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Vertigo and Dizziness

Hey there, time traveller!
This article was published 21/06/2022 (1179 days ago), so information in it may no longer be current.

Chances are when you hear the word “Physiotherapy” the first body part that comes to mind may be a knee, or a shoulder, or perhaps the low back. But physiotherapy for the ear?

Dizziness is one of the leading reasons individuals visit their physician’s office in any given year, and it can be caused by a variety of factors. A problem within the Vestibular System (balance sensors in the inner ear) is a common cause of dizziness and may cause other sensations, including vertigo, dizziness, blurred vision, nausea, disequilibrium, and poor balance.

A Physiotherapist with additional training in Vestibular Therapy can takeyou through a detailed assessment to help diagnose the cause of yourvertigo or dizziness, provide treatment to resolve or reduce your symptoms, and equip you with the exercises and education needed to get you feeling better. Your physiotherapist is an important part of your health care team, and will communicate with your physician. You can directly access privatepractice physiotherapists without the requirement of a doctor’s referral.

Two of the most common conditions that cause vertigo and dizziness are BPPV, and Vestibular Neuritis. These two different conditions have very different treatments. Other conditions that may cause vertigo and dizziness include Meniere’s Disease, Canal Dehiscence, damage from certain medications, or even from dysfunction in your neck.

SO HOW CAN VESTIBULAR PHYSIOTHERAPY HELP?

BPPV (Benign Positional Paroxysmal Vertigo) is a condition in which tiny crystals in the inner ear become dislodged and shift into the semi-circular canals where they do not belong. Movement of the head into certain positions may cause these crystals to move through the canal, resulting in a sensation of vertigo. Common triggers of vertigo related to BPPV are positions such as lying flat in bed, rolling over in bed, bending forward, and tipping the head backwards. BPPV is treated with an exercise called a “canalith repositioning maneuver” which involves moving the head through a series of positions to help guide the crystals out of the canal and back in to place. There are a variety of maneuvers that may be used, depending on which semi-circular canal is affected. A physiotherapist trained in vestibular therapy will use specialized equipment called Frenzel goggles to determine which ear, and which canal is affected. Sometimes, individuals are directed to “look up a maneuver on Youtube” to treat BPPV themselves. This may be challenging, as it is important to know which ear and which canal is affected in order to effectively treat BPPV. Most cases of BPPV can be effectively treated in 1-3 sessions with a series of simple exercises without the requirement of medication.

Vestibular Neuritis or Labyrinthitis (inflammation of the balance nerve or balance and hearing nerves) are also common causes of vertigo. Vestibular Neuritis is most often caused by a virus in the inner ear. While sometimes an individual will have recently had a cold or flu which triggers the Neuritis, more commonly this condition will seem to occur “out of the blue”. Vestibular Neuritis/Labyrinthitis is typically characterized by 1-3 days of sudden, intense and constant vertigo. An affected individual will often also experience vomiting, have difficulty walking due to imbalance, and generally need to stay in bed. As the inflammation subsides the vertigo improves, although the individual will often continue to feel dizzy or woozy with head movement, experience motion sickness with some visual stimuli, and generally demonstrate poor balance. These symptoms usually fade over the course of several weeks, but in some cases the brain struggles to “re-calibrate” itself and the symptoms persist. Vestibular Rehabilitation exercises help to re-set your system, reduce dizziness, and improve balance function. Vestibular rehab often involves eye and head movements (gaze stability exercises), balance exercises, and habituation exercises to reduce the dizzy signals your brain is producing.

Vertigo, dizziness, and problems with your balance can be very frightening and debilitating, and greatly affect your quality of life. A Vestibular Physiotherapist can help clear your head, reduce your risk of falling, and get you back to your life!

Aynsley Fraser Kiernicki is a Vestibular Physiotherapist at Physiotherapy ‘n Balance. You can find Aynsley and many other great physiotherapists in the find a physiotherapist section of our website www.mbphysio.org.