Mar 29, 2023 The Hearing/Balance Connection

What to Know About Dizziness, Vertigo and Other Unsteady Sensations

Feeling dizzy, lightheaded or otherwise unsteady is as common as it is dangerous. About 69 million Americans have balance problems including vertigo—the sensation of spinning or moving even though your body remains still. Balance difficulties often contribute to potentially debilitating falls in people over age 65. That makes it important to understand what keeps us steady and what can go wrong, says Jinbo Jung, DPT, Senior Physical Therapist at the Robert Wood Johnson University Hospital (RWJUH) Hamilton Balance and Hearing Center.

Dizziness isn’t just a vision problem.

“There’s a relationship between hearing and the balance, or vestibular, system,” Jung says. What experts sometimes call the balance organ is located in the inner ears. It consists of a bony structure containing three fluid-filled canals that help determine where the body is in space. Nerves connect the vestibular system to the brain, which sends information through the central nervous system to the rest of the body. “The vestibular system is sensitive to changes in head and body position, which also involves movement of the eyes,” Jung says.

Solutions often come from physical therapists and audiologists.

Primary care physicians often refer patients with balance problems to an audiologist who has expertise in assessingvestibular disorders. Treatment is then often handled by physical therapists specially trained in vestibular therapy. Vestibular deficits can make everyday activities like walking, climbing stairs, showering and brushing teeth difficult, but therapy can rehabilitate people and help them regain control over their movements, activities and lives.

Tests can pinpoint problems.

A variety of tests help audiologists and physical therapists understand what’s causing balance issues. For example, using a variety of methods to observe eye movements as the head tilts in assorted positions or as you view an object from different directions can reveal which ear and even what part of the vestibular organ is involved. Simple body movements can restore balance. Many cases of dizziness are caused by a condition called benign paroxysmal positional vertigo (BPPV), in which tiny crystals that help maintain orientation in the inner ear become displaced. “The distinct feature of BPPV is a room-spinning sensation,” Jung says. “Treating it requires a simple maneuver to get crystals back where they belong.” A therapist often can correct the problem in a single session.

Treatment is individually tailored.

People with severe symptoms, difficulties with either ears or more complex vestibular issues may require multiple sessions or additional forms of rehabilitation therapy. A trained vestibular therapist may work on posture, head position and gaze to help people deal with problems such as staying balanced while walking, especially when turning the head—as you might do while strolling down a grocery aisle. In some cases, balance difficulties may signal an underlying chronic health issue such as uncontrolled diabetes or blood pressure, or an issue with the neck or brain.

“Most people see good results from vestibular therapy in a matter of weeks,” Jung says. “If they don’t, we know what to recommend for further evaluation, such as seeing a neurologist, to get people the help they need.”

Hope For Hearing Loss

Judith McCallisterJudith McCallister had tried hearing aids before, but they didn’t seem to help much. Then a nephew of the 79-year-old resident of Bucks County, PA, encouraged her to seek help at the nearby Robert Wood Johnson University Hospital (RWJUH) Hamilton Balance and Hearing Center. “After a couple of follow-up visits, my new hearing aids were working properly,” McCallister says. “I absolutely am feeling different and more independent. My phone is through my hearing aids—I even stream TV through them.” More people like McCallister could have similar success. Hearing loss affects about a third of adults ages 65 to 74 and nearly half of those older than 75, according to the National Institute on Aging. Yet only about 20 percent of people who might benefit from treatment seek help. “There’s an unfortunate stigma around hearing loss and treatment options, especially hearing aids, but hearing loss is a common medical condition,” says Lorraine Sgarlato, AuD, Senior Audiologist at the Balance and Hearing Center. It’s not a superficial problem. “Adults with hearing loss are at higher risk of developing certain health conditions such as social isolation, depression, anxiety, falls, cognitive decline and even dementia,” Sgarlato says. She recommends adults ages 50 to 60 get screened for hearing loss and those 61 and older receive diagnostic testing annually. Treatment options include hearing aids, special training, certain medicines and surgery, with options tailored to patients’ lifestyles and resources. The RWJUH Hamilton Balance and Hearing Center offers a 30-day full refund on hearing aids, which allows patients to find the right match and fit at no cost until they’re fully satisfied with a hearing device.

Do You Have Healthy Hearing?

You might need a hearing evaluation if:

  • You experience dizziness
  • You’ve had a fall
  • You have pain or ringing in your ears
  • People around you often seem to mumble
  • You often ask people to repeat themselves
  • Others complain that you turn the TV volume too high
  • You have trouble following conversations when more than one person is talking
  • You have to listen carefully or strain to understand a conversation
  • You have trouble hearing on the phone
  • You have difficulty hearing in noisy settings such as restaurants

RWJ Balance & Hearing Center is located at 2 Hamilton Health Place, Hamilton Township, NJ 08690. Call (609) 245-7390 to schedule an appointment.