FAQ
Browse a selection of our most frequently asked questions and answers about balance and dizziness disorders. Submit your own question here.
Acoustic Neuroma
Advocate for Yourself
Physiotherapists do not diagnose. Physiotherapists work with you based on how your imbalance or dizziness presents. Well-trained physiotherapists can make a working hypothesis of what is wrong and can help guide your medical doctor or specialist towards a diagnosis.
Vestibular audiologists do diagnostic vestibular testing. They can, for example, test to see if you have bilateral vestibular hypofunction or a bilateral vestibular disorder. Similar to how audiologists can say, “You have a sensory hearing loss,” vestibular audiologists can say, “You have a loss of balance function.” They will not label your disorder, but will say things like, “This balance sensor seems to be 50% functional” or “There is a dysfunction on this or that balance sensor.” This information will be passed on to your doctor to make a diagnosis.
Most of the time, doctors ordering a CT scan or MRI of your temporal bone – the bone enclosing your inner ear – are looking for major structural abnormalities. Usually, they want to see the health of the bone, whether or not it is intact, and if there are any tumours on the balance and hearing nerve or on the structures at the back of your head. An acoustic neuroma, for example, is a benign tumour causing hearing loss and dizziness as it grows around the hearing and balance nerve. Acoustic neuromas show up on an MRI.
Neither CT scans nor MRIs can, however, help diagnose most causes of dizziness and imbalance. Imaging cannot show if the tiny inner-ear balance sensors are working. In summary, the role of medical imaging is to rule out – or in – certain structural causes for balance and dizziness disorders.
Balance
“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”
There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.
In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.
The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.
In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.
The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.
Physiotherapists do not diagnose. Physiotherapists work with you based on how your imbalance or dizziness presents. Well-trained physiotherapists can make a working hypothesis of what is wrong and can help guide your medical doctor or specialist towards a diagnosis.
Vestibular audiologists do diagnostic vestibular testing. They can, for example, test to see if you have bilateral vestibular hypofunction or a bilateral vestibular disorder. Similar to how audiologists can say, “You have a sensory hearing loss,” vestibular audiologists can say, “You have a loss of balance function.” They will not label your disorder, but will say things like, “This balance sensor seems to be 50% functional” or “There is a dysfunction on this or that balance sensor.” This information will be passed on to your doctor to make a diagnosis.
Most of the time, doctors ordering a CT scan or MRI of your temporal bone – the bone enclosing your inner ear – are looking for major structural abnormalities. Usually, they want to see the health of the bone, whether or not it is intact, and if there are any tumours on the balance and hearing nerve or on the structures at the back of your head. An acoustic neuroma, for example, is a benign tumour causing hearing loss and dizziness as it grows around the hearing and balance nerve. Acoustic neuromas show up on an MRI.
Neither CT scans nor MRIs can, however, help diagnose most causes of dizziness and imbalance. Imaging cannot show if the tiny inner-ear balance sensors are working. In summary, the role of medical imaging is to rule out – or in – certain structural causes for balance and dizziness disorders.
Vestibular audiologists report on the results of hearing, balance and vestibular function tests. If you had a VEMP test, they may say, “Your utricle and saccule are within normal range.” Or, they may say, “Your water test was normal or abnormal.” Ask for a written report of hearing tests as well as diagnostic tests of the balance sensors in your inner ear. Get an understanding of what these reports mean by reading our Diagnostic Tests for Balance and Dizziness Disorders.
Please visit this section of our website: https://balanceanddizziness.org/disorders/other-causes/#effects. It is a rather long list and likely not exhaustive. We recommend talking to your doctor or pharmacist if you think a medication (or combination of medications) may be causing dizziness or imbalance. Sometimes an alternate medication can be prescribed.
This is a very interesting observation. In order to keep balance, our brain collects information from the vestibular system (the inner ear balance sensors), the visual system and the proprioceptive system (the sensation coming from skin, muscles and joints). The brain analyzes these three “buckets” of information to figure out what the body is doing and to send orders back to the body to adjust and keep balance. When you are carrying a heavy object, either in one or both hands, you are enhancing the cues from the proprioceptive system going to the brain. From your report, this seems to help your brain to adjust more easily and for you to feel more balanced.
This principle, as a means of strategically calculated and positioned weighted vests, has been used in balance rehabilitation of some central nervous system balance disorders, such as Parkinson’s Disease. You may wish to explore this option with your health care professionals team.
If you feel more anxious when on these surfaces, here are some suggestions you could explore.
You may try to first just stand on the edge of that surface. While standing there, just notice your body. “Scan” it with your attention, all the way from the soles of your feet to your head. Notice any areas of tension and soften them if you can. Notice whether your heart is beating fast, your breathing is shallow or you are sweating. If that is happening, take some deep breaths, with a longer out-breath, like a sigh of relief. Intentionally relax and slow down. Take as much time as you need to feel calm, relaxed and safe just standing there.
Then you may also want to work on some sort of habituation to these surfaces. I’d try starting with some walking poles and see if you feel more stable and less like falling when on these types of surfaces. You’d want to try perhaps just a few steps at a time, for just as long as you feel safe. You would want to repeat this several times a week for some practice and exposure. If the process works, you should start to feel that you don’t tense up as much and feel more relaxed. Then you could try using only one pole and repeat until you feel stable. You could then try using no poles and see how you are.
These are the poles we normally recommend, but you may be able to find a cheaper alternative:
There are many causes for dizziness and balance disorders, including life-threatening conditions. The CT and MRI scans you had were to rule out more serious causes for vertigo. They are not meant to find out exactly what is happening. When the scans come back clear, your primary care physician may try medications that are available and see what happens.
However, the vestibular/balance system is very complex and sometimes the cause is neither sinister nor straight forward. An example is Persistent Postural-Perceptual Dizziness (PPPD).
In less straight-forward cases, specialized professionals and/or diagnostic testing may be needed to lead you to understanding what is causing your dizziness and to implement appropriate management strategies.
The road to diagnosis and management of a dizziness and balance disorder is often a journey and we understand that it can be confusing and frustrating.
Diagnosis
Physiotherapists do not diagnose. Physiotherapists work with you based on how your imbalance or dizziness presents. Well-trained physiotherapists can make a working hypothesis of what is wrong and can help guide your medical doctor or specialist towards a diagnosis.
Vestibular audiologists do diagnostic vestibular testing. They can, for example, test to see if you have bilateral vestibular hypofunction or a bilateral vestibular disorder. Similar to how audiologists can say, “You have a sensory hearing loss,” vestibular audiologists can say, “You have a loss of balance function.” They will not label your disorder, but will say things like, “This balance sensor seems to be 50% functional” or “There is a dysfunction on this or that balance sensor.” This information will be passed on to your doctor to make a diagnosis.
Most of the time, doctors ordering a CT scan or MRI of your temporal bone – the bone enclosing your inner ear – are looking for major structural abnormalities. Usually, they want to see the health of the bone, whether or not it is intact, and if there are any tumours on the balance and hearing nerve or on the structures at the back of your head. An acoustic neuroma, for example, is a benign tumour causing hearing loss and dizziness as it grows around the hearing and balance nerve. Acoustic neuromas show up on an MRI.
Neither CT scans nor MRIs can, however, help diagnose most causes of dizziness and imbalance. Imaging cannot show if the tiny inner-ear balance sensors are working. In summary, the role of medical imaging is to rule out – or in – certain structural causes for balance and dizziness disorders.
Dizziness
Please visit this section of our website: https://balanceanddizziness.org/disorders/other-causes/#effects. It is a rather long list and likely not exhaustive. We recommend talking to your doctor or pharmacist if you think a medication (or combination of medications) may be causing dizziness or imbalance. Sometimes an alternate medication can be prescribed.
If you feel more anxious when on these surfaces, here are some suggestions you could explore.
You may try to first just stand on the edge of that surface. While standing there, just notice your body. “Scan” it with your attention, all the way from the soles of your feet to your head. Notice any areas of tension and soften them if you can. Notice whether your heart is beating fast, your breathing is shallow or you are sweating. If that is happening, take some deep breaths, with a longer out-breath, like a sigh of relief. Intentionally relax and slow down. Take as much time as you need to feel calm, relaxed and safe just standing there.
Then you may also want to work on some sort of habituation to these surfaces. I’d try starting with some walking poles and see if you feel more stable and less like falling when on these types of surfaces. You’d want to try perhaps just a few steps at a time, for just as long as you feel safe. You would want to repeat this several times a week for some practice and exposure. If the process works, you should start to feel that you don’t tense up as much and feel more relaxed. Then you could try using only one pole and repeat until you feel stable. You could then try using no poles and see how you are.
These are the poles we normally recommend, but you may be able to find a cheaper alternative:
Falls
“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”
There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.
In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.
The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.
In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.
The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.
Medications
Please visit this section of our website: https://balanceanddizziness.org/disorders/other-causes/#effects. It is a rather long list and likely not exhaustive. We recommend talking to your doctor or pharmacist if you think a medication (or combination of medications) may be causing dizziness or imbalance. Sometimes an alternate medication can be prescribed.
Motion Sensitivity
If you feel more anxious when on these surfaces, here are some suggestions you could explore.
You may try to first just stand on the edge of that surface. While standing there, just notice your body. “Scan” it with your attention, all the way from the soles of your feet to your head. Notice any areas of tension and soften them if you can. Notice whether your heart is beating fast, your breathing is shallow or you are sweating. If that is happening, take some deep breaths, with a longer out-breath, like a sigh of relief. Intentionally relax and slow down. Take as much time as you need to feel calm, relaxed and safe just standing there.
Then you may also want to work on some sort of habituation to these surfaces. I’d try starting with some walking poles and see if you feel more stable and less like falling when on these types of surfaces. You’d want to try perhaps just a few steps at a time, for just as long as you feel safe. You would want to repeat this several times a week for some practice and exposure. If the process works, you should start to feel that you don’t tense up as much and feel more relaxed. Then you could try using only one pole and repeat until you feel stable. You could then try using no poles and see how you are.
These are the poles we normally recommend, but you may be able to find a cheaper alternative:
PPPD
There are many causes for dizziness and balance disorders, including life-threatening conditions. The CT and MRI scans you had were to rule out more serious causes for vertigo. They are not meant to find out exactly what is happening. When the scans come back clear, your primary care physician may try medications that are available and see what happens.
However, the vestibular/balance system is very complex and sometimes the cause is neither sinister nor straight forward. An example is Persistent Postural-Perceptual Dizziness (PPPD).
In less straight-forward cases, specialized professionals and/or diagnostic testing may be needed to lead you to understanding what is causing your dizziness and to implement appropriate management strategies.
The road to diagnosis and management of a dizziness and balance disorder is often a journey and we understand that it can be confusing and frustrating.
Self Help
“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”
There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.
In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.
The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.
In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.
The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.
Vestibular Disorders
“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”
There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.
In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.
The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.
In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.
The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.
Physiotherapists do not diagnose. Physiotherapists work with you based on how your imbalance or dizziness presents. Well-trained physiotherapists can make a working hypothesis of what is wrong and can help guide your medical doctor or specialist towards a diagnosis.
Vestibular audiologists do diagnostic vestibular testing. They can, for example, test to see if you have bilateral vestibular hypofunction or a bilateral vestibular disorder. Similar to how audiologists can say, “You have a sensory hearing loss,” vestibular audiologists can say, “You have a loss of balance function.” They will not label your disorder, but will say things like, “This balance sensor seems to be 50% functional” or “There is a dysfunction on this or that balance sensor.” This information will be passed on to your doctor to make a diagnosis.
Most of the time, doctors ordering a CT scan or MRI of your temporal bone – the bone enclosing your inner ear – are looking for major structural abnormalities. Usually, they want to see the health of the bone, whether or not it is intact, and if there are any tumours on the balance and hearing nerve or on the structures at the back of your head. An acoustic neuroma, for example, is a benign tumour causing hearing loss and dizziness as it grows around the hearing and balance nerve. Acoustic neuromas show up on an MRI.
Neither CT scans nor MRIs can, however, help diagnose most causes of dizziness and imbalance. Imaging cannot show if the tiny inner-ear balance sensors are working. In summary, the role of medical imaging is to rule out – or in – certain structural causes for balance and dizziness disorders.
Vestibular audiologists report on the results of hearing, balance and vestibular function tests. If you had a VEMP test, they may say, “Your utricle and saccule are within normal range.” Or, they may say, “Your water test was normal or abnormal.” Ask for a written report of hearing tests as well as diagnostic tests of the balance sensors in your inner ear. Get an understanding of what these reports mean by reading our Diagnostic Tests for Balance and Dizziness Disorders.
There are many causes for dizziness and balance disorders, including life-threatening conditions. The CT and MRI scans you had were to rule out more serious causes for vertigo. They are not meant to find out exactly what is happening. When the scans come back clear, your primary care physician may try medications that are available and see what happens.
However, the vestibular/balance system is very complex and sometimes the cause is neither sinister nor straight forward. An example is Persistent Postural-Perceptual Dizziness (PPPD).
In less straight-forward cases, specialized professionals and/or diagnostic testing may be needed to lead you to understanding what is causing your dizziness and to implement appropriate management strategies.
The road to diagnosis and management of a dizziness and balance disorder is often a journey and we understand that it can be confusing and frustrating.
Vestibular Rehabilitation
“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”
There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.
In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.
The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.
In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.
The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.
If you feel more anxious when on these surfaces, here are some suggestions you could explore.
You may try to first just stand on the edge of that surface. While standing there, just notice your body. “Scan” it with your attention, all the way from the soles of your feet to your head. Notice any areas of tension and soften them if you can. Notice whether your heart is beating fast, your breathing is shallow or you are sweating. If that is happening, take some deep breaths, with a longer out-breath, like a sigh of relief. Intentionally relax and slow down. Take as much time as you need to feel calm, relaxed and safe just standing there.
Then you may also want to work on some sort of habituation to these surfaces. I’d try starting with some walking poles and see if you feel more stable and less like falling when on these types of surfaces. You’d want to try perhaps just a few steps at a time, for just as long as you feel safe. You would want to repeat this several times a week for some practice and exposure. If the process works, you should start to feel that you don’t tense up as much and feel more relaxed. Then you could try using only one pole and repeat until you feel stable. You could then try using no poles and see how you are.
These are the poles we normally recommend, but you may be able to find a cheaper alternative:
Vestibular Testing
Physiotherapists do not diagnose. Physiotherapists work with you based on how your imbalance or dizziness presents. Well-trained physiotherapists can make a working hypothesis of what is wrong and can help guide your medical doctor or specialist towards a diagnosis.
Vestibular audiologists do diagnostic vestibular testing. They can, for example, test to see if you have bilateral vestibular hypofunction or a bilateral vestibular disorder. Similar to how audiologists can say, “You have a sensory hearing loss,” vestibular audiologists can say, “You have a loss of balance function.” They will not label your disorder, but will say things like, “This balance sensor seems to be 50% functional” or “There is a dysfunction on this or that balance sensor.” This information will be passed on to your doctor to make a diagnosis.
Most of the time, doctors ordering a CT scan or MRI of your temporal bone – the bone enclosing your inner ear – are looking for major structural abnormalities. Usually, they want to see the health of the bone, whether or not it is intact, and if there are any tumours on the balance and hearing nerve or on the structures at the back of your head. An acoustic neuroma, for example, is a benign tumour causing hearing loss and dizziness as it grows around the hearing and balance nerve. Acoustic neuromas show up on an MRI.
Neither CT scans nor MRIs can, however, help diagnose most causes of dizziness and imbalance. Imaging cannot show if the tiny inner-ear balance sensors are working. In summary, the role of medical imaging is to rule out – or in – certain structural causes for balance and dizziness disorders.
Vestibular audiologists report on the results of hearing, balance and vestibular function tests. If you had a VEMP test, they may say, “Your utricle and saccule are within normal range.” Or, they may say, “Your water test was normal or abnormal.” Ask for a written report of hearing tests as well as diagnostic tests of the balance sensors in your inner ear. Get an understanding of what these reports mean by reading our Diagnostic Tests for Balance and Dizziness Disorders.
There are many causes for dizziness and balance disorders, including life-threatening conditions. The CT and MRI scans you had were to rule out more serious causes for vertigo. They are not meant to find out exactly what is happening. When the scans come back clear, your primary care physician may try medications that are available and see what happens.
However, the vestibular/balance system is very complex and sometimes the cause is neither sinister nor straight forward. An example is Persistent Postural-Perceptual Dizziness (PPPD).
In less straight-forward cases, specialized professionals and/or diagnostic testing may be needed to lead you to understanding what is causing your dizziness and to implement appropriate management strategies.
The road to diagnosis and management of a dizziness and balance disorder is often a journey and we understand that it can be confusing and frustrating.
