Vestibular Disorders & 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 is 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 you’re inner ear causing your symptoms, we can fix it!

The vestibular system (your inner ear) is composed of fluid, semi-circular canals, crystals, and much more. Problems can arise from each of these structures. These are caused by ear infections, injuries, tumours, aging, head trauma, 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).

Benign Paroxysmal Positional Vertigo

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 as a result of by positional changes. This includes lying down to sleep at night, rolling in bed, bending forward to tie their shoelaces, 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: Your physiotherapist can complete a simple manoeuvre to treat BPPV is treatable in 1-3 sessions!

Unilateral Vestibular Loss

A unilateral vestibular loss (UVL) can also cause vertigo initially. However, other experiences include 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. You can feel these symptoms 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 trained physiotherapist with a background in vestibular rehabilitation may be your next step for assessment and treatment of your dizziness and vertigo. Your physiotherapist will complete an 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