Sufferers of vertigo will know how debilitating it can be – and how frustrating it is when it persists.
But if your doctor keeps sending you away with medication after it’s been ongoing for a month, know that experts have now warned they will do no good.
Instead, patients who experience chronic symptoms – which can include dizziness, loss of balance and feeling sick or being sick – should be given exercises to do.
In a study published by the British Medical Journal, a team of researchers recommend that doctors prescribe vestibular rehabilitation, a form of ‘brain retraining’.
It involves carrying out a special programme of activities that encourage your brain to adapt to the abnormal messages sent from your ears.
Experts say that chronic vertigo should not be treated with medication but with vestibular rehabilitation, a form of ‘brain retraining’ (file photo)
Vertigo – defined as a false sensation that the body or environment is moving – is a symptom, rather than a health condition itself.
Each year around 1 in 20 people experience vertigo, according to the study’s authors from the University of Bristol and VU University Medical Center Amsterdam.
Around 80 per cent of sufferers find that it severely impairs their daily functioning.
It is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain.
Some cases improve over time, without treatment. However, some people have repeated episodes for many months, or even years, such as those with Ménière’s disease.
Medicines, such as prochlorperazine and some antihistamines, can help in the early stages or most cases of vertigo – but not after four weeks say the team.
The team examined the medical literature and found that there is ‘moderate evidence’ – partly from general practice studies – that vestibular rehabilitation ‘is a safe and effective treatment for chronic vertigo’.
On the other hand, they say, there is ‘low evidence’ that patients with chronic vertigo can find relief with anti-vertigo drug betahistine compared with a placebo.
The experts recommend doctors initially offer patients presenting with vertigo specific treatments – which may include drugs – for the disorder they suspect they have.
But if vertigo symptoms persist for more than a month they make clear: ‘There is no place for betahistine or any other anti-vertigo drugs in the treatment of chronic vertigo: stop all anti-vertigo drugs that the patient is using for acute vertigo and offer vestibular rehabilitation to all patients with chronic vertigo.’
They also note that a recently published trial on patients accessing the exercise methods online was shown to be ‘effective and well liked by patients with chronic vertigo’.
Patients who need more support should be offered referral to physiotherapists or audiologists they say.
WHAT IS VESTIBULAR VERTIGO?
Vestibular rehabilitation, also called vestibular rehabilitation training or VRT, is a form of ‘brain retraining’.
It involves carrying out a special programme of exercises that encourage your brain to adapt to the abnormal messages sent from your ears.
During VRT, you keep moving despite feelings of dizziness and vertigo. Your brain should eventually learn to rely on the signals coming from the rest of your body, such as your eyes and legs, rather than the confusing signals coming from your inner ear.
By relying on other signals, your brain minimises any dizziness and helps you to maintain your balance.
An audiologist (hearing specialist) or a physiotherapist may provide VRT. Your GP may be able to refer you for VRT, although it depends on availability in your area.
In some cases, it may be possible to use VRT without specialist help. Research has shown that people with some types of vertigo can improve their symptoms using a self-help VRT booklet.
However, you should discuss this with your doctor first. If it’s likely to be useful, you can download a copy of this booklet from the Ménière’s Society.
Source: NHS Choices