Balance &
Dizziness
Many
people seek chiropractic care for low back, mid-back, neck pain, and
pain in the extremities, but what about balance and/or dizziness, as
they often go together? Can chiropractic management help people
suffering from frequent falls due to balance and/or dizziness
problems? Let’s take a look!
When
considering treatment for balance, we must talk about the
“proprioceptive system.” The way the body “communicates”
between all the various body parts is by proprioceptors—which are
located in skeletal muscles and joint capsules—that relay
information to the brain. This information from the various body
parts is then integrated with incoming information from the
vestibular system (inner ear). The brain also relies heavily on the
cerebellum located in the back of the head, which is largely
responsible for coordinating the unconscious (automatic) aspects of
proprioception. The ability to maintain balance, such as when
standing on one leg (eyes open and closed), is dependent on the
ability for the ALL THREE of these systems to work properly, and like
any other skill, “…practice makes perfect!” Please try standing
on one leg and then shut your eyes. Can you feel your ankle, foot,
leg, and the rest of your body struggle to keep you balanced? For
those of us under age 60, it’s “normal” to be able to balance
on one foot with eyes closed for 25 seconds (or 10 and 4 seconds if
you are between 60-69 or, 70-79 years old, respectively)! Scary,
isn’t it? But don’t feel bad, as most of us can’t do this at
first. With practice and the right exercises, you will be able to do
it. Your “kinesthetic sense” CAN BE improved, and your doctor of
chiropractic can guide you in the process. So, how does dizziness fit
into this picture? Let’s talk about the ear!
Our
ears have two jobs: hearing and balance. The outer ear catches sound
and funnels it to the eardrum which vibrates and moves three little
bones that transmit the information to the cochlea and finally to the
brain allowing us to hear sound. Deep inside the ear is the
“vestibular apparatus,” which is the organ of equilibrium that
assists in balance. Here, three semi-circular canals are filled with
fluid and two sac-like structures located at the base called the
utricule and saccule. The fluid in the canals flows past little
hair-like structures that are connected to nerves that relay
information to the brain, telling it where we are in space
(horizontal—laying down, vertical—standing) and if we’re moving
forwards/accelerating or moving up/down (like in an elevator).
There
are little tiny “stones” in these two sacs that move the little
hair-like structures but they can dislodge into the canal and alter
the flow of fluid (like a rock sticking out of a flowing river
creating eddy currents), which alters the direction the little hairs
bend, resulting in vertigo or dizziness as the brain is receiving
conflicting information from the hairs bending in multiple/different
directions. This is called “BPPV” (benign paroxysmal positional
vertigo), which is brief episodes of vertigo immediately following a
change in head position such as rolling over in bed, getting up from
sitting or laying, etc. This is the most common cause of vertigo. If
you Google “BPPV,” you will find different exercises that can
move these little stones back into position (Brandt-Daroff and
Epley’s maneuver), both of which work well often within a day or
two. This is a good place to start, and if the balance/dizziness
(vertigo) doesn’t improve, then you should consider other
possibilities such as inner ear inflammation or acute vestibular
neuritis, Meniere’s disease, vestibular migraine, acoustic neuroma,
blood pressure issues, medication side effects, and more. Your
chiropractor can teach you the BPPV exercises and perform cervical
adjustments, which can also help significantly.
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