For most of us, feeling dizzy, off balance, or like the world is spinning only happens when we’ve over-indulged in our favorite drink. But for people with vestibular disorders, these symptoms can be a frequent, and often debilitating, occurrence. Dizziness and vertigo are relatively common. In fact, as many as 35% of people over 40 years or older in the U.S. have experienced some form of vestibular dysfunction(1), and in people over 65 years and older, 80% have experienced dizziness(2). Overall, vertigo from a vestibular problem accounts for a third of all dizziness and vertigo symptoms reported to health care professionals(3).
Your vestibular system is composed of three canals and two sacs which are filled with fluid. The fluid shifts when you turn your head or change positions and stimulates hair cell receptors to tell the brain what is happening. The brain uses this information to maintain your balance and help your eyes stay focused. Problems in the vestibular system can be caused by how/when the receptors fire or by problems with the nerves that transmit this message to the brain.
The most common cause of vertigo is benign paroxysmal positional vertigo, or BPPV, accounting for about 50% of dizziness in older people.4 In those with BPPV, particles from the sacs get caught in the canals and cause the hair receptors to fire when they shouldn’t be. This causes vertigo, a sensation that the world is spinning. This vertigo can happen with changes in head position, like lying down in bed, laying on your side, looking up, or getting out of bed. In most cases of BPPV, a physical therapist trained in vestibular rehabilitation can clear these particles from the canal to relieve the feeling of vertigo in one or two sessions.
Other disorders of the vestibular system affect the vestibular structures themselves, vestibular nerves, or areas in the brain that receive input from the vestibular structures. In these cases, a patient can experience dizziness or vertigo with certain movements like turning the head quickly or bending over to put laundry away. Vestibular rehabilitation can help these patients minimize or eradicate these symptoms through specific exercises. These exercises help the patient’s brain to correctly integrate input from the vestibular system, as well as from the eyes and body to decrease dizziness and improve balance.
For most people, dizziness is not something you just have to live with. It is not a normal part of aging. And most importantly, it is something that can be improved! If you or someone you know is experiencing dizziness, vertigo, or problems with balance, I encourage you to consult with your doctor and see if vestibular rehabilitation might help.
Please visit the following link for more helpful information:
1. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009;169(10): 938-944.
2. Ator GA. University of Kansas Department of Otolaryngology Division of Otology Talk: Vertigo – Evaluation and Treatment in the Elderly. http://www2.kumc.edu/otolaryngology/otology/VertEldTalk.htm.
3. Neuhauser HK, Radtke A, von Brevern M et al. Burden of dizziness and vertigo in the community. Arch Intern Med. 2008;168(19):2118–2124.
4. Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ, Hain TC, Herdman S, Morrow MJ, Gronseth GS. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurol. 2008;70:2067–2074.