Vestibular Disorders and Rehabilitation
Dizziness…it can mean many different things to many different people. Is it light-headedness, floating, swaying, imbalance, rocking or spinning (better known as vertigo)? Your definition of dizziness can help your doctor and/or physiotherapist determine what the cause of it is. Causes are many, and may include, but are not limited to, medications, health conditions such as blood pressure issues, or vestibular system problems which are your inner ear and part of your balance system. If you have checked in with your doctor and your health and medications check out, check in with your physiotherapist to see if it’s your inner ear causing your symptoms…we can fix it!
The vestibular system (your inner ear) is composed of fluid, semicircular canals, crystals, and much more. Problems can arise from each of these structures caused by ear infections, injuries, tumours, ageing, head trauma (car accident, falls, impact sports, strokes, brain injuries), illness or disease, medication, blood flow problems or insidiously. People often present with dizziness and/or vertigo when the vestibular system is affected. The two most common vestibular disorders are benign paroxysmal positional vertigo (BPPV) and unilateral vestibular loss (UVL).
BPPV is a common cause of vertigo (the sensation of you spinning, or the room spinning around you). The most common complaint of those with BPPV is vertigo brought on by positional changes such as lying down to sleep at night, rolling in bed, bending forward to tie their shoe laces, or looking up. BPPV happens when crystals in the inner ear are ‘out of place’ and travelling through the canals. The causes of BPPV include head trauma, specific trauma to the vestibular apparatus (such as an inner ear infection), or insidiously (just because). Now the good news…BPPV is treatable in 1-3 sessions with a simple manoeuvre that can be completed by your physiotherapist!
A unilateral vestibular loss (UVL) can also cause vertigo initially, however, is often paired with nausea and/or vomiting with any and all movements, and unsteadiness. It often comes on quickly and without warning, with severe symptoms lasting a few days. After the initial week, symptoms often settle down and for most people have no lasting symptoms as the brain compensates for these changes. Others, when the brain has poorly compensated, will continue to have mild symptoms, often including unsteadiness, dizziness, or a catching up sensation when turning the head. These symptoms are pronounced when walking, going grocery shopping or in large crowds. When symptoms persist beyond one week after the initial event, the brain needs help to compensate requiring specific exercises to aid in recovery.
In all cases of dizziness or vertigo, proper consultation is important to determine the exact cause of your symptoms. After ruling out specific medical issues or medication side effects, seeking out a physiotherapist who is trained in vestibular rehabilitation may be your next step for assessment and treatment of your dizziness and vertigo. Your physiotherapist will complete and in depth assessment to help determine the cause of your symptoms, and provide treatment and/or home exercises to reduce your symptoms.
Antonio Zenone
Physiotherapist
Trailside Physio