Balance is an autonomic function with inputs from the eyes, ears and somatosensory, and is regulated by the brain stem. Balance disorders which produce dizzyness can arise from miscommunication of any of these components. If you've addressed the eyes and ears without solving the problem, look to the brain stem. Various factors can contribute to its dysfunction, including chronic inflammation. If you have neck issues, that may be irritating the brain stem. Consider Low Level Laser Therapy targeting the brain stem and the neck (muscles and bones) using 810 nm and 908 nm Near Infrared Wavelengths. This therapy is safe and backed by an overwhelming amount of scientific research. It is also cost effective, I paid $25/session at my selected facility.

Also, with vestibular loss can arise a disorder called visual-vestibular mismatch. This is treated with compensation techniques and physio that involves habituating to the motions that trigger symptoms.

I would consider the brain stem first. If that produces no results then dig deeper with the VVM. I've had success with both.

Thank you Mark and Hains

Yes, I have been doing some vision related exercises in vestibular rehab and have recently started vision-specific therapy with a special optometrist. I am going to keep up with this and see if it helps.

Hains - I am interested in the low level laser therapy for the neck. Is there a website or organization that can help one find a practitioner that does this? How did you find your practitioner that helped you? How are your symptoms now?

My Naturopath has a unit in-house. However, in my research a came across a product locator (Google search Theralase Clinic Locator, I can't post links).

I use the Theralase TLC 900-CH which is a multi-laser unit that uses 660nm (red) and 908 nm (NIR). There are other similar products. The important parameters are wavelength and power settings. The 810 nm wavelength is also beneficial, so I wouldn't discriminate against it if you find something of the sort nearby.

I linked my insomnia and dizzyness back to my brain stem, hence the suggestion. I'm half way through my initial 10 session treatment plan and have noticed a significant improvement in sleep and my dizzyness has pretty much stopped. Additionally, my neck feels looser after every session. All this has happened since starting the LLLT treatment.

I can't say for sure that this is the miracle pill because i am also doing myofacial release, VVM excercises, breath training (Wim Hof), and Vielight Intranasal Infrared, concurrently. However, since starting the Theralase treatment I actually feel like my PCS is coming to an end (after 20 months), so I definitely endorse the product and treatment.

Hains - thank you, that is great information. I'm glad you have found things that help you! Just one more question - is cold laser the same thing as LLLT? I see a lot of PTs and Chiros that say they do cold laser but it doesn't necessarily say "LLLT".

CatOhio - yes it takes a great deal of patience! Keep up the good work! Some days are better than others, but I try not to ever give up hope. It sounds like you are doing a lot of good things. I would say keep up with the vestibular and vision therapy. It can take a long time and progress is slow, but I believe it helps a lot of people. Acupuncture also really helped me with anxiety, stress and some of the dizziness and neck issues too.

Take care

Hi all,

Glad I am not alone in this, but I know it is brutal. Could be worse of course, but this really has me angry/depressed/slow! I need to update my history too.

Wanted to run something by everyone...I had been doing behavioral optometry, but not much progress, ( I do have prism lenses for work). Then pursued another PT (after insurance denying both PT and speech therapy).

Recently resumed Carrick chiro since not seeing improvement for nearly 2 yrs. Sorry for all the history- my question relates to vision and vestibular therapy.
I am now being told that the gaze stabilization needs to precede vestibular rehab.
Does anyone have any experience/input on that?

Thanks,
Grace

RRC,

The key issue with laser or LED near infrared therapy is wavelength. 800 to 1000 nm wavelength is suggested as best.

I have a ReVive system that cost about $80. I used it for weeks on a shoulder to help with recovery from surgery. Unfortunately, it caused such an increase in inflammation that I had to stop using it. I only used it for 15 minutes 2 or 3 times a day.

Some will try to say low level laser (gas laser) is better than LED/laser diode near-infrared but both are the same if they put out the same wavelength. It is a matter of the physics of light. The research shows no difference.

Different wavelengths provide different benefits so be sure to get a deep tissue wavelength. 390 to 600 nm for skin repair and 800 to 940 nm for deep tissue. By deep tissue, the maximum depth is only 4 mm or 0.4 cm Some claim a penetration depth of 40 mm but the US NIH research says 4 mm is the deepest penetration.

Not sure how to explain my situation but I will attempt.

I don't always feel stable but I have no evidence to prove I am not. I am doing activities that require balance again and all seems ok, yet it never quite feels like I am solid.

Not really sure if I am making it up or I actually feel off but I certainly don't feel like the old me, I try to ignore it.

Bud

Yes, Cold Laser and LLLT are interchangeable terms.

My research differs slightly from Mark's (below). You need to focus on 2 variables: Wavelength and Power. I mentioned 660nm, 810nm, and 908nm as the specific wavelengths confirmed as therapeutic in the scientific literature. Power output is what controls the depth of penetration into the body. The scientific literature suggests that LED lights are effective but do not penetrate as deep as lasers. Therefore, lasers are more effective for large muscles, hard tissue and brain injuries. An LED will never penetrate the skull, but a laser with a high, but safe, power output (eg. 75-100mW) has a chance.

In your research you will come across varying units. Wavelengths, an expression of light, are usually measured in nanometers (nm), different wavelengths have different effects on the body. mTBI and whiplash treatment research suggest 660nm, 810nm, and 908nm. Power, the electrical output of the device projecting the wavelength, is measured in Watts (W) or milliWatts (mW). Power density (mW/cm2) is the power output per area (cm2; metric measurement), which is the coverage on your body. Energy, measured in Joules (J), is Power(w)*Time(s). Energy density (a.k.a dosage), is measured as (J/cm2). Some people will debate the appropriateness of the energy density measurement, just ignore the conversation as it will not help with your recovery. Rather, the unit you select should come with some kind of treatment protocol. Stick with that as it was approved by the manufacturer.

Also note that exceeding the recommended treatment times will cause overheating of the area and will result in inflammation, negating any therapeutic effects. I made this mistake early on. Please learn from my mistakes.

I actively use the following protocols, and am finding them to be effective. They may not be the best, but with my resources I have refined my treatment to this:

Brain Stem via back of the skull, through the cerebellum: 908nm, 60 seconds, 75mW, 1.13mW/cm2.

Neck (hard tissue): 908nm, 180 seconds, 60mW, 2.7mW/cm2.

Neck & Upper back (soft tissue): 908nm, 180 seconds, 50mW, 2.25mW/cm2.

I totally disagree based on the NCBI.NLM.NIH website and basic physics. Power output relates to the amount of area that can be treated. There is a limit to the power per area (milliWatts/square centimeter) that can be safely tolerated. This varies by the wavelength. Think sunburn. The power per area is limited to 10 to 20 times the power of noontime sun, depending on the wavelength.

Wavelength relates to depth of penetration. Light wavelength is well known as related to penetration of an object. Long wavelength infrared light will pass through glass but short wavelength ultraviolet light will not. Again, think sunburn. UVA/UVB sunblock prevents short wavelength light from penetrating the skin and causing damage. It does not stop long wavelength so you still feel the warmth from the sun.


PubMed Central, Figure 2: Semin Cutan Med Surg. 213 Mar; 32(1): 41–52.



The primary difference between a Laser Diode and LEDs is the focus of the energy. Lasers transmit the light in a narrow beam. Some LD systems use multiple beams to cover a larger area. Lasers were originally developed for therapeutic uses because they were the only way the wavelength could be controlled

LEDs transmit the light in a wider spray.

The laser system manufacturers have been trying to distort the facts to maintain sales as LED systems have become available at affordable purchase for home prices. But, the research shows LED's to be just as effective. Laser systems have higher power outputs that require more technical understanding of the therapy protocols so as to not cause harm. This higher power means a treatment can be shorter. Home LED systems require more time.

But, only the therapist benefits from the time savings as the therapist can treat more patients during each day. The patient has to drive to the appointment, wait, get treated, settle the bill and drive home and schedule these treatments around a daily schedule of life.

So, for me, a home LED system was the choice. Unfortunately, my shoulders have had chronic inflammation problems for 40 years and stimulating healing causes an increase in blood flow increasing already bad inflammation. As my surgeon said, I have angry shoulders but he can't see what is causing them to be so angry.

I have not tried my system on my upper neck but based on recent neck struggles, I am considering it.

Here is an interesting study about NIR penetration.
Near-IR light penetrates skull to aid traumatic brain injury - Laser Focus World

Ok. Thank you Mark and Hains for all of the great info. Some of it is a little to technical for me though, and it goes right over my head

It sounds like you all bought your own LLLT unit and are doing it at home? I don't feel like I have enough knowledge about it to do that. Any practical advice on what to look for in a practitioner that can treat me with LLLT? So each treatment will only last a few minutes?