Will Flying Increase My Symptoms?
Patients often ask me “if I get on a plane will my symptoms get worse?” and in reality the answer is, possibly. Depending on the symptoms you are having, the mechanism behind why you are having those symptoms, and how far along you are on your recovery journey you may or may not experience any symptoms.
What Happens During a Concussion?
Most patients that present to Peak Brain Performance Centers have sustained a head injury of some sort causing damage within the central vestibular system. The central vestibular system plays an important role in knowing where we are located at in space by receiving information from the vestibular (inner ear) system, the visual system, and the proprioceptive (muscles and joints) system. Similar to working on a job site where everyone has a certain task to accomplish that contributes to the overall completion of the project, if one person is unable to complete their task, other employees must now pick up the slack in order for the job to get done. The same is true with regards to the three aforementioned systems; all three must be contributing enough information to the brain so that we know where we are located in space. Vestibular dysfunction often increases our reliance on the visual system. Because your visual, vestibular, and proprioceptive systems should work together to help you know where you are in space, when one has a dysfunction the other two need to work harder to compensate. For people with a vestibular disorder, this typically results in visual dependence, which can cause visual vertigo and visual motion sensitivity.
Visual Dependancy
When aboard an airplane particularly upon the ascend and descend when not seated next to the window you are now relying on the feedback from your vestibular system as well the pressure displaced on your back against the chair to accurately localize that you are moving. The big problem here is that most individuals who have sustained a head injury damage their vestibular system making their visual system become more dominant. Without being able to see out the window to visualize the movement of the environment as the plane moves your three systems are no longer portraying the same amount of imformation to the brain which may lead to you experiencing a symptom flare. Now for the average person this shouldn’t be a big deal because if I can’t see out of the window to visualize the aircraft moving but my vestibular system as well as my proprioceptive system are intact, then I am able to relay enough information to the brain about my location in space. The problem occurs when individuals have a vestibular injury and are also unable to use their visual system (such as when seated in the aisle), the proprioceptive system isn’t able to relay enough information to the brain about whether or not you are moving and this can lead to the provocation of symptoms.
Pressure Changes
The second possible issues one could encounter is if you are traveling with a vestibular disorder that is impacted by pressure in the inner ear as well as its fluids such as a Perilymphatic Fistula, endolymphatic hydrops, and Meniere’s Disease. According to the Association for Research in Otolaryngology—Head and Neck Surgery, ear problems are the most common medical complaint of air travelers. This is largely because changes in altitude and fluctuating pressure impact the middle ear, which is the pressure regulation portion of the ear. The ear ‘pops’ when one changes elevation in order to change the pressure and volume of air in the space between your eustachian tube and ear drum. For most people, this is temporary and popping your ear allows for air to flow through the eustachian tube, equalizing the pressure in your middle ear so it matches the pressure outside of your body. This change in pressure helps to keep your eardrum intact and maintains equal pressure in your inner ear. For most, this is just a mild irritation, but for those with vestibular disorders, this change in pressure can trigger other symptoms.
Light and Sound Sensitivity
It is also very common for individuals to struggle with light and or sound sensitivity after a head injury which could lead to you experiencing a symptom flare due to the bright lights and loud sounds aboard an aircraft. However, this subcategory of complaints can be more easily managed by simply dressing more like the cool kids and wearing sunglasses and headphones when aboard the aircraft.
Is there anything I can do?
With all that being said most if not all of these conditions are treatable and can be managed through non-pharmaceutical and non-surgical means; there is hope for you to be cruising at 30,000 feet up in the air, squeezed into that uncomfortble middle sea,t and a toddler kicking the seat behind you once again. I hope this article was able to shed a little light on the possible mechanisms behind why you may or may not experience more symptoms when aboard an aircraft as well as the importance of finding a provider who is well versed in the possible mechanisms behind your unique injury. If you or someone you love is continuing to struggle with lingering neurologic symptoms click the contact us button at the top of our page to schedule a complimentary phone consult with the doctor and find out how we may be able to help you.