When you think of the brain and/or nervous system, what comes to mind? For most people, they think of the big cerebral cortex under the skull that weighs about 3 pounds.
What if were to tell you that one of the most powerful systems in the entire nervous system starts in the inner ear? Within the inner ear lies the vestibular system. The vestibular system is extremely complicated and is made up of a bunch of very tiny anatomical structures that send information to our brain when we move through our environment. This can be any movement of your head or body in space such as walking, turning your head, going in an elevator or escalator, riding in a car, running, biking, turning over in bed, etc. If your vestibular system works well, you’ll take it for granted and not think twice about it. If your vestibular system is dysfunctional, you may have significant symptoms.
What Symptoms Could I Have if I Had Issues With My Vestibular System?
- Vertigo (spinning sensation)
- Motion Sickness
- Unsteadiness on your feet or loss of balance
- Feeling of being pulled to one direction
- Tightness on one side of your body
- Nausea and/or vomiting
- “Sensory Overload”
- Troubles processing movement in your environment
- Difficulty functioning in big crowds, grocery stores or in areas with a lot of lights, sounds, colors, movement, etc
- Neck pain/stiffness (especially when imaging looks normal)
- Abnormal Heart Rhythms
As you can see, the vestibular system can contribute to a whole host of symptoms when it’s not working optimally. Your brain thrives off of receiving and processing sensory input (light, sound, touch/feel, taste, smell and also feedback from your body in regards to movement). When the information coming in from your vestibular system is accurate and your brain processes it well, you likely won’t experience many of the symptoms listed above (assuming the vestibular system is the cause). If the information coming in from your vestibular system is slow, inaccurate and doesn’t match up with information coming through your visual field or from other feedback coming from the muscles, receptors and joints in your body, then we have a high likelihood of developing symptoms.
Some of the symptoms may feel like more of a nuisance, such as neck pain, whereas other symptoms may be debilitating, like anxiety, migraines, vertigo, loss of balance, etc.
What Causes Vestibular Dysfunction?
I’m sure you’re puzzled by what could possibly cause an issue inside your inner ear or in the areas of the brain that process/receive the information coming from the inner ear/vestibular system.
You’re probably saying to yourself “I haven’t had any trauma in that area, so how can it get injured?”
Here are some of the most common reasons the vestibular system becomes dysfunctional:
- Concussion/Traumatic Brain Injury
- Calcium stones/”crystals” that reposition in the wrong location within the inner ear (top cause of vertigo)
- Viral infection
- Tick-Borne Infection (Lyme Disease is the most famous)
- Poor blood flow/circulation
What do you do if your vestibular symptoms are caused by a dysregulated immune system?
If there is an immune mechanism that can damage to the nervous system and specific nerves related to the vestibular system, such as Lyme disease, co-infections, viral infections, autoimmunity and inflammation, then that issue must be addressed as soon as possible. We use functional medicine to help address the underlying cause in these cases. Functional medicine uses supplements (herbs, vitamins, minerals, homeopathic products) and diet/lifestyle recommendations to try to calm down the immune response and restore proper immune function as much as possible.
Once we are seeing progress with the immune system, we then recommend doing therapy to help strengthen the vestibular system and increase function.
How does therapy or exercises to my vestibular system help? What kind of things would I be doing in therapy?
The brain and nervous system works very similar to how a muscle functions. If you have a muscle that has become very weak, how do you get it stronger? There is no diet or supplement in the world that will get that muscle stronger unless………you exercise the muscles! You can to stimulate/activate the muscle to replicate protein and hypertrophy the muscle to make it stronger. Use it or lose it! Same exact mechanism happens in the brain.
If the inflammation, infection or immune-based issue is being addressed, you’re essentially putting the vestibular system and brain in a good environment for it to heal, but you still need to activate the pathways to get the function to improve. Just living your life will stimulate the vestibular system. You activate it by going for a walk, riding in a car, exercising, etc. However, when you have two sides to your vestibular system (each inner ear), there needs to be a nice symmetrical balance between both sides and your brain also needs to process the information well. This is where functional neurology comes in.
Functional neurology involves a detailed examination to look into the function of brain and nervous system. We look at not just the vestibular system, but also all of the other systems that can influence the vestibular system and how it functions. For example, eye movements, vision, balance and proprioception (feedback from your body to your brain letting you know where you are in space, especially if your eyes are closed or it’s dark) all influence the vestibular system. We need to look at the whole picture and develop a plan that is specific to YOU! It’s not a one-sized-fits-all approach. You need a plan that is specific to your needs.
After a comprehensive functional neurological examination, we will apply a series of specific exercises that target areas that aren’t functioning optimally. By stimulating these pathways (without promoting symptoms), the goal is to build up the metabolic capacity and endurance of the pathways so your brain and vestibular system can handle much more stimulation without fatiguing and giving you symptoms. Again, the common symptoms are mentioned above. Some of the common exercises functional neurology involves focus on the following: balance, fine motor coordination, eye movements, vestibular rehab (head and body movement with and without fixating on a target), gait, sensory feedback, motor planning, etc. For more a more detailed explanation of what functional neurology is, click here.