you experience light-headedness, a sensation of losing your balance, or a sense of feeling unsteady, you may be one of the millions of Americans who experience dizziness. Dizziness is one of the most common complaints and affects 20% to 30% of the general population. In fact, dizziness is a common reason that adults seek medical attention. When your balance is weakened, you may feel unsteady, woozy, or disoriented. You may have blurred vision or experience a sensation of movement. It may seem that the room is spinning (vertigo). You may not be able to walk without staggering, or you may not even be able to get up. Sometimes nausea, vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, and anxiety accompany the dizziness and balance problems.

Dizziness can be associated with a variety of conditions, including:

• Viral or bacterial infections, including ear infections
• Foreign objects in the ear canal
• Blood pressure changes
• Vascular problems
• A fistula (hole) in the inner ear
• Ménière’s disease
• Medicines or drugs poisonous to the ear or balance system (ototoxic medicines)
• Multiple sclerosis
• Visual disorders
• Tumors, especially of the vestibular portion of the eighth cranial nerve (known as acoustic neuroma)
• Head injury
• Migraine

What is vertigo?

Vertigo is a type of dizziness in which there is a sense of movement or spinning. Changing position, such as sitting up in bed, can make it seem worse. Nausea and vomiting may accompany the vertigo at times.

Balance testing

Balance system assessment is often recommended when a person has:

• Rapid, involuntary eye movement (also known as nystagmus)
• Complaints of vertigo or dizziness

Dizziness and Balance Compliments of

• Balance dysfunction
• Difficulty walking
• Suspected disease of the vestibular system

Tests of the balance system are performed to help determine:

• The cause of the symptoms
• Where in the balance system the problem is occurring
• What changes are happening in the balance function
• How vision, the inner ear, and other sensory systems affect functional balance

Some of the tests of balance can be done in the physician’s office or at the bedside in the hospital. Others require specialized equipment located in the audiology office or clinic.

Balance (or Vestibular) Rehabilitation

Your audiologic (hearing), balance, and medical diagnostic tests help indicate whether you are a candidate
for vestibular (balance) rehabilitation. Vestibular rehabilitation is an individualized balance-retraining exercise program. The retraining teaches compensations that may decrease dizziness, improve balance, and improve general activity levels. Many audiologists provide limited vestibular rehabilitation. However, other clinicians, such as physical therapists are trained to provide more extensive vestibular rehabilitation. Rehabilitation with a clinician who specializes in vestibular rehabilitation may be effective in minimizing or relieving some of the symptoms. This is especially true if the dizziness is caused by head movement, motion sensitivity, or certain positions. Rehabilitation is also excellent for recovery of balance and improving daily functional activities.

When should I see an audiologist?

Audiologists perform audiologic and balance assessment to gather information about your hearing and balance function. Test results help determine the possible causes of dizziness. Results of these assessments, in combination
with medical findings, will provide diagnostic information trained to provide more extensive vestibular rehabilitation. Rehabilitation with a clinician who specializes in vestibular rehabilitation may be effective in minimizing or relieving some of the symptoms. This is especially true if the dizziness is caused by head movement, motion sensitivity, or certain positions. Rehabilitation is also excellent for recovery of balance and improving daily
functional activities.

Sherri Boos, PT, DPT
Yukon Wound Care & Rehabilitation