Balance Problems

What is dizziness?

For some people, dizziness is a feeling of unsteadiness or a spinning sensation. Others may experience extreme balance disorders that affect many aspects of their lives. Dizziness may be a fleeting sensation or the prolonged and intense symptom of a wide range of health problems that can affect a person's independence, ability to work, and quality of life. Experts believe that more than 40 percent of Americans will experience dizziness that is serious enough to go to a doctor. Even dizziness that seems minor, if undiagnosed, may be a signal of underlying disorders.

Balance problems are among the most common reasons that older adults seek help from a doctor. Many people are surprised to learn that the source of their imbalance may be in their inner ears. Balance (or vestibular) problems are reported in about 9 percent of the population who are 65 years of age or older. Fall-related injuries such as breaking (or fracturing) a hip are a leading cause of death and disability in older individuals. Many of these hip fractures are related to balance disorders. Although this fact sheet is about adults, children who complain about or describe balance problems should be seen by a doctor.

Balance disorders may also lead to other problems including fatigue, difficulty walking, or disinterest in everyday and leisure activities. If you or your child, parent, friend, or co-worker has a balance problem--take it seriously. Talk to the doctor about what happens when you feel dizzy or lose your balance. Be as careful as possible to describe your experience of dizziness specifically.

Dizziness has been ranked third (after headache and lower back pain) among complaints heard in a Physician's office. Benign Paroxysmal Positional Vertigo (BPPV) is the #1 form of vertigo that Dr Cunningham has had great success treating.

There are two treatments of BPPV that are usually performed in the doctor's office. Both treatments are very effective, with roughly an 80% cure rate, according to a study by Herdman and others (1993).The maneuvers, named after their inventors, are both intended to move debris or "ear rocks" out of the sensitive part of the ear (posterior canal) to a less sensitive location. Each maneuver takes about 15 minutes to complete. The Semont maneuver (also called the "liberatory" maneuver) involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other. It is a brisk maneuver that is not currently favored in the United States.

The Epley maneuver is also called the particle repositioning, canalith repositioning procedure, and modified liberatory maneuver. It is illustrated in figure 2. Click here for an animation. It involves sequential movement of the head into four positions, staying in each position for roughly 30 seconds. The recurrence rate for BPPV after these maneuvers is about 30 percent at one year, and in some instances a second treatment may be necessary.

We are experts in evaluating and treating this and most other forms of balance disorders. Please call (818) 341-5407 for a no obligation consultation.