Have you ever been dizzy?

According to the National Institute of Deafness and other Communication Disorders: .

• At least half (50%) of the overall United States population is affected by a balance or vestibular disorder sometime during their lives.*

Mrs. Jones says: “The alarm had just gone off -- it was 5 AM and my day was about to start (breakfast for the four of us, the two kids off to school and my husband and I off to our jobs). As I sat up, the entire room began to spin mercilessly. The nausea was overwhelming and I was unable to walk. I had to crawl to the bathroom and didn't quite make it in time" -- what a mess. Not a good way to start one's day!

Mr. Smith says: "Every time I roll over toward the right in bed, I get dizzy! Toward the left is no problem. If I lay backwards in the dentist chair or while having my hair done, I get the same dizziness -- spinning. I avoid certain positions -- turning my head from side to side -- looking upwards -- bending over -- because of this very distressing spinning sensation". It occurs every day and has for months.

John says: "I have this feeling of being off-balance which comes and goes. It is worse when I am walking on uneven terrain like cobblestones or on the uneven turf. It is also bothersome negotiating stairs (especially going down) as well as going up and down the aisles of the supermarket. If I trip I don't seem to catch myself like I used to -- I tend to fall more easily."

These scenarios represent some of the more common presentations of balance problems experienced by so many -- the consensus being that there is almost nothing worse than being "off-balance". Typically, we don't appreciate -- or even barely think about -- our finely tuned, highly accurate systems which keep us in balance -- until something goes wrong.

• Every year, one-third to one-half of the population age 65 and over experience falls.**
  
  
• Falls are a leading cause of fatal and nonfatal injuries in older adults. **

Most of us feel that any unsteadiness, insecurity of our gait, or a feeling of being "off-balance" are simply signs of getting older -- or being out of shape. On this basis, and depending upon the severity of the symptoms, many of us try to overlook (or live with) the symptoms. Those who seek medical attention fearing an underlying sinister cause, often have multiple tests (examinations, blood tests, Cat Scans, MRIs, ENGs, etc.) which may all be normal -- leaving one without a specific diagnosis or beneficial treatment.

Interestingly, balance problems generally stem from two sources -- a "site of lesion" indicating something anatomically wrong (Menieres disease, multiple sclerosis, a tumor, etc.) which would generally be indicated by a positive finding on one of the above noted tests OR much more frequently a "functional problem" resulting in some degree of impairment (dizziness, off-balance or lightheadedness) with the above noted tests being normal. It is this group that can benefit from new technology (in-office testing) which identifies the specific weakness of the balance system and provides the basis for treatment improving or resolving the impairment.

Mrs. Jones, above, was suffering from a viral involvement of her balance system (viral neuronitis) which so often occurs following a routine upper respiratory infection or flu. It can either go away by itself in time (requiring no treatment) or remain intermittently symptomatic (requiring testing and a short course of vestibular therapy).

Mr. Smith was experiencing one of the most common causes of dizziness -- Benign Paroxysmal Positional Vertigo (BPPV) often referred to as positional dizziness or positional vertigo. Often this can be treated definitively in the first office visit. If symptoms persist, functional balance testing identifies a balance weakness which can be treated.

John’s problem is often seen as one gets less mobile or active -- often secondary to a less active lifestyle (by one's choice, because of an illness, or as one gets older). His symptoms are related to a weakness of the balance (vestibular) system much as one's cardiovascular system or musculoskeletal system tend to weaken by decreased use or increasing age. His treatment would be vestibular therapy, which is nothing more than caIisthenics for the balance system -- similar to using exercise machines for a weak muscle.

Problems with one's balance can range from being merely irritating to being totally disabling. With today's technology, the diagnosis and treatment of these problems can often result in eliminating the irritating symptoms and markedly improving or resolving the more disabling ones.

* http://www.onbalance.com/clinical_info/prevalence/vestibular.aspx
** http://www.onbalance.com/clinical_info/prevalence/falling.aspx