Vertigo, Dizziness and Balance
Our vestibular rehabilitation service provides assessment and treatment for people who are suffering from vertigo, dizziness and balance problems.
Vestibular Physiotherapy is a specialised area of physio requiring extensive training to be able to safely assess, diagnose and treat these conditions. During your assessment your physio will ask you a structured series of questions to gain important information about your history. They will perform a series of specific tests and where required use 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 closely 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 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). Vestibular disorders can sometimes cause blurred/double vision and imbalance.
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.
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:
re-positioning 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
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;
side effect from medications
headaches (especially migraines)
postural hypotension (blood pressure drop when moving from lying/sitting to standing)
Cervicogenic dizziness is an under diagnosed type of dizziness, arising from a problem in the neck. Physiotherapy management in these cases involves a thorough assessment of the cervical spine, 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 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.
A US based website full of information about vestibular disorders and useful resources
A site aimed at helping those with chronic vestibular disorders.
The site is great for simple explanations about vestibular disorders.
Dizziness and Balance Disorders Centre
An Australian organisation aimed at the education and development of practitioners of vestibular rehabilitation
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