Get Sick In The Car? Let’s Talk About Motion Sickness!
Do you struggle with getting sick in the car or while shopping in a grocery store?
If so, vestibular physical therapy is for you!
These problems arise from having what is called Visual Motion Sensitivity. Were you aware that physical therapy could help with this? This is one of the many conditions that we treat at Rebalance Physical Therapy. Our office is located in Upstate Greenville, South Carolina and our goal is to help you reclaim the activities you avoid due to the fear of getting symptoms of dizziness.
What Is It?
Motion sensitivity is more of an umbrella term that gets several diagnoses thrown under it. But at its core, visual motion sensitivities come from a mismatch of information between the visual system and the vestibular system in the inner ear. To understand the relationship between these two systems, let’s zoom out and talk about balance as a whole. We can stand tall, walk, run and so much more because three systems are communicating to tell you where you are in space. These three systems are the visual system, vestibular system, and the somatosensory system. They all work in harmony to keep you upright. So going back to motion sensitivity, if your visual system is telling you one thing while you are moving and your vestibular system is telling you another, there is a mismatch and as a result you will become dizzy. If this miscommunication is not corrected and compensation can no longer take place, a dysfunction can occur.
What is the difference between motion sickness and motion sensitivity?
A good way to tell the difference between the two is do you get sick even if you are not the one moving? Motion sickness involves being in a moving vehicle such as a car, train, bus, rollercoaster, plane, etc. On the other hand, visual motion sensitivity can be an issue even when you are not moving due to how long your visual system has had to compensate for your inner ear (vestibular system). This can look like symptoms of dizziness and unsteadiness while scanning in a grocery store, being in a crowded space like a concert or watching fast sequence action movies. These two conditions show how a weakened vestibular system can start affecting your everyday life such as always having to sit in the passenger seat progressing to always being the one driving or having to online shop to avoid going into the grocery store.
How does it work?
We have a reflex in our body called the VOR, the Vestibular Ocular Reflex. In the simplest terms, this reflex is able to keep the image of what your eyes are seeing “in the correct position” while your head is turning. The science behind this is fascinating and involves several things such as the central nervous system, eye muscles, and the different organs in the vestibular system. In our previous blog, we discussed a little of the vestibular apparatus in regard to Benign Paroxysmal Positional Vertigo (BPPV). Those same otolith organs and semicircular canals are firing with different head and body movements. The otolith organs fire with linear acceleration, so if you are driving in a car and you slow down or speed up, those organs are firing. In contrast, the semicircular canals fire when we deal with angular motion such as turning your head to look over your shoulder while driving. If these organs are not firing correctly or the information is not matching up with what our eyes are seeing, motion sickness can occur.
What are Risk Factors for Motion Sensitivities?
There are many reasons why someone would develop visual motion sensitivity. Some have pre-existing conditions such as concussions, whiplash disorders from car accidents, head injuries, previous vestibular disorders and so many more. These pre-existing conditions can exist for years before the onset of symptoms.
Diagnosis and Treatment for Motion Sensitivities
We want to bring awareness to these two diagnoses because they CAN be treated, and you do not have to live in fear of getting sick every time you drive in a car or go into a crowded area. Diagnosis involves testing balance as a whole and seeing how the three systems are firing and if compensation or dependency on one of the systems is occurring. An extensive test of your vestibular and visual system will take place to assess the vestibular ocular reflex, dynamic visual acuity, and fixation blocked assessment of your eyes to get a full picture of what can be treated. Treatment is individually curated for each patient based on what is found, but overarching treatment will include retraining the vestibular system in multiple environmental situations to mimic real life activities. Unlike BPPV, this treatment takes time (approximately 4-6 weeks) to see a difference as the vestibular system is learning to fire and the visual system is becoming less dominant. Our goal is to get you dizzy free and fear free to move as you like and as you need!
