Inner ear / balance problem

peterwright said:

I have just been diagnosed, outof the blue, with an inner ear / vestibular virus that sees me hardly able to walk and spinning out if i try. It has totally derailed my rididng and I am very depressed as i have a lot of important events coming up. Has anyone out there had similar experiences and if so any suggestions for getting healthy quickly and if so how long were you off the bike ?

I had it at a time when I was travelling and non riding at all.
I was off my feet for ~2 days and took a couple more to be feeling good again.
Not sure of anything that helps heal more quickly apart from the usual things with viruses; i.e. rest, plenty of fluids, healthy food...
If it does persist, you can try something called an Epley Manoeuvre with either a physiotherapist or you local doctor. Not particularly pleasant but it often works well for relieving vertigo.

I have Meniere's Disease, which is an inner ear disorder that basically can result in the same things that you are experiencing. So yeah, you bet that I can relate. There are treatment options for vertigo, which any good MD can work you through. Is there a magic wand to get you through it quicker? Well sort of...just heal. On days when it's like I am riding on my own tilt a whirl. I prop up in bed and fire up the Tivo. Would I rather be out riding, well hell yeah, or any number of other things. Is that realistically an option though, not remotely. I just have to get still and quiet, follow my treatment options and let it pass.

There is definitely nothing to be gained by stessing out and getting frustrated. This is especially true in your case where it sounds like the condition is temporary and treatable. Give yourself some time to recover. And don't make it any harder on yourself than you have to. A vertigo condition puts a ton of stress on the brain and on the body. It can be dibilitating as hell and can definitely lead you into a funk while you are off of your feet. That is understandable. Don't make it worse though by fighting it with frustration and anger. You didn't ask for this condition. It just happened. I would think that what you would need to do now is to help your body out until the virus has run its course.

Either way, be really careful not to push getting active again too soon. It won't be smart either to get back on the bike on the road until you are really ready. That will only invite more issues, and the distinct possibility for permanent injury issues at that. I deal with vertigo and balance issues pretty much every week at some point or another. Believe me, you can't ride a bike when your brain is telling you that your body is spinning. And until this virus effect has run its course, something as simple as twisting your head back to check traffic can send you careening off the road in complete disorientation. Worse yet, it can just as easily send you careening into oncoming traffic.

In basic terms, cut yourself some frikkin slack Peter! Take it real easy. Heal up. And when you are back on your own two feet, work your way back onto the road.

Hope this helps big guy. 😉

rule62 said:

I have Meniere's Disease, which is an inner ear disorder that basically can result in the same things that you are experiencing. So yeah, you bet that I can relate. There are treatment options for vertigo, which any good MD can work you through. Is there a magic wand to get you through it quicker? Well sort of...just heal. On days when it's like I am riding on my own tilt a whirl. I prop up in bed and fire up the Tivo. Would I rather be out riding, well hell yeah, or any number of other things. Is that realistically an option though, not remotely. I just have to get still and quiet, follow my treatment options and let it pass.

There is definitely nothing to be gained by stessing out and getting frustrated. This is especially true in your case where it sounds like the condition is temporary and treatable. Give yourself some time to recover. And don't make it any harder on yourself than you have to. A vertigo condition puts a ton of stress on the brain and on the body. It can be dibilitating as hell and can definitely lead you into a funk while you are off of your feet. That is understandable. Don't make it worse though by fighting it with frustration and anger. You didn't ask for this condition. It just happened. I would think that what you would need to do now is to help your body out until the virus has run its course.

Either way, be really careful not to push getting active again too soon. It won't be smart either to get back on the bike on the road until you are really ready. That will only invite more issues, and the distinct possibility for permanent injury issues at that. I deal with vertigo and balance issues pretty much every week at some point or another. Believe me, you can't ride a bike when your brain is telling you that your body is spinning. And until this virus effect has run its course, something as simple as twisting your head back to check traffic can send you careening off the road in complete disorientation. Worse yet, it can just as easily send you careening into oncoming traffic.

In basic terms, cut yourself some frikkin slack Peter! Take it real easy. Heal up. And when you are back on your own two feet, work your way back onto the road.

Hope this helps big guy. 😉

Hey Rule62

Firstly, thanks for such a thoughtful and helpful response - much appreciated.
You have hit on so many of my feelings at present. I had an MRI this morning and feel a lot better as the result was clear - at least i am not dealing with something life threatening. I believe I have Vestibuar Neuronitis - an acute attack that I am working through. I seem to be making daily progress (never as fast as i want) and am walking out and baout now - will probably have a tentative ride next week - going mad oherwise. Lots of ear rehab exercises being done - walking pidgeon toes along a straight line like a drunk test etc etc - all very frustrating but I treat it like training.

Anyway - once again a big thanks for the encouragement and support.

Peter

No problem Peter. Glad to hear that things are looking better! 🙂

rule62 said:

No problem Peter. Glad to hear that things are looking better! 🙂

Just went out on road for a quick test ride having ridden around indoors for a bit -rode into a curb, fell off and banged my knee and put a ding in my rim. Feel like an idiot and wish I hadnt as I am now also pretty shaken up by what happened (and what could have happened)

I really felt like I could do it but got really odd sensations when I moved my head around. Funny because driving is fine which i know others suffer with.

Back to the drawing board, trouble is have lost confidence in my judgement now so don't know when to try again.

Peter

Bummer Peter. I can guess how you are feeling about now. Maybe next time try your test on grass? :o

There were many times that I wondered if I could retrain my balance centers to function to the point that I could be safe out on a bike. All that I can say is that for me, it took a while but it did work out. There are still days when I have learned to stay off the road, but they are the exception and not the norm. The first time I went to the swimming pool it was pretty weird too. I don't know if it was the weightlessness, or the action of the water, but it threw me for a loop. After a few more visits and a little time to get used to it though, it isn't an issue for me unless I am having a bad day all together.

The bike test that I use is to sit on my bike balancing against something - like in the middle of a a doorway and using only light pressure with my finger tips to stay centered. I look back like I am checking traffic, down and up, like I am checking my gears, etc. On the days when I am safe to head out, I don't get any residual feeling of motion when my head moves back facing forward. On the days when I find that I will need to stay in, when I pull my head back around from checking behind me for example, my balance center ping pongs back and forth a few times before reorienting to the front.

Bottom line for me though has been that I have been a lot more able to adapt than I ever thought that I would. Confidence questions and a bit of uncertainty are there many days, but not to the point that I can't tell pretty quickly whether I have any business going out on the road. And I am well over 2,000 road miles already this year, with about another 1,200 on the trainer. So keep your chin up Peter. Don't let a set back shake you too much. Learn what you can from it and don't quit! You are a likely a lot closer to turning the corner than you might think. 😉

Hi Rule

Thanks again - you seem to be a real support for me at present. I have been sitting here nursing my sore knee and feeling real stupid for getting it so wrong and also planning to cancel my weeks training camp next Mon to Fri.

I plan to do nothing until Fri this week and then do your test as suggested.

The problem today was definitwly on returning head to forwards after clipping in - that was what threw me off. I had ridden round in curcles indoors prior to that with no problems but in trainers and so not having to look down ! Amazing what a diffewrence that made to the loss of balance.

Like you say - a learning experience but there you go. I certainly will not quit and will ride again soon.

Once again, thanks so much for your support.

Cheers

Peter

Hello, Peter,
Have you considered the idea that you may have a pinched nerve or structural pressure surrounding the vestibular nerve? If vestibular neuronitis is what they are diagnosising you with, it is basically "inflammation of the vestibular nerve". My question would be why?

Chiropractic would be an option and has proven time and time again to deliver wonderful results in the instances of ear infections, as it removes pressure on the ear canal allowing the tissues to heal and drain. Vertigo is another common condition that is easily treatable in some cases.

Hi Dr Serena

Thanks for your post. I have seen an ENT specialist and she was unsure about the diagnosis but was clear that I had suffered an acute vestibular event.I had not had any hearing problems nor any previous noticeable virus. As a result of this she sent me for an MRI which I duly had. The MRI showed no problems and i assumed no inflammation of the vestibular nerve ? I therefore assumed vestibualr neuronitis as a result of a virus. The odd thing is that I have not felt poorly apart from the vertigo systems at any point - I have not felt viral so to speak !

I did have a stiff neck on waking a few weeks prior to the event and I suppose this could have been linked but am not really sure.

I have focused on just exposing myself to normal daily events in an attempt to fast track my recovery and get back on the bike etc. I feel ok after an indoor session (thankfully i did not fall off this bike)

I will gladly consult a Chiro or physio if you think there could be some progress in so fdoing. i had simply assumed I was going through the "normal" recovery and re-adjustment process.

Thanks

Peter

Yes from further details I would definately consult a doctor of chiropractic. A physiotherapist would not be appropriate in diagnosing your condition further as it relates to nerve impingement as they are not doctors by education, but instead therapists. Doctors of chiropractic are highly trained in understanding the pathways of the delicate nervous system. Some chiropractors also are familiar with cranio-sacral which may also be beneficial. Those that practice kinesiology (muscle testing) also work with cranials, but ask your friends and colleques for names. The best way to find a chiropractor is by referral.

Good luck. I think you really find chiropractic, regardless, to benefit your overall athletism, as well as find it a great form of prevention from sports injuries just as Lance has.

You could try the Epley Manoevre!!!

Either a general practitioner or a physio could do this with you.

If you are going to a chiroprator, look into them first as there are some very dodgey ones around and the published evidence for their effectiveness is rather scanty at best.

Peter-
You should be aware that vertigo is not just related to the ear (such as neuritis, virus, etc) or nerve irritation from a misalignment in the spine or cranials either. When someone enters my office with this, I also assume it could be vascular insufficiency either from weakened vasculature or compression from a degenerative spine. This is serious. Approach to treatment is different in these cases but still beneficial. It is important to find someone that you know is well educated.

To ease your mind if you were considering...there is actually alot of evidenced based research supporting chiropractic manipulative therapy in scientific journals. In fact, due to the research and the longstanding history in the United States, the government has now placed chiropractic with the Department of Defense, Veteren's Hospitals, and on Capitol Hill. Third party reimbursements also are covering chiropractic due to the research they have been provided.

I've listed some sites below where you will find research, including peer-reviewed journals, on vertigo and chiropractic:

http://www.chiroweb.com/archives/15/04/08.html

http://www.chiroweb.com/archives/13/26/07.html

http://www.chiroweb.com/archives/13/02/03.html

This one includes an article on the Epley's:
jcca-online.orgSearchView!SearchView&Query=VertigoOpen ↗

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a104086&nav=abs&special=hilite&query=%5Ball_fields%5D%28vertigo%2Cmanipulation%2C%29

http://www.chiroweb.com/find/research.html

http://www.amerchiro.org/media/research/

I'm off my soap box....just passionate about what I do. It may not be the answer but its another opinion and option to check into.

Hi DrSerena

Thanks for the post - I took your advice and have today had a session with a well known local chro who rides a bike !

He manipulated the opposite side of my neck to where the poorly ear / side is and has arranged for me to come back on friday for another session. If the diagnosis is not BPV (ENT ruled this out) and is a viral infection, then can the manipulation still help me ? If so how ?

As I have already also confirmed via the MRI that there is no swelling of the vestibular nerve on either side, does this not rule out this type of manipulation as effective treatment ?

Help me here because from what I can see and research, Chiropractic treatment seems to be implicated more in cases of BPV ?

Anyway - I am giving it a full go in the hope he can get me on my bike quicker.

Cheers

Peter

peterwright said:

I have just been diagnosed, outof the blue, with an inner ear / vestibular virus that sees me hardly able to walk and spinning out if i try. It has totally derailed my rididng and I am very depressed as i have a lot of important events coming up. Has anyone out there had similar experiences and if so any suggestions for getting healthy quickly and if so how long were you off the bike ?

Thanks

Peter

Peter,

This may not be similar. But I have experience an Vertigo which cause my dizziness from 2000-2002 2weeks on and off. It took me 1 and half year to recover by seeing the ENT (ear, nose and tounge) specialist. After it stop finally got back on my bike and won the Dual Deaflympic Gold Medal here in Melbourne, 2005 January. But sudden 1 month ago i've fractured my skull, and now having ear balance trouble which sometimes i walk off the balance. Which I've never experience it. But I know what to do to get the result and see what can get fix. Simple see the ENT or Neurologist that could help you.

Regards
Reece-Emerson van Beek

Hello Peter.

I am an audiologist practicing in a balance center in Grand Rapids, Michigan. As you might imagine, providing diagnostic information over the internet is frought with problems. I will do my best to answer whatever questions you have.

A couple of points of importance:

There have been posts here suggesting the Epley Maneauver. This is totally contraindicated if you are truly experiencing just vestibular neuronitis. The Epley is treatment specifically for Benign Paroxysmal Positional Vertigo. It requires proper training and a thorough understanding of the mechanisms of the vestibular system. The Epley should not be performed unless you have BPPV, and the involved ear and semicircular canal is clearly identified.

If your problem was cervical vertigo, then possibly Chiropractic treatment would be of some benefit. I do not see how it would provide relief for vestibular neuronitis. I could explain that to you more in another post if you wish.

Virus attacks do not necessarily cause you to have symptoms such as the flu etc. They can be specific to the inner ear or even just a part of the inner ear (hearing or balance) or the associated nerves. If your problem was indeed virus related (you may never know), it has probably done it's damage and gone on it's way. There may be medications to help you but that should be discussed with your doctor. Regardless, vestibular therapy is the correct way to go in such cases. This will take time. Your brain needs to compensate for the problem. It is a natural compensation, and therapy only aids in that process.

Patience and vigilant compliance with the therapy regimen will ultimately get you where you want to go.

Best wishes.

[font=Comic Sans MS]I have had a simular problem for years. It comes and goes without warning. My doctors keep saying it is a virus, but offer no solution but an over-the-counter drug known as Meclizine. One doctor told me "The good news is these things usually burn themselves out; the bad news is they usually take your hearing when they do." My symtoms include vetigo, loss of balance, and sudden loss of hearing in one ear. If anyone has a real solution, I would like to hear it. It's a pain in the ass.[/font]

undefinedVery cool. We ride bike too....Dr. Alyson actually conducted a cycling study in our office measuring power output with our custom orthotics.

undefined Benign Positional Vertigo means basically "non pathogenic or non-serious" and involves the labrynthine or inner ear. So the ENT ruled this out- good. MRI ruled out pathology to the vestibular nerve. Any alterations in taste, smell, vision, or difficulty talking? Does your ear feel full, plugged, or itchy? Is your ear red? Have you had a recent infection of some sort? Have you been prone to ear problems in the past? Would you describe that you have more dizziness or loss of position in space? Did you have a recent accident or fall to the head?

As much as chiropractic can also affect the cranial nerves exiting out from the spine in the upper cervical region (ie. vestibularcochlear nerve-CN 8) which affects vertigo it also involves the neck which is a HUGE area of "balance" receptors for the body-letting your body know where it is in space. Why did they say it was a virus? Is it because they can't find anything else at this point? I wouldn't doubt that its possible but let's consider elsewhere. The body is more complicated than anyone could imagine. Just because vertigo is commonly associated with the ear doesn't mean necessarily coming from the ear. I've had neck pain clear up by supporting the feet-kinetic chain....think cassette and chain on your bike.

undefinedLewit states that upper cervical spine receptors are very important for equilibrium and thus, "it is no coincidence that vertigo and dizziness are very frequently of cervical origin."11 Basic scientists support this statement. For example, Guyton states that, "by far the most important proprioceptive information needed for the maintenance of equilibrium is that derived from the joint receptors of the neck."

Read the second chiroweb information for more explanation and diagnostic orthopedic tests used to help determine some of this.

undefined BPV can be caused by head and neck trauma, colds, etc and these all also affect the neck. If you were reading some of this correlation than it would only make sense to also have chiropractic, but that doesn't mean you can't recieve chiropractic if BPV is not what you have. If you read the first two chiroweb sites you will see that they are not discussing chirorpactic and treating BPV but chiropractic and treating the neck which affects proprioceptors which affect equilibrium.

It sounds like your in good hands. Think of it as also a spinal check-up since youv'e never had one, much like a dental check-up. You only have one spine, you know and you should value it like you do your teeth. Benefits you should also be experiencing include improved range of motion, decreased neck tension, improved strength into the upperbody, as well as improved nervous control to the organs affected by cervical nerves.

Be patient and give it time. The first few visits are really fine tuning and allowing the doctor to understand how your body as an individual responds to care. The tissues surround the neck will want to play "tug-o-war" so it takes some consistency to "put 'em in their place".

In Health,
Serena

Hi Otofreq

Thanks for taking the time to post.

I think that on balance 😄 it is likely that I had or have a virus and that vest neuronitis is the most likely diagnosis. My doubt lies in that the ENT could not confirm this due to insufficient nausea and an inability to show that any hearing deficiency was NOT there before I came to see her. On top of this my GP had me taking Stugeron and so i was medicated when I saw her.

I have been doing some of the exercises she gave me and have been exposing myself to general life activity such as work and driving and walking, in the hope that this will help my brain to re-adjust.

My reason for looking at the Chiropractic option (apart from the uncertain diagnosis above) is that I had a sore neck for 2 weeks leading up to the attack and I also had a heavy fall from my bike in jan/Feb this year and banged my head and neck. i felt that Chiro treatment might also help my recovery speed up by freeing up the neck ?

Please can you advise on what are the most effective exercises to finish the rehab process. I really feel I am at 80% and a little bit stuck there. Improvement is difficult to quantify now and progress seems very slow / plateaued. I want to be sure I am doing the right thing ?

Thanks for any help.

Peter

Had Labarynthitus last year - the viral kind - causes you to be sick constantly for a couple of days and you loose your balance for quite some time. I was unable to ride or drive for over three months! Bloomin awful - complete loss of condition and very depressing - so I sympatise.

All I could do for much of the time was lie down. Once you are able to walk properly - go for longer and longer walks - this does seem to help somewhat - although this may just be the fact that I was outside!

Hope you get well soon.