Our vestibular rehabilitation physios Ben Fairfax, Alex Umbers and Simon Johnstone treat people suffering from vertigo, dizziness and balance problems.
This area of physio requires 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 and symptoms. They will perform a series of specific tests and where required use equipment (such as Video Frenzel Goggles) to assist in diagnosing your condition and guiding treatment.
Our physios work closely with medical specialist such as ENTs, neurologists, rehabilitation physicians as well as audiologists and optometrists to achieve an optimal outcome for our patients. You do not need a referral to come and see one of our vestibular physios. Part of their assessment process is to rule out conditions that may require imaging or further medical investigation. If they are concerned, they will refer you to your doctor.
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 it is typically 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 also 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
- motion sensitivity/motion sickness (especially from moving the head)
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
- desensitisation exercises using specific exercises, videos, virtual reality googles etc.
Examples of vestibular disorders include;
- BPPV
- Meniere's disease
- vestibular neuronitis
- acoustic neuroma
- labyrinthitis
- Mal de Debarquement Syndrome
Problems within the vestibular system can also be a side effect of ear surgery and certain medications (such as antibiotics).
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.
Dizziness can arise from a wide variety of causes including;
- neck problems (cervicogenic dizziness)
- side effect from medications
- stroke
- headaches (especially migraines)
- postural hypotension (blood pressure drop when moving from lying/sitting to standing)
- anxiety
- motion sickness
- dehydration
Cervicogenic dizziness is an under diagnosed type of dizziness, arising from a problem in the neck. Physiotherapy management in these cases involves an assessment of the cervical spine, specific hands on treatment and exercise prescription.
Balance
Balance is achieved through the brain processing sensory information from our eyes, inner ear and muscles/joints.
When we see somebody with balance problems we use specific tests to look at each of these systems in order to identify the cause(s) of 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.
Physiotherapy management will be focused on balance retraining and lifestyle/environmental modifications. Ensuring we have good balance and mobility during our everyday activities is essential to reduce the risk of falls.
Useful Links
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.
An Australian organisation aimed at the education and development of practitioners of vestibular rehabilitation
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
