Balance Problems

Treatment

In a large percentage of cases, balance problems are caused by the vestibular system or inner ear. Vestibular rehabilitation is an exercise program designed by specially trained therapists to help compensate for a loss or imbalance within the vestibular system. Additional causes of balance problems include medications, poor vision, gait and balance disorders or other medical conditions. A team of specialists recommend the best treatment approach for each patient.

Vestibular Rehabilitation

Vestibular rehabilitation can offer relief of symptoms for persons suffering from an inner ear disorder. Vestibular rehabilitation is an exercise program designed by specially trained therapists to help people compensate for a loss or imbalance within the vestibular system.

The program may include balance activities and/or eye or head movement exercises. The balance activities help people maximize the use of the remaining vestibular function, their sight, and the sensation in their feet to keep their balance. When there is an imbalance in the vestibular system, a person may also experience dizziness because the reflexes that help with eye movement have been changed. The eye exercises help the brain relearn these reflexes. Because each patient's symptoms and needs are different, it is very important to design a program to meet individual needs.

Fall prevention is a very important part of vestibular rehabilitation. Even if testing shows that someone suffering from imbalance does not have a vestibular disorder, he or she may be referred to vestibular rehabilitation for fall prevention. Conditions other than vestibular disorders which may cause imbalance are poor eyesight, poor sensation in the feet or weak leg muscles. A balance aid such as a walking stick may be all that is needed to help people maintain their balance and prevent injuries from falling. Patients may also be referred to an occupational therapist to discuss home safety and assistive devices. The goal is to prevent patients from falling and keep them independent and safe. Read more about fall prevention.

Common Diagnoses Which May Benefit from Vestibular Rehabilitation

• Benign Paroxysmal Positional Vertigo (BPPV)
• Infections of the inner ear
• Labyrinthitis
• Neuronitis
• Post-surgery for acoustic neuroma
• Meniere's disease/endolymphatic hydrops
• Central vertigo resulting from CVA (stroke) or TBI (traumatic brain injury)
• Multiple system involvement
• Patients who have reduced or absent functioning in one or more balance systems
• History of loss of balance or falls

Balance Disorders Which May NOT be Helped by Vestibular Rehabilitation

• Episodic vertigo, such as occurs with Meniere's disease, if the attacks are too close together (less than one month apart)
• Balance problems that are not related to the inner ear; for example certain neurological, cardiovascular or psychiatric problems.

Primary care physicians will refer patients to specialists who can treat conditions that are not remedied by vestibular rehabilitation.