Physiotherapy for Vertigo and Dizziness

Matthew Wright-Smith and Cory Graham are trained in vestibular rehabilitation therapy and offer various remedies and treatments for vertigo and dizziness depending on the cause and diagnosis. If you live in Langley or Greater Vancouver and are looking for a professional vestibular rehabilitation therapist, contact HealthX today!

What is Vertigo and is There a Treatment For it?

Vertigo or Dizziness is a condition where a person experiences a false sensation of spinning or swaying, making them feel as if they or their surroundings are moving without any actual movement. Vertigo usually stems from inner ear problems, as our sense of balance is dependant on three inputs of our sensory system: the eyes, sensory nerves, and inner ear. Your eyes work to determine spatial awareness, your inner ear detects gravity and motions, and your sensory nerves send signals to your brain that translate as body movement and positions. Vertigo occurs when the signals from your inner ear are inconsistent with what your eyes and sensory nerves are collecting, resulting in confusion in your spatial awareness. Depending on the cause and diagnosis, Vertigo is treatable through a type of therapy called Vestibular Rehabilitation.

What is Vestibular Rehabilitation?

Vestibular Rehabilitation Therapy is an exercise-based program that treats issues patients may have with vertigo and dizziness. The treatment has been developed to help patients improve their balance and spatial issues to reduce their feelings of dizziness, with the ultimate goal of strengthening their vestibular system.  Treatments will vary depending on the diagnosis but may involve specific positioning maneuvers to drain crystals in the inner ear, or you may require a series of exercises such as Habituation, Gaze Stabilization, or Balance Training.

What Are The Potential Benefits of Vestibular Rehabilitation?

• Decrease in dizziness and headaches
• Improvement in balance and confidence to maintain balance
• Decreased risk of frequent falling
• Improved ability to stabilize your gaze
• Increased body strength and confidence
• Return of prior level of movement and function
• Improved neck motion, reduced pain symptoms

What are the Symptoms of Vertigo/Dizziness/Altered Balance?

If you think you suffer from Vertigo or Vestibular System Damage, you may experience the following symptoms:

• Spinning
• A feeling of being unbalanced or pulled to one direction
• Tilting
• Swaying
• Ringing in the ears
• Nausea & vomiting

Vertigo, dizziness and balance problems account for about 5-10% of all physician visits. It is also the number one reason for physician visits in those over 65 years old. Vestibular physiotherapy can help diminish dizziness and balance problems, and its treatment efficacy can be determined within 3-4 visits. This treatment utilizes careful assessment, specialized techniques and specific vestibular rehabilitation exercise.

What Causes Vertigo and Dizziness?

As previously mentioned, inner ear problems are the most common cause of Vertigo and Dizziness. Other common causes are as followed:

VESTIBULAR SYSTEM INNER EAR (LABYRNTH)

BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder arising in the inner ear which is caused when a collection of calcium particles collect in the inner ear canals. Its symptoms are repeated episodes of positional vertigo – a spinning sensation caused by changes in the position of the head. BPPV is the most common cause of the symptoms of vertigo. Assessment and treatment can lead to a complete recovery in one physiotherapy visit for unilateral BPPV. More complex presentations will require follow up treatment.

VISUAL (EYES) AND CENTRAL INTEGRATION (BRAIN)

VESTIBULO-OCULAR REFLEX (VOR)

We see with our brain not with our eyes. The brain interprets electrical signals via the optic nerve and vestibular system and uses reflexes to maintain our position in space. The most common reflex is the VOR. The VOR uses eye movement that functions to stabilize gaze by countering movement of the head. In VOR the semicircular canals of the inner ear measure rotation of the head and provide a signal for the oculomotor nuclei of the brainstem, which innervate the eye muscles. The muscles counter-rotate the eyes in such a way that a rightward head rotation causes an equal leftward rotation of both eyes, with the result that gaze direction stays stationary. Any delay or deficit of the vestibulo-ocular reflex will cause a mismatch within the entire vestibular system and cause a feeling of dizziness, swaying or light headedness. Some patients report the feeling of standing on a ship at sea. Assessment and treatment for a dysfunctional VOR can significantly improve these symptoms dramatically.

PROPRIOCEPTIVE INPUT: SKIN, MUSCLES, JOINTS

Our Musculo-skeletal system contains a multitude of complex receptors that provide information to the Central Nervous System (Brain) abut our position in space to maintain balance. Neck stiffness and tightness can cause a mismatch in signals and visual data between the neck receptors and the vestibular system. Turning the head rolling over in bed can trigger the mismatch and cause symptoms of vertigo, dizziness or feeling unbalanced. Treatment of tight neck joints and muscles through manual therapy and IMS is very effective for reducing the mismatch and achieving equilibrium between the vestibular systems.

NECK PROPRIOCEPTION (JOINT POSITION SENSE)

Any deficit or delay in proprioception can lead to a mismatch in sensory nerve integration within the vestibular system leading to dizziness and balance issues. Although the integration is quite complex, patients displaying a reduction in cervical proprioception have improved their symptoms with specific exercises designed to retrain the neck proprioceptive system. While treatment effects are not as dramatic as those for BPPV, with time and persistence patients can significantly reduce and sometimes eliminate their persistent dizziness.

If you are in need of treatment, schedule an appointment with one of our trained therapists today.

Meet Your Therapists