Balance is something we take for granted. Usually, walking over uneven ground, negotiating crowds or supermarket aisles and getting on and off escalators doesn’t make us feel anxious or in anyway concerned about our balance. However, when our balance is affected, seemingly trivial activities can become extremely fatiguing and at times anxiety-provoking.
For us to feel balanced we rely on information from three sources: vision, muscles and joints and the vestibular organs in the inner ears. Receiving accurate information from these sources about how we relate to the surrounding environment makes it possible for us to switch on the muscles that control our eyes, head, neck, trunk and legs so that we stay upright and have clear vision when we are moving. A person can become very disorientated if the sensory input from one of these sources conflict.
There are many reasons why people can suffer from a vestibular disorder. It may occur following a virus, an infection of a heavy knock on the head. In some cases, dizziness can arise when crystals, which form part of the sensory receptors in each ear, are displaced – a condition known as Benign Paroxismal Positional Vertigo or ‘BPPV’. However, it can also occur without any clear cause.
The role of the vestibular organs are to inform the brain which way is up and in what direction and how fast our head is moving. This information is important for us to co-ordinate our head movements with the rest of the body and our head and eyes so that the world remains steady and in focus. People who experience vestibular problems and lack head and eye co-ordination often report feeling unbalanced, disorientated, dizzy, ‘spaced-out’, nauseous, anxious and panicky, and sometime feel as if the world is jumping around. In BPPV, moving the head in a particular direction e.g bending forward, looking up or quickly turning the head can provoke severe dizziness and nausea.
Often people who experience these types of symptoms try to avoid moving their head or doing any activities that provoke their symptoms. However, this often leads to social isolation and depression and does not improve balance in the long term.
So how can neurological physiotherapy help?
The first thing we do is help people to understand the nature of their symptoms and why they may have come about. Often understanding your condition helps to reduce anxiety and allow you to regain some control over the condition. This also helps you avoid the secondary complications mentioned above.
We will conduct an assessment of your balance systems and help you to work out how to return to work and cope with your condition in day-to-day situations. This may include assessing your everyday surroundings, things like your workplace, the set-up of your desk, your posture and so on.
We take people through a series of exercises to address their symptoms, starting slowly at first and building up over time to expose you gradually to more complicated environments. Many people wrongly believe that the way to get better is to avoid things that make them dizzy or otherwise provoke their symptoms. In neurological physiotherapy, however, we will not avoid the things but instead retrain your brain to cope with actions or environments that provoke your symptoms so that you become symptom-free and regain your confidence.
Most people, depending on the underlying cause of their condition, get better with treatment. neurological physiotherapy plays an important role in helping them to return to leading normal lives.