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Vestibular Physiotherapy

Vestibular Physiotherapy covers presentations and pathologies associated with vestibular organs in our inner ear. A problem with the vestibular system usually results in dizziness, vertigo, lightheadedness and even disorientation.

 

A more well-known condition is the dislodgement of inner ear crystals (otolith / otoconia), which would result in vertigo (often described as room spinning).

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Other conditions can arise due to hydrostatic pressure changes, compression of nerves which supply the vestibular organ, disruption to blood supply to the organ and the brain (stroke) or pathologies associated with the brain.

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An important role of the Physiotherapy during the early stages of an episode is to exclude the possibility of more concerning causes such as a Stroke.​

Benign Paroxysmal Positional Vertigo (BPPV)

also known as

Vertigo due to "Ear Crystals"/Otoliths

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BPPV is one of the most prominent conditions that causes vertigo. Usually associated with head movements, people report that the world or the room is spinning even as they are sititng or laying still.

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The inner ear organ consists of three canals:

- Horizontal

- Anterior

- Posterior

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There are specific Physiotherapy tests to locate where the otoliths have been displaced so that corrective movements can be performed to return them to where they belong.

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In treatment sessions for BPPV, patients would usually report significant improvement in the first session for vertigo.

Meniere's Disease

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Meniere's Disease is one other leading cause of balance issues associated with the vestibular organ. The mechanism of the condition results in alteration of the viscosity of the peri-lymphatic fluid which results in pressure changes in the inner ear organ.

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Symptoms of Meniere's Disease:

- intermittent hearing loss on one side / both sides (could also be attributed to a high sodium diet)

- sensation of 'fullness' in the ears

- balance issues, usually presenting with a bias to one side

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Research evidence has proven Physiotherapy to be helpful in managing Meniere's Disease with Vestibular Rehabilitation.

Cervicogenic Dizziness also known as Neck-related Dizziness

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Dizziness can arise out of musculoskeletal conditions that affect the neck and shoulder region, such as:

  • Whiplash from trauma or motor vehicle accidents

  • Poor posture resulting in increased muscular tone in the neck

  • Increased sensitivity in neck muscles

 

Treatment for this could involve:

  • Soft tissue release

  • Dry needling

  • Retraining neck muscles to adjust posture to reduce load on over-sensitised areas

Mal de Debarquement Syndrome

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A sensation that one is still on a boat or in a car even after disembarkment for an extended period of time.

This usually happens when a patient has been in a car or on a boat for an extended period of time.

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It is normal to feel unbalanced right after alighting from a boat or a car as the vestibular system is adjusting after being in a state of constant movement.

However, if the symptoms persist days after disembarkment, this indicates that there is interference in the vestibular system.

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