I have very severe tin­nitus and I find lots of exer­cise very dif­fi­cult because I have prob­lems with my bal­ance and dizzy spells. I have a hula hoop but even that can put me off bal­ance at times. Have you any other sug­ges­tions?

Professional think­ing about how to cope with tin­nitus has changed a lot in recent years. Rather than just labelling it an inex­plic­able and incur­able con­di­tion, many phys­i­cians encour­age suf­fer­ers to try and reduce the intrus­ive effects by learn­ing how to repro­gramme the way their brains deal with the noises. If you haven’t already done so, check out the inform­a­tion at two web­sites, the British Tinnitus Association and the Tinnitus and Hyperacusis Site to get lots more tips and self-​help advice on this phe­nomenon.

The rela­tion­ship between your tin­nitus and the other prob­lems – dizzi­ness and poor bal­ance – may be quite com­plic­ated. Our bal­ance con­trol organs live in our inner ears, but although there are lots of con­nec­tions between hear­ing and bal­ance, they are sep­ar­ate sys­tems.

If you have had the tin­nitus badly for a long time, you may have assumed that the dizzi­ness and bad bal­ance are just part of the con­di­tion. But this isn’t neces­sar­ily the case: there are many causes of dizzi­ness and poor bal­ance – and in most cases the effects can be reduced or cured. I strongly sug­gest that if you have not yet done so, you ask the GP to help you get your dizzi­ness and poor bal­ance invest­ig­ated by appro­pri­ate spe­cial­ists. You may have developed an inner-​ear prob­lem that can be put right.

You should also be aware that many med­ic­a­tions – or spe­cific com­bin­a­tions of drugs – can cause dizzy, off-​balance symp­toms. A simple change of med­ic­a­tion (eg blood pres­sure pills) can bring a dra­matic improve­ment.

Once you have had your “ves­ti­bu­lar” (bal­ance) sys­tem invest­ig­ated, you will gain a clearer idea as to what kinds of exer­cise are essen­tial, help­ful or to be avoided. You might, for instance, qual­ify for refer­ral to a spe­cial “strength and bal­ance” pos­tural sta­bil­ity course of exer­cise, which run in many areas of the coun­try now as part of the government’s efforts to reduce falls among older people. These classes will teach you how to sharpen your bal­ance and cope with dizzi­ness.

I don’t think the hula hoop is a great exer­cise option for you – it can be quite dizzy-​making at the best of times! However, there is one kind of exer­cise that stands a good chance of help­ing all of your prob­lems as well as provid­ing an over­all con­di­tion­ing workout, and that’s tai chi. Excellent for bal­ance, tai chi also pri­or­it­ises breath­ing con­trol and co-​ordination, which in turn pro­motes relax­a­tion. Many tin­nitus suf­fer­ers find it hard to relax, so this is a real bonus.

You might also try an aqua­cize class (water aer­obics). The chest-​level water will sup­port you when you lose your bal­ance and the fact that these classes are ener­getic, very noisy and a lot of fun may also be a wel­come dis­trac­tion from the tin­nitus.