Vestibular Physiotherapy and Vertigo

To understand why we use Vestibular Physiotherapy, it’s important to tackle a common question: What is vertigo?

Vertigo is a type of dizziness characterized by a sensation of spinning or a feeling of being off-balance. It is often described as a false sense of motion or a spinning room, even when there is no actual movement. Vertigo is not a condition itself but rather a symptom of an underlying problem within the balance and equilibrium system of the body.

The most common cause of vertigo is an issue with the inner ear, specifically the vestibular system, which is responsible for maintaining balance. Conditions such as BPPV, Ménière’s disease, labyrinthitis, and vestibular neuritis can all result in vertigo.

Apart from inner ear problems, other potential causes of vertigo include certain medications, head injuries, migraines, and disorders affecting the brain or central nervous system.

Symptoms of Vertigo

Symptoms of vertigo are not limited to, but can often include:

  • A spinning sensation
  • Dizziness
  • Unsteadiness
  • Nausea
  • Vomiting
  • Difficulty with coordination & balance

The symptoms may occur spontaneously or may be triggered by specific movements or positions, such as standing up quickly or looking up.

Treatment for Vertigo

Treatment for vertigo depends on the underlying cause. In some cases, the condition may resolve on its own without medical intervention. However, if vertigo persists or is too painful, patients consider medications to alleviate symptoms, physiotherapy exercises to improve balance and reduce dizziness, and maneuvers to reposition displaced inner ear crystals in the case of BPPV.

The Vestibular System: Is it Related?

The vestibular system is responsible for maintaining balance and spatial orientation in the body. While it is not always the reason for dizziness, when this system is not functioning properly, dizziness often occurs. Here are some common vestibular causes of dizziness that we address with vestibular physiotherapy:

  • Benign Paroxysmal Positional Vertigo (BPPV): When small calcium crystals in the inner ear become dislodged and migrate into the semicircular canals, which are responsible for detecting head movements.
  • Meniere’s Disease: A chronic condition characterized by recurring episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness in the affected ear.
  • Vestibular Neuritis: Inflammation of the vestibular nerve, usually caused by a viral or bacterial infection. Sudden and severe vertigo can be accompanied by nausea, vomiting, and difficulty with balance. Symptoms typically improve as inflammation subsides.
  • Labyrinthitis: Similar to vestibular neuritis but involves inflammation of both the vestibular nerve and the cochlear nerve, affecting both balance and hearing. It can cause dizziness, vertigo, hearing loss, and ringing in the ears.
  • Vestibular Migraine: A type of migraine; symptoms can be severe and may or may not be accompanied by a headache. Other common symptoms include nausea and a sensitivity to light and sound.
  • Acoustic Neuroma: A noncancerous tumor that develops on the vestibular nerve, responsible for hearing. It can cause dizziness, vertigo, and hearing loss. However, acoustic neuromas are relatively rare.
  • Cervicogenic Dizziness: A type of dizziness that is caused by dysfunction or disorders in the cervical spine (neck) or its associated structures. It is believed to result from a combination of altered sensory input from the neck and its influence on the vestibular system.
  • Persistent postural perceptual dizziness (PPPD): A disorder characterized by persistent dizziness, unsteadiness, and imbalance that is typically present for at least 3 months. It is believed to be a functional disorder of the balance system and brain’s sensory receptors. PPPD is often triggered by a previous vestibular or balance disorder. Movements such as standing up, walking in busy areas, or exposure to visually stimulating environments can worsen symptoms.

These are just a few examples of vestibular causes of dizziness. As mentioned, the Vestibular System is not always the culprit of dizziness. A proper vestibular physiotherapy evaluation is necessary to determine the exact cause of your symptom(s) so you can receive treatment that’s right for you! This is where vestibular physiotherapy at Stride’s Red Deer clinic comes in.

What is Vestibular Physiotherapy?

The vestibular system, located in the inner ear, plays a crucial role in maintaining balance, spatial orientation, and coordination of eye movements. Vestibular physiotherapy (vestibular rehabilitation therapy/VRT) is a form of physical therapy that focuses on treating disorders and dysfunctions of this system.

Vestibular physiotherapy aims to alleviate symptoms such as dizziness, vertigo, imbalance, and unsteadiness, which can be caused by the disorders mentioned above. Vestibular physiotherapy is designed to help patients adapt to and compensate for their vestibular deficits, improve balance, and enhance overall functional abilities.

Vestibular Physiotherapy Treatments

Vestibular physiotherapy is typically performed by a qualified physiotherapist who has received training in vestibular physiotherapy and vestibular rehabilitation.

The specific techniques and exercises used in vestibular physiotherapy may vary depending on the individual’s condition and symptoms, but they generally involve:

  • Canalith repositioning maneuvers: Used to treat conditions like benign paroxysmal positional vertigo (BPPV). By performing specific head and body movements, the therapist aims to reposition dislodged calcium crystals in the ear to alleviate vertigo symptoms.
  • Gaze stabilization exercises: Focused on improving the ability to keep the eyes fixed on a target while the head is in motion. They help enhance the coordination between eye movements and head movements, reducing dizziness and improving visual stability.
  • Balance training: Exercises that challenge an individual’s balance and stability with the goal of improvement. This treatment may include activities such as standing on unstable surfaces, walking on different surfaces, and performing specific movements while maintaining balance.
  • Habituation exercises: Designed to desensitize the vestibular system to motion or specific triggers that provoke dizziness or vertigo. Patients gradually expose themselves to these triggers in a controlled manner to reduce symptoms over time.
  • General conditioning exercises: In addition to specific vestibular exercises, these may be included to improve overall strength, flexibility, and endurance. These exercises can enhance overall physical fitness and functional abilities.

What Happens During a Vestibular Physiotherapy Assessment

During a vestibular physiotherapy appointment, your vestibular physiotherapist will start by conducting a thorough evaluation of your medical history, including any previous diagnoses, medications, and symptoms you’re experiencing. This is followed by a physical examination that focuses on assessing your balance, coordination, eye movements, and other relevant functions related to the vestibular system. They may also evaluate your overall strength, flexibility, and physical fitness to ensure every base is covered.

Going further, your physiotherapist may perform specific tests which include the Dix-Hallpike test or other positional tests to assess for BPPV, oculomotor tests to assess eye movements, and various balance assessments.

Based on the assessment findings, your vestibular physiotherapist will develop an individualized treatment plan designed to address your vestibular deficits, reduce symptoms, and improve your functional abilities. Don’t worry if it sounds confusing – your vestibular physiotherapist will walk you through it so you understand your condition and treatment plan!

What Happens During a Vestibular Physiotherapy Treatment

Subsequent treatment sessions will involve hands-on physiotherapy, instruction in specific exercises, and guidance on home exercises and strategies to manage your symptoms. Your vestibular physiotherapist will guide you through the exercises and techniques, ensuring proper form and progression as you improve.

Throughout the course of your vestibular physiotherapy treatment, your physiotherapist will monitor your progress and adjust your treatment plan as needed. They will assess changes in your symptoms, functional abilities, and balance to determine the effectiveness of the therapy and make any necessary modifications.

A vestibular physiotherapy appointment can vary depending on your needs, your physiotherapist’s approach, the severity of your condition, and the resources available in the clinic. However, the overall goal is to address and provide relief from your vestibular symptoms and improve your quality of life!

To see if vestibular physiotherapy might help you with the symptoms you’re experiencing, give us a call at 403-343-8891!

You can also fill out the form below or book your appointment online with Stride Physiotherapy!

Stride practitioners offering Vestibular Therapy