Complementary and Alternative Medicine Therapies
This information is intended as a general introduction to this topic. As each person is affected differently by balance and dizziness problems, speak with your health care professional for individual advice.
Complementary and alternative medicine (CAM) refers to any medical and health care system, practice or product that is not generally considered part of conventional (mainstream) medicine as practiced by those who hold a degree of doctor of medicine (MD) and other allied registered health professionals.
When a practice is used along with conventional medicine (the system used by licensed medical doctors and allied health professionals in Canada), it often referred to as “complementary” or “integrative” health care. When it is used in place of conventional medicine, it is called “alternative." In practice, these terms are often used interchangeably and there are a number of grey areas. Inform yourself before trying any CAM treatments.
New drugs and medical devices must be approved by Health Canada. The approval process includes research reports and peer reviews. The final stage of conventional medical research involves evaluation through controlled double-blind studies. This means that neither the researchers nor their volunteer subjects are aware of who is receiving the treatment being tested and who is receiving a placebo (an inactive medicine or procedure). Effects are documented meticulously to ensure accurate reporting and to stop the study if there are problems.
Very few evidence-based scientific studies have been carried out to see how well complementary and alternative therapies work specifically for people with balance and dizziness disorders. If verification of effectiveness through careful research is not provided, then you may wish to give the treatment a pass. It may be ineffective or harmful as well as costly.
The story of Dr. John Epley and his eponymous manoeuvre, however, is a lesson in keeping an open mind about new treatments and waiting for evidence. Dr. John Epley first presented his elegant idea that a single set of head manouevres could cure most cases of BPPV to colleagues at a meeting in 1980. Skeptical muttering filled the room. Some doctors even walked out. One comment card read, “I resent having to waste my time listening to some guy’s pet theory.”
Since then, the Epley manoeuvre has been extensively tested in clinical settings. It has proven to be an effective lasting treatment for the vast majority of people with the most common type of BPPV.
Dr. Epley’s story is a cautionary reminder of the importance of being open-minded about any new treatment. Until something has been clinically tested, there is no way to know if it works or not.
Complementary therapies can be used alongside conventional medical treatment to help you feel and cope better with dizziness and imbalance. Just because a complementary practice is popular or works for someone else, however, does not necessarily make it right for you.
A good complementary therapist will not claim that their treatments are a cure for your dizziness or imbalance. They will encourage you to discuss these treatments with your medical doctor.
Therapies some people find helpful for dizziness and balance include:
Practicing relaxation techniques can help reduce stress or anxiety, improve sleep, and promote a general feeling of well-being. Mindfulness meditation can be performed anywhere; it only takes a few minutes a day. There are many techniques. It is a matter of finding which one works best for you. It takes time and diligence to see results.
Many people with dizziness have a lot of neck and shoulder muscle tension as well as pain. This is often misinterpreted as dizziness provoked by a neck problem. However in most cases, the neck and shoulder problem is caused by the patient’s natural reaction of avoiding neck movement. Since head movements often trigger dizziness, such movements frequently are avoided. The result is neck and shoulder stiffness. Massage therapy can often be effectively combined with vestibular rehabilitation to provide relief.
It is important to have massage done by a registered massage therapist (RMT). Massage therapy is a recognized healthcare profession in BC. The College of Massage Therapists of BC maintains a searchable database of registered massage therapists in BC.
There is much debate in the medical literature about whether chiropractic treatments work - and, in cases where it seems to work, why. Many medical professionals remain skeptical and consider it a pseudoscience.
Balance and dizziness problems have many causes. Some may include neck, shoulders and back problems. Sometimes, these problems are secondary to dizziness and vertigo – muscle tension and pain may develop as head and neck movements are reduced to not trigger dizziness. In these instances, chiropractic treatments may be helpful. People who have suffered neck injuries may also find relief with chiropractic adjustments.
On the other hand, several dizziness and balance problems most likely will not improve with chiropractic treatments. Some people, such as those with migraine, may have worse dizziness after chiropractic treatments.
The College of Chiropractors of British Columbia regulates chiropractors in BC under the Health Professions Act.
Biologically based therapies
Biologically based therapies involve the use of nature-based substances such as botanicals and herbs to ease symptoms. Keep in mind that just because something is natural does not mean it is harmless. Inform your medical doctor of any over-the-counter preparations you take. Some can cause illness, allergic reaction or a serious interaction with other medications.
Some people find ginger to be an effective treatment for the nausea and vomiting that goes along with some dizziness disorders. But there is no good evidence to support ginger as an effective treatment for dizziness. Sources include Gravol® Natural Ginger Tablets or tea made with freshly grated ginger. Crystallized ginger is tasty but high in sugar.
Aromatherapy (essential oil therapy) may help promote relaxation, particularly when used in combination with massage therapy. There is some evidence that lavender oil may play a small role in promoting better sleep. Essential oils, such as lavender or peppermint, on the temples or under the nose may be helpful for those with migraine.
Aromatherapy is not a recognized health profession in BC. The BC Alliance of Aromatherapy, however, is committed to establishing standards for aromatherapy practice in the province.
Acupuncture is promoted as both a complementary practice and an alternative medical treatment. Acupuncture is a grey area – while the World Health Organization lists 31 symptoms and conditions shown in controlled trials to be effectively treated by acupuncture (including neck pain, headache, nausea and vomiting and depression), the National Council Against Health Fraud maintained there is inadequate or nonexistent scientific evidence to support these claims.
Acupuncture is a designated health profession BC under the Health Professions Act. It is regulated through the College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC.
Alternative therapies are generally used by people as a replacement for conventional medical treatment. People with balance and dizziness disorders have various reasons for trying alternative treatments. Some therapies sound promising but there is no scientific or medical evidence to show they work.
Some types of alternative therapy may not be safe and could be harmful. Ear candling, for example, can cause burns and even damage the eardrum: It has been proven to be ineffective in removing earwax. And some fad diets may fail to include important nutrients while over-doing others.
Homeopathic medicine was developed in Germany over 200 years ago before the basic principles of modern medicine had been developed. Homeopathy is based on two ideas: the “Law of Similars,” also known as “like cures like", (meaning a disease can be cured by a substance that produced similar symptoms in healthy people) and the “law of minimum dose” (meaning the lower the dose of the medication, the greater its effectiveness).
Many homeopathic products are diluted to the point that no molecules of the original substance remain. They are derived from plants (such as red onion, arnica, deadly nightshade and stinging nettle), minerals (such as white arsenic) and animals (such as crushed whole bees). A comprehensive assessment of evidence has concluded that there is no reliable evidence that homeopathy is effective for any health condition. It is no more effective than a placebo (inactive medicine or procedure).
Homeopathy is a controversial topic. A number of its key concepts do not agree with fundamental scientific concepts. For example, it is not possible to explain in scientific terms how a product containing little or no active ingredient can have any effect. This, in turn, creates major challenges to rigorous clinical investigation of such products. For example, researchers cannot confirm that an extremely dilute mixture contains what is listed on the label; nor have they been able to develop objective measures that show effects of extremely dilute products in the human body.
Another research challenge is that homeopathic treatments are highly individualized and there is no uniform prescribing standard for practitioners. There are hundreds of different remedies that can be prescribed in a variety of dilutions for thousands of symptoms.
Health Canada regulates homeopathic products as a type of natural health product. It reviews homeopathic products to ensure that they are safe and that the health claims are supported by traditional homeopathic evidence. There is no requirement for support by modern scientific evidence. Since 2015, however, labels on products marketed in Canada for children are required to include that claims for efficacy are “based on traditional homeopathic references and not modern scientific evidence".
Most homeopathic products contain little more than water and sometimes sugar. The biggest risk of homeopathy in the treatment of dizziness and balance disorders is that scientific diagnosis and effective treatment or management of a condition can be delayed.
So far, research into balance and dizziness disorders has not come up with any miracle cures. Until then, stick to prescribed treatment plans and work on building your wellness toolkit.
The titles listed are available for loan through public libraries in BC. If your local library does not own a copy, ask for it to be sent from another library through interlibrary loan.
Looks at the the cognitive biases that lead to pseudoscience, the history of pseudoscience, the reasons for its wide acceptance, how it is endangering our society, how to recognize it, and how we might reduce its impact.
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National Center for Complementary and Integrative Health. 2018. Homeopathy. Available from: https://bit.ly/1Nf0Miq
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Science-based medicine. Vertigo voodoo: A crazy-sounding cure that actually works. December 18, 2018. Available from: https://bit.ly/2uZYdB7
Page updated September, 2019.