Balance
Vertigo and balance
Spinning or unsteadiness that a vestibular assessment can often explain and treat.
Photograph: RAY LEI, Pexels
In one paragraph
Some spinning and unsteadiness comes from the inner ear (BPPV), some from the neck, and some from a balance system that has lost practice. Vestibular assessment can tell them apart; BPPV in particular often responds to a repositioning manoeuvre and to balance retraining.
What you may notice
- 01
Short spins when you roll over in bed or look up.
- 02
Unsteadiness in crowds, in the dark or on uneven ground.
- 03
Dizziness that comes with a stiff neck or a headache.
- 04
A fear of falling that has made you move less.
The first visit
What is looked at
Positional tests for the inner ear, eye-movement and balance tests, and a neck examination; the pattern points to the source.
Treatment
What is done
Repositioning manoeuvres for BPPV, exercises that retrain the balance system, treatment of the neck where it contributes, and a walking and strength programme where confidence has gone.
See a doctor first if
Dizziness with sudden severe headache, double vision, slurred speech, weakness or numbness, or a new hearing loss needs emergency medical care.
The range in question
The textbook full range for a healthy joint, the figure the assessment measures you against.
Questions
What is BPPV?
Benign paroxysmal positional vertigo: loose crystals in the inner ear that trigger brief spins with certain head positions. It is common and usually treatable with a manoeuvre.
Is the treatment safe?
The manoeuvres and exercises are gentle; you may feel dizzy for a moment during them, which is expected and explained beforehand.
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