Dizziness and Unsteadiness in Older Adults: Bristol, Bath and North Somerset

Feeling dizzy or unsteady is one of the most common complaints in later life, and it is not something you just have to live with. There is usually more than one cause, several of them can be treated, and fixing them also cuts the risk of a fall.

Why it becomes more common with age

Staying steady depends on three things working together: the balance organs in your inner ears, your eyes, and the feeling in your feet. With age, each one tends to send weaker signals. Add in tablets, blood pressure and weaker legs, and it is easy to see why so many older people feel a bit unsteady.

The common causes

• BPPV – short bursts of spinning when you lie down, roll over or look up. It is more common as we get older, and it is often fixed in one or two visits.
• Blood pressure dropping when you stand up – a light-headed, grey feeling as you get out of a chair or bed.
• Tablets – blood pressure tablets, water tablets, sleeping tablets and some others can all add to it. Ask your GP or pharmacist for a review. Do not stop anything yourself.
• The inner ear not working as well – on one or both sides, sometimes after an infection years before.
• Eyesight – cataracts, and varifocal glasses that blur the edge of a step.
• Less feeling in the feet – common with diabetes.
• Weak legs – which make every wobble harder to recover from.
• Fear of falling – which makes people stiff and cautious, and that in turn makes them less steady.

What helps

Getting the right cause treated. BPPV is treated with a simple repositioning manoeuvre. An inner ear that is not working well gets better with eye, head and balance exercises, which train the brain to cope. Blood pressure and tablets are for your GP.

Strength and balance training. Exercise that genuinely challenges your balance, done at least twice a week, is one of the best ways to cut falls. Walking alone is not enough.

Getting up slowly. Sit on the edge of the bed for a minute before you stand. Move your ankles up and down a few times first. Stand still for a moment before you walk off.

Making the house safer. Good lighting, especially at night, rails on both sides of the stairs, and no loose rugs.

What a home assessment looks at

The physiotherapist asks about the dizziness and anything else that has changed, checks your eye movements and balance, tests for BPPV, and measures your strength with simple tests such as standing up from a chair. Because they are in your home, they can also see the stairs, the bathroom, the bedroom and the route to the toilet at night, which is where many falls happen.

You end up with a clear plan: treatment on the day if it is BPPV, a short set of exercises, and practical changes around the house.

Bring the family in

If a relative is worried about you, they are welcome at the visit. It often helps for them to hear the plan and know how to help.

When to get urgent help instead

Most dizziness is not dangerous. But some is, and it needs a doctor, not a physiotherapist.

• Call 999 if dizziness comes on suddenly with a drooping face, weakness or numbness in an arm or leg, slurred speech, double vision, trouble walking or a very bad headache. These can be signs of a stroke.
• See your GP or call 111 the same day if you suddenly lose hearing in one ear, if you have a high temperature with it, or if you have fainted or blacked out.
• See your GP if you feel faint or light-headed rather than spinning, especially when you stand up. That is often blood pressure or tablets, and worth a check.

Who in the team helps

Raj does vestibular rehabilitation for dizziness and vertigo himself, and Anna also works with people who feel dizzy. Several of the team have a particular interest in balance and falls.

Home visits across Bristol, Bath and North Somerset

Home visits for dizziness and balance are available across Clifton, Henleaze, Bath, Keynsham, Weston-super-Mare, Clevedon, Portishead and across Bristol, Bath and North Somerset. You can read more about vertigo treatment in Westbury-on-Trym and Keynsham, or our guide to falls prevention for older adults.

About Raj and the My Rehab at Home team

Rajan Kurian (HCPC PH113871) founded My Rehab at Home, a team of five physiotherapists who visit people at home across Clifton, Henleaze, Bath, Keynsham, Weston-super-Mare, Clevedon, Portishead and across Bristol, Bath and North Somerset. Raj also works in the NHS as a First Contact Physiotherapist in GP surgeries and a Senior Physiotherapist in local hospitals. He works with Sophie, Fliss, Anna and Katie, whose interests include falls and balance, recovery after surgery, stroke and neurological conditions, vertigo and dizziness, jaw (TMJ) problems and rehabilitation after an amputation.

Read Raj's profile or call 01594 203707.

Please mention Mobile Physiotherapist.co.uk when you call.