Vestibular Migraine & Decreased Sensory Perception
Do you ever get the feeling, when you’re standing on solid ground, that the floor has fallen out from beneath your feet? I used to feel this all the time. I first explained this sensation to an endocrinologist at the Cleveland Clinic (back in 2014 when I was still trying to find a diagnosis). She proceeded to test my feet– pricking the bottom with a dull needle and touching different points on my skin with a vibrating tuning fork to test my sensory perception. “So strange,” she said. What the doctor found was decreased sensory perception in certain parts of my feet— she said it was almost as though I was diabetic. Her explanation for what I was experiencing was that the nerves in my feet would simply stop sensing the ground, leaving me to feel as though it had disappeared, and that I was falling. Why was this happening? She had no clue, but at least I had an idea of what was going on.
Today, this comes into play when walking on surfaces that I can’t predict, like icy parking lots or loose boulders on a jetty. In these places, I go from walking normally to being completely incapacitated, because my feet can’t feel the ground. I have no way to tell if I’m falling or slipping! I end up holding a friend’s arm or something sturdy so I know where I am spatially. It’s the strangest thing!
What My Vestibular Therapist Recommended
My vestibular rehab therapist and I have been working on this ability for the past few weeks. Each session, he creates obstacle courses out of rocker boards, foam blocks, and balance beams, and I have to get myself from end to end while catching tennis balls and answering quiz questions like “name a vegetable that starts with letter e.” I can look at a foam block or a rocker board and predict what that surface will feel like; the rocker board is going to tilt, then eventually stop as the side hits the floor. But if I’m distracted by mental tasks of ball catching and question answering, then I can’t think about the surfaces I’m standing on. This makes things a whole lot harder and forces my body to pay attention to my sensory and vestibular inputs, rather than entirely on my visual system. (Visual over-compensation is also extremely common in vestibular migraineurs!)
Last weekend, the vestibular rehab team at Bryn Mawr Rehab Hospital (where I go for vestibular therapy in the suburbs of Philadelphia, PA) had a seminar on vestibular disorders led by Dr. Susan Whitney. Dr. Whitney is a specialist who suffers from migraine herself, and works to increase vestibular migraine awareness in the vestibular disorders screening process by teaching vestibular therapists what the red flags are in favor of the vestibular migraine diagnosis. You know, things like a family history of migraine, sound and light sensitivity during an episode, etc.Incredibly, Dr. Whitney actually mentioned the problem of decreased sensory perception in the feet during her talk on vestibular migraine! My vestibular therapist was excited to share this newfound information with me. Her solution? To use a stimulating foot massager to increase sensory perception! Dr. Whitney had a vestibular migraine patient who complained of these same sensations (or lack thereof). Her treatment for this vestibular migraineur was for him to roll his feet over a nubby dryer ball for a few minutes a couple of times per day. The nubs of the ball would stimulate the nerves in his skin, and over time, these nerves would grow and get better and better at sensory perception!
I’m a huge fan of drug-free treatments for my symptoms, so when I got home, I immediately bought myself a similar product online, which I just got in the mail today! What I got was a foot roller– a nub-covered cylinder that I could roll my feet over while sitting and working on my computer. I tried it for the first time today, and I can totally see why this would work. It’s super stimulating and makes your feet feel every little nub! I am very excited to see if this helps with my inability to walk on unpredictable surfaces, and will write another blog post in a few weeks or so to let you know if it worked. If you’d like to stay updated, you can follow my blog here.
Alternatives to Dryer Balls
If you’re not interested in purchasing anything, my vestibular therapist mentioned a free alternative foot exercise. The exercise is pretty simple– you stand up, and roll your weight onto different parts of your feet. You can start by shifting your weight onto your heels, lifting the balls of your feet off the ground. Then, you slowly roll your weight onto the outermost edges of your feet, then onto your toes, around the inside, and back to your heels. It’s a circular motion, with your right foot moving counter-clockwise, and the left foot moving clockwise simultaneously.
You can do this eyes closed or open, depending on how good your balance is. When I first tried it, I had a hard enough time doing it eyes open! Different parts of my feet had different levels of sensitivity, making the exercise somewhat challenging.