• Facebook - Grey Circle
  • Instagram - Grey Circle

Vertigo, Dizziness and Balance

Our vestibular rehabilitation service provides assessment and treatment for people who suffer from vertigo, dizziness and balance problems.

Our physiotherapists will listen to your particular case in detail and use specific tests and equipment (such as Video Frenzel Goggles) to assist in diagnosing your condition.

These conditions often require a multidisciplinary approach in their management and we work with medical specialist such as ENTs, neurologists, rehabilitation physicians as well as audiologists and optometrists to achieve an optimal outcome. If we feel that your condition needs further investigation we can guide you in the right direction, usually through consultation with your GP.

Anyone can suffer from vertigo, dizziness and balance problems and in many cases symptoms come on suddenly and with no obvious cause.

Vertigo

Vertigo is the sense that the environment is moving around you or that you are moving within your environment. It is most often felt as a spinning sensation. 

When you experience vertigo this is almost always a sign that you have a vestibular disorder (a problem with the inner ear or the nerve connecting it to the brain). 

Examples of vestibular disorders include BPPV, Meniere's disease, vestibular neuronitis, acoustic neuroma and labyrinthitis. Problems within the vestibular system can also be a side effect of ear surgery or certain medications. 

As well as vertigo, vestibular disorders can cause blurred/double vision and imbalance. 

People with vestibular disorders often have difficulties with;

  • looking up e.g. washing hair, hanging clothes on the line

  • lying down or turning over in bed

  • changing directions when walking

  • difficulties negotiating complex environments such as a supermarket 

Rehabilitation may include:

  • repositioning manoeuvres (e.g. Epley) to remove crystals from the canals in the inner ear (as in BPPV)

  • exercises to retrain the eyes and head to work together again 

  • desensitisation exercises using specific videos or virtual reality googles

Dizziness

The term dizziness is often used interchangeably with words such as lightheadedness and imbalance, and it differs from vertigo in that there is no feeling of movement or spinning.  

 

Dizziness can arise from a wide variety of causes including;

  • neck problems

  • side effect from medications

  • stroke

  • headaches (especially migraines)

  • postural hypotension (blood pressure drop when moving from lying/sitting to standing)

  • anxiety

  • motion sickness

  • dehydration

An under diagnosed type of dizziness is one which is arrises from the neck, namely cervicogenic dizziness. Physiotherapy management of these cases involves a thorough assessment of the neck and posture and specific hands on treatment and exercise prescription.

Motion sensitivity is another condition which can be managed within the clinic. Motion sensitivity is common and is usually not the result of a serious pathology.  In most cases simple exercises and/or education about management is beneficial.

Balance

Balance is achieved through the brain processing sensory information from our eyes, inner ear and muscles/joints. 

When we assess somebody with balance problems all of these systems are taken into account.  Specific tests are used to identify the reasons for your imbalance. Problems with balance may arise simply from weak muscles or poor proprioception (the ability of joints and muscles to identify movement) however they can also be due to a specific disorder, such as a vestibular or neurological condition. 

 

When we have diagnosed the likely cause of your imbalance we can proceed with physiotherapy management or refer you on to a medical practitioner/service better placed to help you. 

Balance retraining and lifestyle/environmental modifications are essential in reducing the risk of falling. Sometimes just choosing the right type of exercise or changing the way you perform everyday tasks is the best way to improve you balance.

Useful links

VEDA

A US based website full of information about vestibular disorders and useful resources

http://vestibular.org

Whirled Foundation

A site aimed at helping those with chronic vestibular disorders.

The site is great for simple explanations about vestibular disorders.

http://www.whirledfoundation.org/

Dizziness and Balance Disorders Centre

An Australian organisation aimed at the education and development of practitioners of vestibular rehabilitation

http://dizzinessbalancedisorders.com.au/

PT Video source: Gabrielle Pierce

A Youtube channel with videos aimed at exposing the watcher to environments that challenge ones motion sensitivity.

WARNING: Do not watch if you are motion sensitive unless it has been recommended

https://www.youtube.com/channel/UCwDX4UUxFH7BZhs2gFYw6oA