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.

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.

Gravol is a drug that acts on the central nervous system. It can be thought of as a numbing agent. It reduces the sensitivity of your central nervous system, and it usually works very well at reducing nausea. It is a symptomatic medication. If it helps you, it will not tell you the reason for your nausea. If you respond to Gravol, that is good because you will have less symptoms. But your healthcare team will need to continue to dig deeper to understand why you are having nausea.

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.

Not all specialists have a particular interest or specialization in vestibular migraine. Ask your referring doctor to match you to one who does. For example, some neuro-otologists, neurologists and neuro-ophthalmologists are comfortable diagnosing and managing headache disorders, including vestibular migraine. This is less common, however, for generalist otologists (ear, nose and throat doctors). Some physiotherapists may be knowledgeable about headaches. Many, however, are more interested in balance and muscle- and joint-related issues. Read more about vestibular migraine.

“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.

“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.

The half-somersault manoeuvre is meant to be self-taught and performed, but, depending on how dizzy, fit and healthy you are, it may be difficult to do. It is an alternative to the Epley manoeuvre, which can also be self-administered. You can read more about the half-somersault maoneuvre here.

Alternatively, you can see a vestibular physiotherapist who can help you with the manoeuvres, both teaching you how to do them and performing them for you. You can find a Vestibular Physiotherapist in your area here. Choose “Find a Physio” or “Find a Clinic” and select the “Advanced Search” option. Enter your criteria, including your city.

I couldn’t help but notice that you mentioned in your email that you suffer from Ménière’s Disease. Note that these manoeuvres are aimed at positional vertigo, which may occur in Ménière’s disease. Positional vertigo presents as short-lived episodes of spinning dizziness that occur only when you move your head in certain ways. On the other hand, Ménière’s Disease presents with intense spinning (dizziness) episodes, that come on suddenly, often for no apparent reason. These are often accompanied by vomiting and last for hours. The manoeuvres for positional vertigo are not recommended when these longer and more severe episodes occur.

You have expressed the feelings of many people affected by dizziness! It is not always easy to find support in your community; you end up seeing quite a few professionals and they are not always on the same page as to your diagnosis and treatment plan. You may be left with uncertainty about what you can expect in the future. Without getting into too much detail about your diagnosis and treatment (you can read more about BPPV here) you are encouraged to do the following:

1) Get informed (learning more about BPPV is a start) and then clarify with your healthcare professionals what their treatment plan is. Ask as many questions as you need. Read some more if you need to. Here is a list of recommended books.

2) Once you feel you have a direction to follow for treatment, stick with it for a set amount of time. Six weeks is a reasonable time frame. During this time, try your very best to stick with the treatment plan and to stay positive.

3) Use the online resources of our Society and your local sources of support. Since you mentioned that there are no specific dizziness support groups, how about you try your community for balance exercises, for example? You can also look for tai chi classes and classes designed for falls prevention. You will most likely find others dealing with similar issues.

4) At the end of your “trial” with this plan, reassess your symptoms and your goals. You may find that you were on the right track, or you may need to start on number one all over again and try a different treatment plan.

Keep in mind that, even if you need to go back and follow a different course of action, that is okay. It will not be forever. Give yourself again about six weeks time and reassess. Stay in the present moment as much as you can, focusing on what you can effectively do right then and there.

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.

Our page “Other Causes” lists Anxiety and Panic Attacks as possible causes for dizziness:
https://balanceanddizziness.org/disorders/other-causes/#mental. Follow the Anxiety Canada link and use their resources such as the Mindshift app for 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.

There are some environmental aids that can help, for example wrist guards or hip protectors can provide some degree of protection. There are also some simple things you can do to help avoid falls in the first place. Examples include reducing clutter around the house, clearing paths for walking, using mobility aids, and installing grab bars and good lighting. Your therapist may also work with your on improving your strength and balance to either avoid losing your balance, or if possible, better controlling the force of a fall.

The half-somersault manoeuvre is meant to be self-taught and performed, but, depending on how dizzy, fit and healthy you are, it may be difficult to do. It is an alternative to the Epley manoeuvre, which can also be self-administered. You can read more about the half-somersault maoneuvre here.

Alternatively, you can see a vestibular physiotherapist who can help you with the manoeuvres, both teaching you how to do them and performing them for you. You can find a Vestibular Physiotherapist in your area here. Choose “Find a Physio” or “Find a Clinic” and select the “Advanced Search” option. Enter your criteria, including your city.

I couldn’t help but notice that you mentioned in your email that you suffer from Ménière’s Disease. Note that these manoeuvres are aimed at positional vertigo, which may occur in Ménière’s disease. Positional vertigo presents as short-lived episodes of spinning dizziness that occur only when you move your head in certain ways. On the other hand, Ménière’s Disease presents with intense spinning (dizziness) episodes, that come on suddenly, often for no apparent reason. These are often accompanied by vomiting and last for hours. The manoeuvres for positional vertigo are not recommended when these longer and more severe episodes occur.

Not all specialists have a particular interest or specialization in vestibular migraine. Ask your referring doctor to match you to one who does. For example, some neuro-otologists, neurologists and neuro-ophthalmologists are comfortable diagnosing and managing headache disorders, including vestibular migraine. This is less common, however, for generalist otologists (ear, nose and throat doctors). Some physiotherapists may be knowledgeable about headaches. Many, however, are more interested in balance and muscle- and joint-related issues. Read more about vestibular migraine.

The balance system is complex and in fact involves 3 major sensory input systems, all controlled by the brain. The inner ear sensors for balance, eyes and the proprioceptors on the body all send information to the brain. Balance centres receive, analyze and integrate these bits of information and then send orders to the body to readjust according to the movement done in the first place.

When you are dizzy with computer use, it usually means that the balance system is relying more heavily on the visual input. It is not fully reassured by the inner ear sensors telling them you are not moving. For more information, read our Motion and Cyber Sickness article.

Having the weights on you or changing your posture as you walk is increasing the cues coming from the proprioceptive system to the brain. This additional input seems to help you balance.

I would recommend you to have your inner ear sensors tested. It might be that they are working just fine but your centres in the brain are not using their information properly or it might be that your brain is in need of all this additional information (visual and proprioception) because your inner ear sensors are dysfunctional.

Not all specialists have a particular interest or specialization in vestibular migraine. Ask your referring doctor to match you to one who does. For example, some neuro-otologists, neurologists and neuro-ophthalmologists are comfortable diagnosing and managing headache disorders, including vestibular migraine. This is less common, however, for generalist otologists (ear, nose and throat doctors). Some physiotherapists may be knowledgeable about headaches. Many, however, are more interested in balance and muscle- and joint-related issues. Read more about vestibular migraine.

The half-somersault manoeuvre is meant to be self-taught and performed, but, depending on how dizzy, fit and healthy you are, it may be difficult to do. It is an alternative to the Epley manoeuvre, which can also be self-administered. You can read more about the half-somersault maoneuvre here.

Alternatively, you can see a vestibular physiotherapist who can help you with the manoeuvres, both teaching you how to do them and performing them for you. You can find a Vestibular Physiotherapist in your area here. Choose “Find a Physio” or “Find a Clinic” and select the “Advanced Search” option. Enter your criteria, including your city.

I couldn’t help but notice that you mentioned in your email that you suffer from Ménière’s Disease. Note that these manoeuvres are aimed at positional vertigo, which may occur in Ménière’s disease. Positional vertigo presents as short-lived episodes of spinning dizziness that occur only when you move your head in certain ways. On the other hand, Ménière’s Disease presents with intense spinning (dizziness) episodes, that come on suddenly, often for no apparent reason. These are often accompanied by vomiting and last for hours. The manoeuvres for positional vertigo are not recommended when these longer and more severe episodes occur.

“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.

The half-somersault manoeuvre is meant to be self-taught and performed, but, depending on how dizzy, fit and healthy you are, it may be difficult to do. It is an alternative to the Epley manoeuvre, which can also be self-administered. You can read more about the half-somersault maoneuvre here.

Alternatively, you can see a vestibular physiotherapist who can help you with the manoeuvres, both teaching you how to do them and performing them for you. You can find a Vestibular Physiotherapist in your area here. Choose “Find a Physio” or “Find a Clinic” and select the “Advanced Search” option. Enter your criteria, including your city.

I couldn’t help but notice that you mentioned in your email that you suffer from Ménière’s Disease. Note that these manoeuvres are aimed at positional vertigo, which may occur in Ménière’s disease. Positional vertigo presents as short-lived episodes of spinning dizziness that occur only when you move your head in certain ways. On the other hand, Ménière’s Disease presents with intense spinning (dizziness) episodes, that come on suddenly, often for no apparent reason. These are often accompanied by vomiting and last for hours. The manoeuvres for positional vertigo are not recommended when these longer and more severe episodes occur.

Our page “Other Causes” lists Anxiety and Panic Attacks as possible causes for dizziness:
https://balanceanddizziness.org/disorders/other-causes/#mental. Follow the Anxiety Canada link and use their resources such as the Mindshift app for help.

There are some environmental aids that can help, for example wrist guards or hip protectors can provide some degree of protection. There are also some simple things you can do to help avoid falls in the first place. Examples include reducing clutter around the house, clearing paths for walking, using mobility aids, and installing grab bars and good lighting. Your therapist may also work with your on improving your strength and balance to either avoid losing your balance, or if possible, better controlling the force of a fall.

The balance system is complex and in fact involves 3 major sensory input systems, all controlled by the brain. The inner ear sensors for balance, eyes and the proprioceptors on the body all send information to the brain. Balance centres receive, analyze and integrate these bits of information and then send orders to the body to readjust according to the movement done in the first place.

When you are dizzy with computer use, it usually means that the balance system is relying more heavily on the visual input. It is not fully reassured by the inner ear sensors telling them you are not moving. For more information, read our Motion and Cyber Sickness article.

Having the weights on you or changing your posture as you walk is increasing the cues coming from the proprioceptive system to the brain. This additional input seems to help you balance.

I would recommend you to have your inner ear sensors tested. It might be that they are working just fine but your centres in the brain are not using their information properly or it might be that your brain is in need of all this additional information (visual and proprioception) because your inner ear sensors are dysfunctional.

You have expressed the feelings of many people affected by dizziness! It is not always easy to find support in your community; you end up seeing quite a few professionals and they are not always on the same page as to your diagnosis and treatment plan. You may be left with uncertainty about what you can expect in the future. Without getting into too much detail about your diagnosis and treatment (you can read more about BPPV here) you are encouraged to do the following:

1) Get informed (learning more about BPPV is a start) and then clarify with your healthcare professionals what their treatment plan is. Ask as many questions as you need. Read some more if you need to. Here is a list of recommended books.

2) Once you feel you have a direction to follow for treatment, stick with it for a set amount of time. Six weeks is a reasonable time frame. During this time, try your very best to stick with the treatment plan and to stay positive.

3) Use the online resources of our Society and your local sources of support. Since you mentioned that there are no specific dizziness support groups, how about you try your community for balance exercises, for example? You can also look for tai chi classes and classes designed for falls prevention. You will most likely find others dealing with similar issues.

4) At the end of your “trial” with this plan, reassess your symptoms and your goals. You may find that you were on the right track, or you may need to start on number one all over again and try a different treatment plan.

Keep in mind that, even if you need to go back and follow a different course of action, that is okay. It will not be forever. Give yourself again about six weeks time and reassess. Stay in the present moment as much as you can, focusing on what you can effectively do right then and there.

“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.

Gravol is a drug that acts on the central nervous system. It can be thought of as a numbing agent. It reduces the sensitivity of your central nervous system, and it usually works very well at reducing nausea. It is a symptomatic medication. If it helps you, it will not tell you the reason for your nausea. If you respond to Gravol, that is good because you will have less symptoms. But your healthcare team will need to continue to dig deeper to understand why you are having nausea.

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.

Not all specialists have a particular interest or specialization in vestibular migraine. Ask your referring doctor to match you to one who does. For example, some neuro-otologists, neurologists and neuro-ophthalmologists are comfortable diagnosing and managing headache disorders, including vestibular migraine. This is less common, however, for generalist otologists (ear, nose and throat doctors). Some physiotherapists may be knowledgeable about headaches. Many, however, are more interested in balance and muscle- and joint-related issues. Read more about vestibular migraine.

“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.

The half-somersault manoeuvre is meant to be self-taught and performed, but, depending on how dizzy, fit and healthy you are, it may be difficult to do. It is an alternative to the Epley manoeuvre, which can also be self-administered. You can read more about the half-somersault maoneuvre here.

Alternatively, you can see a vestibular physiotherapist who can help you with the manoeuvres, both teaching you how to do them and performing them for you. You can find a Vestibular Physiotherapist in your area here. Choose “Find a Physio” or “Find a Clinic” and select the “Advanced Search” option. Enter your criteria, including your city.

I couldn’t help but notice that you mentioned in your email that you suffer from Ménière’s Disease. Note that these manoeuvres are aimed at positional vertigo, which may occur in Ménière’s disease. Positional vertigo presents as short-lived episodes of spinning dizziness that occur only when you move your head in certain ways. On the other hand, Ménière’s Disease presents with intense spinning (dizziness) episodes, that come on suddenly, often for no apparent reason. These are often accompanied by vomiting and last for hours. The manoeuvres for positional vertigo are not recommended when these longer and more severe episodes occur.

There are some environmental aids that can help, for example wrist guards or hip protectors can provide some degree of protection. There are also some simple things you can do to help avoid falls in the first place. Examples include reducing clutter around the house, clearing paths for walking, using mobility aids, and installing grab bars and good lighting. Your therapist may also work with your on improving your strength and balance to either avoid losing your balance, or if possible, better controlling the force of a fall.

You have expressed the feelings of many people affected by dizziness! It is not always easy to find support in your community; you end up seeing quite a few professionals and they are not always on the same page as to your diagnosis and treatment plan. You may be left with uncertainty about what you can expect in the future. Without getting into too much detail about your diagnosis and treatment (you can read more about BPPV here) you are encouraged to do the following:

1) Get informed (learning more about BPPV is a start) and then clarify with your healthcare professionals what their treatment plan is. Ask as many questions as you need. Read some more if you need to. Here is a list of recommended books.

2) Once you feel you have a direction to follow for treatment, stick with it for a set amount of time. Six weeks is a reasonable time frame. During this time, try your very best to stick with the treatment plan and to stay positive.

3) Use the online resources of our Society and your local sources of support. Since you mentioned that there are no specific dizziness support groups, how about you try your community for balance exercises, for example? You can also look for tai chi classes and classes designed for falls prevention. You will most likely find others dealing with similar issues.

4) At the end of your “trial” with this plan, reassess your symptoms and your goals. You may find that you were on the right track, or you may need to start on number one all over again and try a different treatment plan.

Keep in mind that, even if you need to go back and follow a different course of action, that is okay. It will not be forever. Give yourself again about six weeks time and reassess. Stay in the present moment as much as you can, focusing on what you can effectively do right then and there.

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.

You have expressed the feelings of many people affected by dizziness! It is not always easy to find support in your community; you end up seeing quite a few professionals and they are not always on the same page as to your diagnosis and treatment plan. You may be left with uncertainty about what you can expect in the future. Without getting into too much detail about your diagnosis and treatment (you can read more about BPPV here) you are encouraged to do the following:

1) Get informed (learning more about BPPV is a start) and then clarify with your healthcare professionals what their treatment plan is. Ask as many questions as you need. Read some more if you need to. Here is a list of recommended books.

2) Once you feel you have a direction to follow for treatment, stick with it for a set amount of time. Six weeks is a reasonable time frame. During this time, try your very best to stick with the treatment plan and to stay positive.

3) Use the online resources of our Society and your local sources of support. Since you mentioned that there are no specific dizziness support groups, how about you try your community for balance exercises, for example? You can also look for tai chi classes and classes designed for falls prevention. You will most likely find others dealing with similar issues.

4) At the end of your “trial” with this plan, reassess your symptoms and your goals. You may find that you were on the right track, or you may need to start on number one all over again and try a different treatment plan.

Keep in mind that, even if you need to go back and follow a different course of action, that is okay. It will not be forever. Give yourself again about six weeks time and reassess. Stay in the present moment as much as you can, focusing on what you can effectively do right then and there.

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.

The balance system is complex and in fact involves 3 major sensory input systems, all controlled by the brain. The inner ear sensors for balance, eyes and the proprioceptors on the body all send information to the brain. Balance centres receive, analyze and integrate these bits of information and then send orders to the body to readjust according to the movement done in the first place.

When you are dizzy with computer use, it usually means that the balance system is relying more heavily on the visual input. It is not fully reassured by the inner ear sensors telling them you are not moving. For more information, read our Motion and Cyber Sickness article.

Having the weights on you or changing your posture as you walk is increasing the cues coming from the proprioceptive system to the brain. This additional input seems to help you balance.

I would recommend you to have your inner ear sensors tested. It might be that they are working just fine but your centres in the brain are not using their information properly or it might be that your brain is in need of all this additional information (visual and proprioception) because your inner ear sensors are dysfunctional.

The balance system is complex and in fact involves 3 major sensory input systems, all controlled by the brain. The inner ear sensors for balance, eyes and the proprioceptors on the body all send information to the brain. Balance centres receive, analyze and integrate these bits of information and then send orders to the body to readjust according to the movement done in the first place.

When you are dizzy with computer use, it usually means that the balance system is relying more heavily on the visual input. It is not fully reassured by the inner ear sensors telling them you are not moving. For more information, read our Motion and Cyber Sickness article.

Having the weights on you or changing your posture as you walk is increasing the cues coming from the proprioceptive system to the brain. This additional input seems to help you balance.

I would recommend you to have your inner ear sensors tested. It might be that they are working just fine but your centres in the brain are not using their information properly or it might be that your brain is in need of all this additional information (visual and proprioception) because your inner ear sensors are dysfunctional.

The balance system is complex and in fact involves 3 major sensory input systems, all controlled by the brain. The inner ear sensors for balance, eyes and the proprioceptors on the body all send information to the brain. Balance centres receive, analyze and integrate these bits of information and then send orders to the body to readjust according to the movement done in the first place.

When you are dizzy with computer use, it usually means that the balance system is relying more heavily on the visual input. It is not fully reassured by the inner ear sensors telling them you are not moving. For more information, read our Motion and Cyber Sickness article.

Having the weights on you or changing your posture as you walk is increasing the cues coming from the proprioceptive system to the brain. This additional input seems to help you balance.

I would recommend you to have your inner ear sensors tested. It might be that they are working just fine but your centres in the brain are not using their information properly or it might be that your brain is in need of all this additional information (visual and proprioception) because your inner ear sensors are dysfunctional.