Round And Round: Poor Balance (Vertigo) And How To Treat It

The occasional or recurrent feelings of dizziness after suddenly standing or sitting up and sensations of spinning (vertigo) or moving despite remaining stationary are collectively termed as ‘poor balance’, which can affect people of all ages and often affect daily life activities in those suffering from balance disorders.

Symptoms:

In addition to dizziness and vertigo, other symptoms of imbalance include:

• Falling or feeling as if you are going to fall
• Elevated blood pressure and heart rate
• Staggering when trying to walk
• Depression, fear, or anxiety
• Difficulty concentrating
• Nausea and vomiting
• Mental confusion
• Blurred vision
• Diarrhea
• Fatigue

Causes:

In some cases, the brain gets confused and induces the feeling of being off balance, resulting in dizziness and other key symptoms of imbalance, while other people might not realize when they are falling due to a lack of sensory information. Other causative factors of balance issues include:

• Strenuous exercise and pressure changes
• Inner ear infections or problems
• Certain neurological disorders
• Arthritis and Age (over 65)
• High or low blood pressure
• Poor blood circulation
• Certain medications
• Head injury
• Sea Travel
• Migraine

Some Balance Disorders:

Certain diseases and medical conditions can also contribute to poor balance:

1- Benign paroxysmal positional vertigo (BPPV):

Dislodging of calcium crystals, that aid in balance control, from their normal position to another point in the inner ear due to the  rapid changing of head positions can induce a brief, intense episode of vertigo, particularly when bending downwards, tilting your head to look up or over your shoulder, reaching up for something over head-level, or even rolling over in bed. The condition often results from a head injury or advancing age.

2- Meniere’s Disease:

Usually developing between the ages of 20-60, this rare disease is the result of fluid volume changes in the inner ear, and is characterized by recurring episodes of vertigo, tinnitus (ringing in the ears), and even hearing loss. However, the exact cause is yet unknown.

3- Perilymph Fistula:

Usually occurring after a head injury, extreme air pressure changes and exercise, or as a result of ear surgery or chronic ear infections, the condition often causes increasing unsteadiness, dizziness, and nausea due to a leakage of inner ear fluid into the middle ear.

4- Mal de Debarquement Syndrome (MDDS):

Sufferers of MDDS can experience feelings of continuous rocking, swaying, or bobbing after prolonged running on a treadmill, or sea travel; which typically stop after a few hours, or days after reaching land in case of sea travel. However, in some cases, symptoms might last for months or years.

5- Acoustic Neuroma:

In rare cases, a benign tumor slowly develops over nerves responsible for hearing and balance, resulting in dizziness or loss of balance. Other symptoms of an acoustic neuroma include hearing loss and tinnitus.

6- Persistent Postural-Perceptual Dizziness:

A common accompaniment to vertigo, this disorder is characterized by unsteadiness or a sensation of something moving inside the head, which often is worsened by reading, watching moving objects, or being in visually complex environments, like shopping malls or amusement parks.

Treatment:

Treatment of balance issues depends upon the causative factors, and can be done through a variety of methods:

1- Medication:

For cases of imbalance caused by external factors such as bacterial ear infections or nausea, a simple adjustment to pre-prescribed antibiotics, or anti-nausea medications might be enough. For inner ear inflammation, corticosteroids may be prescribed, while anti-vertigo medication may relieve vertigo symptoms, although extreme drowsiness is a notable side-effect.

2- Vertigo:

Along with medication, doctors may suggest specific balance retraining exercises, aka vestibular rehabilitation, some of which require professional assistance, while others can be performed at home, like the ‘Epley Maneuver’, which involves quick movements of sitting up, lying on your back, turning your head to one side, and sitting back up after 2 minutes, for symptom reduction or elimination.

3- Meniere’s:

Dietary and lifestyle changes might be recommended for people with Meniere’s Disease, such as reducing sodium and caffeine intake and quitting smoking for smokers. Extreme cases might require operating on the vestibular system, i.e. inner ear to correct the imbalance.

4- Unknown Or Incurable Causes:

Most balance issues can be treated, or even cured by addressing the cause. However, for improper balance that results from unidentified or incurable causes (aging and other chronic conditions), symptom management through exercise and preventative measures are the only option.

They include avoiding walking in the dark, wearing low-heeled or specialized walking shoes, or structural modifications at home and in the workplace, such as adding handrails, to avoid injuries (broken bones, joint displacement, etc.) in case of symptom onset. If you regularly experience trouble walking due to sudden episodes of dizziness, contact your doctor to determine the exact cause.

At oladoc, you can find an ENT specialist in Lahore, Multan, Islamabad and get a confirmed appointment. Moreover, you can also get an appointment by calling our helpline: 042-3890-0939.