Should You Try Vestibular Rehabilitation Therapy for Your Dizziness or Vertigo?

Feelings of dizziness, vertigo, and loss of balance are more common than most people realize; 42% of the United States population (ninety million people) experience this at least once during their lifetime, and for many the situation becomes chronic. In the elderly, dizziness is the most common reason that people over seventy five visit a doctor, and for people over sixty five, falls resulting from a loss of balance are the number one cause of serious injury and death.

Approximately three-fourths of these cases of loss of balance and dizziness are caused by peripheral vestibular disorders that affect the inner and middle ear, such as labyrinthitis, perilymphatic fistula, vestibular neuritis, acoustic neuroma, benign paroxysmal positional vertigo (BPPV) and Ménière’s disease. These disorders cause abnormalities in the delicate areas of the inner ear that disrupt our ability to maintain and control our sense of balance. Although most cases of chronic vertigo and dizziness occur in adults, the condition can affect children suffering from it even more, because they are so active that a lack of balance can prevent them from engaging in sports or other activities.

These conditions can be treated with drugs and surgery, but there is another treatment methodology that uses physical therapy to stimulate and retrain the vestibular system and provide relief – Vestibular Rehabilitation Therapy (VRT). Vestibular Rehabilitation Therapy exercises are prescribed individually for each patient’s specific symptoms and often involve the use of eye exercises, head movements and gait training designed to improve patients’ gaze and stability. VRT cites its goals as seeking to improve balance, decrease the experience of dizziness, improve patients’ stability when moving or walking, improve coordination, minimize falls, and reduce anxiety.

For many people suffering from bilateral or unilateral vestibular loss and the conditions described above, Vestibular Rehabilitation Therapy has often been shown to be effective in reducing their symptoms. Several studies have confirmed VRT’s effectiveness in patients who did not respond to other treatment methodologies. On the other hand, VRT is not as likely to be beneficial if the underlying cause of vertigo or dizziness is due to transient ischemic attacks (TIA), anxiety or depression, reactions to medications, migraine headaches or low blood pressure.

Because the specific exercises in a regimen of VRT vary according to the patient’s symptoms and conditions, it is not easy to give an overview of them. But most of the exercises involve therapist-led movements of the head and body to help your brain and body retrain themselves to compensate for the erroneous information they are receiving from their inner ear, and thus regain control over their balance and equilibrium. Consult a balance specialist if you have experienced vertigo or dizziness for long periods of time, and if an inner ear cause of the problem is indicated, ask for more information about Vestibular Rehabilitation Therapy. You may also want to contact the Vestibular Disorders Association and take advantage of many of their short publications and resource materials.

Tips for Cleaning Your Own Ears and Dissolving Ear Wax the Right Way

Having trouble hearing? Probably the most common cause of short-term hearing loss is an accumulation of ear wax within the ear canal. If you’re reasonably certain that ear wax is the resource for your short-term hearing loss, you most likely want to clean your ears. The question is how to do this safely, and without causing damage to the delicate tissues of your ear or your ability to hear.

It is best to get started with a few reminders on what not to do when cleaning your ears. Never stick any physical objects in your ear. Whether it’s a cotton swab or other tool, you’re more likely to make the problem worse by further compressing the ear wax if you go poking around in your ear. One more thing you should never do is attempt to use any product that shoots water under pressure directly into your ears; to do this risks rupturing your eardrums. Last but not least, if you know that you have a ruptured eardrum, leave cleaning your ears to a hearing specialist. The same holds true if you think you have an ear infection. Indications of ear infections include ear pain, fever, fluid draining from the ears and vomiting or diarrhea.

To clean your own ears safely and gently in your own home, all you need is a syringe or bulb, available from any drug store, and a rinse solution. You can buy a carbamide peroxide solution at the local drugstore, or make your own solution by combining equal measures of 3-4%, mineral oil and glycerin.

To make use of the carbamide peroxide solution, carefully squeeze the solution into the ear with the bulb or syringe. It works best to lay on your side and have a towel readily available to catch drips. Try to avoid touching the ear with the syringe or bulb if you can. Keep the solution in each ear for a few minutes allowing it time to work on dissolving the wax.

After this rinse solution has softened and loosened the ear wax, flush your ears with lukewarm water, and then dry your ears thoroughly with a towel, being careful not to stick it into the ear canal. You can repeat this procedure twice daily for 2-3 days if your ears still feel obstructed. If the situation continues, speak with an audiologist or hearing specialist for assistance.

Treatment Protocols for People with Central Auditory Processing Disorder/CAPD

There are many good reasons why Central Auditory Processing Disorder, or CAPD, is hard to diagnose accurately. The problem is not because the children cannot hear words and phrases being spoken to them, but because their brains have an inability to interpret the words and grasp their meaning, which implies that conventional hearing tests do not always identify CAPD. One more reason it is difficult to diagnose is because kids often acquire complex coping behaviors. These children can be experts at using expressions or reading lips to hide their problem.

These particular characteristics of CAPD also make treatment of the disorder tricky, because any individual wanting to enhance the child’s speech comprehension must constantly be aware of them and look for ways to work around them. Unfortunately there is no definitive cure or therapy for CAPD that works consistently well across all kids. Each therapy plan is highly individualized and crafted based on the patients’ limitations. With that being said, there are a variety of treatment protocols that may greatly enhance the developmental abilities of children with Central Auditory Processing Disorder.

CAPD therapy falls into 3 broad categories: direct treatment, environmental change and compensatory strategies.

  • Direct Treatment – Direct treatment refers to the use of computer-assisted learning and 1-on-1 sessions to make the most of the brain’s natural plasticity, its capacity to transform itself, and establish new ways of processing and thinking. These kinds of techniques include the use of the “Fast ForWord” educational software from Scientific Education or Hasbro’s “Simon” game to improve kids’ capacity to discriminate, order, and process the sounds they hear. Some therapists use dichotic training to cultivate the childrens’ ability to hear multiple sounds in different ears and process them the right way, while others use the “Earobics” program by Houghton Mifflin Harcourt to improve phonological awareness.
  • Environmental Change – In the category of environmental change one strategy is lowering the quantity of ambient noise via soundproofing and putting in acoustic tiles, wall hangings or curtains because background noise is proven to make it more difficult for an individual with CAPD to comprehend speech. Increasing the volume of selective voices in the classroom is also helpful; the instructor wears a microphone and the CAPD pupil wears a tiny receiver that enhances the instructor’s voice to make it more distinguishable from other sounds or speakers. One more environmental modification is better lighting. A well lit face is a lot easier for a person with Central Auditory Processing Disorder to “read” for cues.
  • Compensatory Strategies – Approaches that focus on helping the CAPD learners to improve their attention, memory, language and problem-solving skills are commonly called compensatory strategies. These strategies give pupils enhanced coping skills and techniques that enable them to succeed at learning, and also make them learn to take responsibility for their own academic progress. Techniques and strategies of this type consist of drills in solving word problems and active listening.

The overall message is that treatments are available if your child is diagnosed with CAPD, but remember that step one is properly diagnosing the condition, and doing this as early as possible. Keep in mind that our skilled hearing expertshearing experts are here to assist you in any way possible and to point you to other trusted area experts for the best CAPD diagnostic and therapy choices.

An Overview of Ruptured Eardrums: Prevention, Symptoms and Treatment

Eardrums are important, playing two vitally important roles in hearing. First they vibrate in response to sound waves. Second they create a barrier that safeguards the inner ear from infection. If your eardrum is fully intact, your inner ear is a safe and sterile environment; but once it has been punctured or torn, microbes can enter and cause a serious infection generally known as otitis media.

The terms ruptured eardrum and perforated eardrum mean the same thing. They both reference a condition whose technical name is a tympanic membrane perforation where there is a puncture or tear in the very thin membrane we know as the ear drum. There a variety of ways that an eardrum may become perforated, the most common of which is an ear infection where the resulting buildup of fluid pushes against the eardrum until it tears. Some people perforate their own eardrums by inserting foreign objects into the ears, for example the use of cotton swabs to remove ear wax. Barotrauma is yet another potential cause of a punctured ear drum. When the pressure inside the ear is very different than the pressure outside the ear – lower or higher – the eardrum may not be able to withstand the pressure difference and ruptures. Flying and scuba diving are a couple of occasions where this is prone to occur. Loud noises and explosions can also cause perforated ear drums. This phenomenon is known as acoustic trauma.

Indications of perforated eardrums include:

  • Pain in the ear
  • Loss of hearing in the affected ear
  • Vertigo or dizziness
  • Fluid draining from the ear

If you encounter any of these signs and symptoms, see a hearing health provider, because if the eardrum is ruptured, immediate and correct treatment is important to prevent hearing damage and infection. Untreated, a ruptured eardrum can result in middle and inner ear infections, middle ear cysts (cholesteatoma), and permanent hearing loss.

At your appointment the specialist will view the eardrum with an instrument called an otoscope. Because of its internal light, the otoscope gives the doctor a clear look at the eardrum. Perforated eardrums generally heal on their own in 8 to 12 weeks. During this time period, your healthcare provider will most likely advise you to avoid diving and swimming and to refrain from blowing your nose as much as possible. It’s also advisable to avoid any non-essential medications. If the puncture or tear is close to the edge of the eardrum, the health care provider can help the healing process by placing a temporary dam or patch to help reduce the risk of infection, or even propose surgery.

Any remaining pain or discomfort can be handled using over-the-counter (OTC) pain medications such as acetaminophen or ibuprofen. Not every perforated eardrum can be prevented, but there are things you can do to reduce your risk. Always get immediate treatment for any ear infections and never put any foreign objects into your ear (even for cleaning).

What Is It and How Is It Treated

Vertigo – a perception of movement in which the individual or the individual’s surroundings seem to spin and move – is, generally an unpleasant event. The feelings of vertigo occasionally include dizziness, spinning or falling. Any time vertigo impacts balance, it can lead to falls and accidental injuries – especially in older adults. More serious cases may also trigger nausea, vomiting, migraine headaches, fainting and visual irregularities called nystagmus.

There can be many causes for vertigo, but one kind of it – benign paroxysmal positional vertigo, or BPPV – relates to hearing. BPPV occurs from calcium crystals that form naturally known as otoliths or otoconia, which in most people cause no problems. In benign paroxysmal positional vertigo, the crystals travel from their normal locations into the semicircular canals of the inner ear. When this occurs, and the individual with BPPV changes the orientation of their head relative to gravity, these crystals move around, resulting in an abnormal displacement of endolymph fluid, which leads to vertigo.

Everyday actions such as tilting your head, looking up and down or rolling over in bed can bring about the benign paroxysmal positional vertigo. The vertigo sensation comes on very suddenly and has a short duration. These symptoms can be made worse by lack of sleep, anxiety, or changes in barometric pressure, such as occur before rain or snow. The condition can manifest itself at any age, but it most commonly appears in people over age 60. The initial trigger for the benign paroxysmal positional vertigo is typically difficult to determine. A sudden blow to the head (for example in an automobile accident) is among the more well-known causes.

Benign paroxysmal positional vertigo is different from other forms of dizziness or vertigo because the episodes are transient (typically under a minute), and because it is always triggered by head movements. Vertigo specialists may diagnose it by having the patient rest on their back and then tilt their head to one side or over the edge of the examination table. Additional tests which can be used to diagnose benign paroxysmal positional vertigo include videonystagmography or electronystagmography, which test for abnormal eye movement, and magnetic resonance imaging (MRI), whose primary role is to eliminate other potential causes, such as brain abnormalities or tumors.

There is no full cure for benign paroxysmal positional vertigo, but it can be effectively treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use bodily movements to shift the crystals to a position in which they no longer cause trouble.Surgical treatment is an option in the exceptional cases in which these treatments are ineffective. See your health care provider if you have felt symptoms which sound as if they could be related to BPPV, especially if they persist for more than a week.

Swimmer’s Ear Prevention and Treatment

Swimmer’s ear, officially known as acute external otitis, is an infection of the outer ear canal (the area outside your eardrum). It was given the name “swimmer’s ear” because it is frequently a result of water remaining in the outer ear after swimming, which creates a damp environment which promotes the growth of bacteria. Swimmer’s ear can also be triggered by putting your fingers, cotton swabs, or other foreign objects into the ears, because they can scuff or injure the delicate ear canal lining, leaving it open to an opportunistic infection. Luckily for us swimmer’s ear is easily treated. If untreated, swimmer’s ear can cause severe complications so it is important to identify the signs and symptoms of the infection.

Swimmer’s ear develops due to the ear’s natural protection mechanisms (which include the glands that secrete ear wax or cerumen) becoming overloaded. Moisture in the ears, sensitivity reactions, and scrapes to the ear canal lining can all encourage bacterial growth, and cause infection. Specific activities will increase your likelihood of getting swimmer’s ear. Swimming (obviously), use of inside-the-ear devices (including hearing aids or ear buds), overly aggressive cleaning of the ear canal and allergies all increase your risk of infection.

Itching inside the ear, slight discomfort or pain which is worsened by pulling on the ear, redness and an odorless, clear liquid draining from the ear are typical signs of a mild swimmer’s ear infection. Severe itching, heightened pain and discharge of pus indicate a moderate case of swimmer’s ear. Extreme symptoms include severe pain (occasionally extending to other regions of the face, neck and head), fever, redness or swelling of the outer ear or lymph nodes, and actual blockage of the ear canal. If left untreated, complications from swimmer’s ear can be very serious. Complications might include short-term hearing loss, long-term ear infections, deep tissue infections which may spread to other parts of the body, and cartilage or bone loss. Therefore if you experience even the milder indicators of swimmer’s ear, it’s a wise decision to visit your doctor immediately.

Doctors usually diagnose swimmer’s ear after a visual exam with a lighted instrument called an otoscope. They will also check at the same time to see if there is any damage to the eardrum itself. Physicians usually treat swimmer’s ear by first cleaning the ears thoroughly, and then by prescribing eardrops to fight the infection. If the infection is serious, your physician may also prescribe oral antibiotics to help combat it.

To avoid swimmer’s ear, dry your ears completely after showering or swimming, avoid swimming in untreated water resources, and do not insert foreign objects into your ears to clean them.

Feeling Out of Balance? Your Hearing May Be the Culprit

If you have been struggling with your balance, your hearing may be the culprit. Many people are surprised to learn that balance and hearing are directly related, and with the help of hearing devices, you just might be able to regain your balance.

The ear has an organ called the labyrinth in the inner ear. This has a direct affect on the balance system, also known as the vestibular system. When it is not functioning properly, the other systems of the body that help it maintain its position, including the eyes, bones and joints, will not function properly. In this case, you might feel dizzy or feel as though things around you are moving.

When your balance is impaired, you may have a balance disorder. Symptoms of a balance disorder may include:

• The feeling of falling
• Vertigo
• Lightheadedness
• Blurred vision
• Feelings of disorientation

Notice, none of these symptoms are related to hearing, yet the ears have a vital role to play in balance disorders.

If the balance disorder is caused by the ears, a hearing specialist may be able to help. Balance retraining exercises, known as vestibular rehabilitation, can help restore balance for some people. Others may find that changes to their diet are the best way to control their balance disorder. Sometimes, in extreme cases, surgery is necessary to repair the ear.

If you are struggling with balance and feelings of dizziness, the first place you may want to look for help is with the audiologist at your local hearing aid provider. With their advice and the benefit of a hearing test, you can get pointed in the right direction to get treatment for your disorder, so you can function well once again.

Factors Affecting Balance in the Elderly Population

There are a number of factors that contribute to the amount of balance an individual has when they are standing or walking. Good balance needs a sensory input that is reliable from the person’s vision, inner ear balance and sense of movement and position for the legs and feet. Elderly individuals are more susceptible to numerous diseases affecting these systems, such as glaucoma, cataracts, macular degeneration and diabetic retinopathy, which all cause problems with vision. Senses in your legs and feet are affected by diabetic peripheral neuropathy, as well as a slow decrease in the vestibular system.

Balance also depends upon having joint mobility and exceptional muscle strength. If you are leading a sedentary lifestyle, having arthritis, or bone and muscle disease, it will play a key part in mobility and strength of your muscles. Since balance is a rather complex function, there is not necessarily one specific cause attributed to an elderly person falling. An older individual with a history of imbalance or chronic bouts of dizziness is considered two to three times more prone to falling when compared to someone who does not have those problems.

There are numerous causes that can contribute to a feeling of dizziness and lightheadedness, as well as a mild sense of vertigo. It could be anything from a disorder of the inner ear, issues with the central nervous system, problems with the cardiac system, low blood sugar, hyper-ventilation, infection, side effects from medications or a bad interaction with medication and an inadequate or imbalanced diet. A thorough evaluation is often required in an attempt to be able to determine all of the potential causes and end up with a proper diagnosis.

When there is more than one problem present, the task can become that much more complicated. In these cases, the amount of trouble within one system may not be as severe, but the effects might combine with enough issues to cause a serious issue with your balance. An elderly person suffering from arthritis in their ankles and a mild form of degeneration in their vestibular functions may have ample balance until they go into an operation for removing their cataracts. The change in their vision throughout the healing process and the necessary adjustment to their new contacts or glasses may be sufficient enough to cause an imbalance that makes them fall.

Dizziness and Balance Disorders

Dizziness and balance disorders are common and may be dangerous! If you are experiencing issues with dizziness, lightheadedness, or are just feeling off-balanced, you should contact an audiologist or otolaryngologist (ENT) as soon as possible! Inner ear dysfunction may be to blame.

The center for the body’s balance is controlled in combination by the brain, eyes, and vestibular system of the inner ear. Having issues with dizziness or balance typically means another problem is present. A thorough medical and balance evaluation should be completed to help determine your underlying issue. While some causes may be treated with pharmaceutical, medical, or surgical intervention, others may require more intensive balance rehabilitation.

Defining dizziness is involved. Dizziness symptoms include everything from feeling a little lightheaded to off-balanced, feeling unsteady or as if you were falling. Dizziness is common, and may make you feel nauseous, faint, anxious, disoriented, or as if you were moving when standing still. Your vision may blur, you may feel a spinning sensation, or objects may appear to spin around you (vertigo). Some people may notice that difficulties worsen when changing head or body position. Make sure to thoroughly describe your dizziness to your audiologist or physician.

Dizziness and balance issues may be associated with something as simple as the presence of a foreign object in the outer ear canal, viral/bacterial infections, changes in blood pressure, or migraines. More invasive disorders can also be connected to dizziness and imbalance, including: vision disorders, vascular disorders, fistulas, Meniere’s disease, multiple sclerosis, and tumors (benign and malignant). Certain types of medications, considered ototoxic or vestibulotoxic, can be detrimental to the vestibular system causing imbalance or dizziness.

Vestibular evaluations (balance testing) may be recommended for some patients. These tests should aid in determining the cause, location, and symptoms. Most testing requires specialized devices, so a trip to the clinic may be necessary. In many cases you will be asked to follow a series of lights in various patterns with your eye movement.

You will probably also move through a variety of positions from lying down to sitting up while the evaluation is being completed. Let your audiologist or physician know of any back and neck difficulties prior to evaluation. You will probably feel dizzy during the assessment.

Here are Some Tips for the Day of Your Assessment.

  • Do not eat heavily. If the assessment is early enough in the day and no other medical conditions will be affected, do not eat prior to testing. Bring crackers or another small snack in case the wait time to be seen runs long.
  • Ask if electronystagmography (ENG) testing is going to be completed. If yes, do not wear make-up or lotions on the head, neck or face. A good connection to your skin needs to be maintained throughout the test. Make-up and lotions may affect the contact between the testing pads and your skin.
  • Tell your audiologist about any major illnesses or back and neck difficulties you have. Other conditions may affect the way you are evaluated.
  • If you feel sick during the assessment, let your provider know. They will assist you in any way they can.
  • Have someone come with you. As your balance/dizziness may be affected, you may not feel up to driving or navigating your way around town following evaluation of dizziness and balance disorders.

Social Widgets powered by