Self Help for Vertigo - Meniere’s Disease
What is Meniere’s Disease?
This is a condition of the vestibular system and is characterized by a group of symptoms which are:
- Intermittent attacks of vertigo usually lasting a few hours
- A sound in your ear – Tinnitus
- Hearing loss
- Feeling of fullness or pressure
The symptoms of tinnitus, hearing loss and ear fullness usually affects one ear although it can affect both ears in very rare cases. You can get a spell of frequent vertigo attacks but they can also go away for long periods of time. In some cases tinnitus and hearing loss may persist and slowly get worse over a period of years.
Is it serious?
Meniere’s disease is not serious but the symptoms can be very troublesome and worrying to you. The vertigo may prevent you from doing your normal daily activities and can sometimes call falls. The hearing loss and tinnitus may affect your quality of life.
It is advisable that you see the vestibular team so that hearing tests and other investigations can be organised.
What causes it?
The exact cause is unknown. It is thought to be due to a build-up of fluid and pressure in your inner ear which affects you balance and hearing systems. The condition occurs more frequently in women and tends to affect people between the ages of 20 -60.
What treatment options are available?
Whilst awaiting your appointment you can do a few things:
- Try to reduce the amount of salt, caffeine and alcohol in your diet
- Keep a diary of attacks. Keeping a note of vertigo, tinnitus, hearing loss and ear fullness helps us make a diagnosis
- Try to reduce stress in your life
- Improve your sleep so that you are well-rested
Your GP might can start you on some medications like Betahistine or Bendroflumethiazide.
For a severe episodes of vertigo, a short course of anti-vertigo and anti-sickness medications like Prochlorperazine and Cinnarizine can help. It is important to note that these medications should not be taken for prolonged periods as they have side-effects. They must not be taken regularly to ‘prevent dizziness’.
Vestibular physiotherapy is a form of treatment to help your balance system. Think of it like a form of exercise specifically for the balance system. The aim is to help your balance system function as well as it possibly can.
There are other more advanced treatments for severe Meniere’s disease and this can be explored with the vestibular team.
What are the benefits and side effects of these treatments?
The lifestyle changes above are safe and quite easy to implement. Some of the medications can have side-effects and this can be discussed with the doctor who prescribed them.
What would happen if I did nothing?
With time, it is likely that the disease will ‘burn itself out’ and you will experience less attacks of severe vertigo. Your balance however may not be completely normal even when the severe episodes go away. The hearing loss can continue to deteriorate and you may need a hearing aid to address this. This often takes years to develop. Tinnitus can become a permanent symptom and some people can find this very troublesome.
How do I get more help and advice?
You might find these websites helpful:
Other things that can help: Tinnitus
Tinnitus is a feature of Meniere’s disease. It can take many forms like buzzing, ringing, humming, whooshing noises and can be at different loudness levels. Over time, most people learn to get used to the tinnitus and are able to ignore it. Sometimes, it can be very loud and troublesome and affect your quality of life or even your sleep. Here are some useful tips to help you with your tinnitus:
- Sound therapy or Masking – You might find that tinnitus is less noticeable during the day especially when there is the noise of daily living in the background. When things get quiet, for example, when alone at home or at bedtime, tinnitus can seem to get louder. Masking is a technique that uses a sound in the background to ‘mask’ or cover the sound of tinnitus. You can use your favourite relaxing music, a radio programme or buy a sound generator. You can even download apps on your smartphone and use earphones. Any noise that you find suitable can be used.
- If you have hearing loss, correcting it with a hearing aid is helpful
- Mindfulness/Coping techniques- This can help by teaching you techniques to deal with stress and anxiety brought on by tinnitus
More advice can be found at tinnitus.org.uk
Exercise
Once your balance improves, you should resume regular exercise which will help your balance system recover slowly. During your normal day to day activities and during exercise, you might think that keeping your head in a fixed position will help prevent dizziness but doing this actually does more harm than good. It is very important to move as naturally as possible to allow your balance system to return to normal.
Here are some simple balance exercises you could try at home:
- Focus on a point in front of you, preferably on a blank wall and shake your head like you are saying “no” or “yes”. Do this until your symptoms start. Try to repeat this 2-3 times per day. If you can manage 30 seconds without getting any symptoms, then you do not need to do this exercise.
- Practise standing with your feet closer together, try holding this position for 30 seconds. If you do not feel steady, try holding onto something. When you feel steady enough to do this without holding on then start doing this when you are washing your hands or brushing your teeth.
- Regular exercise is beneficial. To stay healthy, the UK Chief Medical Officers’ Physical Activity Guidelines, on GOV.UK, state that adults should try to be active every day and aim to do at least 150 minutes of physical activity over a week, through a variety of activities. This can be broken up to 40 minutes of exercise 3 x weekly or 15 minutes 3 x daily.
For more advice on your balance system and exercises see our balance page.
General Health
A good diet and healthy sleeping pattern will make you feel healthier. Reduce the amount of ‘screen time’ as this can cause eye strain. Alcohol can affect the part of the brain that controls balance so we advise reducing alcohol intake.
Make sure you have had a recent eye check with your optician. Eye strain can cause symptoms of dizziness.
Your GP may wish to monitor your blood pressure over a period of time. Both high and low blood pressure can cause dizziness. If you have palpitations, please inform your GP about this.
On occasions, dizziness can be brought on by prescription medication. This is especially so with:
- Antidepressants
- Epilepsy drugs
- Medications to control high blood pressure
- Anxiety medication
- Sleeping tablets
- Painkillers
Anti-Vertigo and Anti-Sickness Medication
These tablets can help during a bad attack of vertigo but we strongly discourage you from taking these medications on a regular basis especially for prolonged periods as they can cause side effects and prevent you from recovering from the original problem. Please do not take them to “prevent dizziness”.
If you take one or a combination of these medications, it may be worthwhile speaking to your GP about the doses or whether or not you need them.
Mental Health
Sometimes, there will be some setbacks in your recovery. Many people with vertigo will feel anxious about resuming activities. This anxiety can affect your confidence in resuming physical activity and delay your recovery. Slow down and increase your activity slowly. Be reassured that feeling this way is quite natural and that most will make a good recovery.
Stress, low mood and anxiety can have many effects on the body. It can make vertigo worse. It is important to address this if you feel that this is a significant problem for you. Your GP may be able to advise you but there is useful online advice on these matters here:
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