June 26, 2018

Vestibular Therapy

Frequent or persistent dizziness and vertigo are commonly reported symptoms in adults and can cause significant disruption in one’s daily life. Dizziness is the sensation of lightheadedness, faintness, or unsteadiness, while vertigo has a rotational or spinning component (like motion when there is none).  Both dizziness and vertigo are usually related to dysfunction in the vestibular system, which includes the inner ear, brainstem, and parts of the brain. The vestibular system helps us balance and orients us in space, especially during movement. An estimated 35% of adults over the age of 40 have experienced some kind of vestibular dysfunction.

There are many causes of dizziness and vertigo.  Benign Paroxysmal Positional Vertigo (BPPV), the most common cause, is a result of a mechanical problem in the inner ear. A patient’s symptoms will include a false sense of spinning or flipping, that is usually triggered by something as simple as getting in or out of bed, looking up, driving, or bending over. This sensation occurs as a result of calcium carbonate crystals, called “otoconia,” dislodging within the inner ear and migrating where they do not belong.

Vestibular dysfunction also frequently manifests in problems with balance. Balance relies on the interplay of three systems: visual, sensory, and vestibular. When there are deficits within the vestibular system, the visual and sensory systems can become overly dominant. Many people become completely reliant on the visual system as the vestibular and sensory systems decline with age. Individuals can become so dominant in the visual system, that balance is completely disrupted when the lights are off or the surface is uneven. This is especially dangerous, because it increases the likelihood of falling and creating other injuries.

A patient who complains of vertigo or dizziness will receive a full evaluation from a vestibular physical therapist to diagnose the source of the symptoms and determine the best course of treatment. An evaluation consists of a thorough patient history, assessment of nerve function, vision, hearing, balance, neck function, as well as specific tests to determine if BPPV is present. Treatment for BPPV involves a highly successful procedure called a canalith-repositioning technique. Examples of this technique include the Epley or Lempert Maneuver, which usually results in resolution of symptoms within 1-3 sessions. Vestibular problems can also be improved through a carefully monitored exercise program. Physical therapists are trained to recognize more serious problems and will refer you to a doctor if needed. 90% of BPPV cases can be treated successfully, with a reduction in dizziness and vertigo, and improved balance.

Axis Sports Medicine has several physical therapists that are trained in vestibular evaluation and treatment. If you or someone you know is having trouble with dizziness, vertigo, or balance, you should call any of our clinics to ask questions or schedule an appointment.