NEW INSIGHTS

Early treatment after an inner ear problem may help people get better faster. Treatments focus on eye and head exercises plus balance exercises to help decrease dizziness and improve the ability to walk without losing balance. A physical therapist will customize the exercises to your specific problems based on a complete examination.

PRACTICAL ADVICE

For people with inner ear dizziness, your dizziness may get better even without treatment. Generally, the more you move, the better you will feel. Staying active is very important and moving your head, even if it makes you dizzy, is one of the best ways to recover from your inner ear problem. For some people, their dizziness does not get better unless they are given exercises for their dizziness and balance problems. Medicine is not usually needed; however, if your dizziness is very bad, your physical therapist may work with your doctor to try to make your symptoms better with medicine so that you can continue doing the exercises. Based on your diagnosis, your best treatment may include eye and head exercises, walking exercises, balance exercises, and education about your dizziness problem. Exercises are progressed as you improve so that you are less dizzy when you sit still and when you do your daily activities. It is important for you to do your exercises consistently, often 3 times per day for several weeks, to obtain full benefit.

Some people with inner ear problems can have balance problems. It is not uncommon to have difficulty with walking straight when you walk, especially if you move your head. People who have trouble feeling their feet because of a disease (peripheral neuropathy) or an injury may have more trouble with their balance after an inner ear problem. Although it seems like it would be better to sit so that you do not fall, it is actually better to get up and walk. You may need to use an assistive device (cane, hiking poles, or wheeled walker) for your safety if you are at a high risk of falling. Your physical therapist can help you determine what device is the best for you. Walking for exercise will make you less at risk for falling and will keep you strong.

INNER EAR BALANCE TREATMENTS

Evidence suggests that early treatment of inner ear problems is helpful in decreasing dizziness. Not all inner ear problems are the same and so not everyone will do every exercise. Your physical therapist will determine which exercises will help you the most based on your dizziness and/or balance concerns.

For more information about the treatment of inner ear dizziness, contact a physical therapist who specializes in inner ear balance problems. Some vestibular physical therapists are listed on the Vestibular Disorders Association (VEDA) Web site (https://vestibular.org/finding-help-support) and the Academy of Neurologic Physical Therapy (ANPT) Web site (http://www.neuropt.org/special-interest-groups/vestibular-rehabilitation/map-of-).

Figure 1 shows an example of a head and eye exercise to help relieve dizziness. Figure 2 shows an example of a common walking exercise that might be prescribed for imbalance.

Figure 1. If you get dizzy when you turn your head, then you might do exercises that involve keeping your eyes on a moving target while you turn your head back and forth.

Figure 2. If you lose your balance when you turn your head while walking, then you might do exercises that involve walking and turning your head.

clinical practice guideline; exercise therapy; patient perspective; peripheral vestibular hypofunction; vestibular diseases; vestibular rehabilitation