Vestibular Physiotherapy (Dizziness Physio)
Dizziness is a common issue in the general population. It is estimated that at least five percent of the Australian population (over one million people) will experience dizziness at some point in their lifetime. There are a number of causes of dizziness which a qualified Vestibular Physiotherapist can help assess for and manage.
What is the Vestibular System?
- Dizziness or Vertigo
- Headaches
- Nausea
- Reduced balance
- Vision or hearing disturbances
- Benign Paroxysmal Positional Vertigo (BPPV)
- Vestibular Neuritis
- Vestibular Migraine
- Acoustic Neuroma
- Meniere’s Disease
- Persistent Postural Perceptual Dizziness (PPPD)
- Post Concussion Syndrome
How can physiotherapy help with dizziness and vertigo?
Vestibular physiotherapy can be a very good option for treating symptoms of dizziness and vertigo, especially if these symptoms are triggered or aggravated by movement. In many cases dizziness that is worse with movement is caused by a disorder involving the inner ear (vestibular) system. Research has shown that vestibular physiotherapy is highly effective in treating vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), viral infection of the inner ear (vestibular neuritis) and vestibular migraine (a form of migraine that causes vertigo and dizziness with or without symptoms of headache).
Your trained vestibular physiotherapist would conduct a comprehensive assessment of your dizziness and vertigo, and, in many cases, would be able to establish the cause for your symptoms and provide you with the most appropriate treatment pathway.
- Habituation exercises: These exercises involve specific movements that are designed to gently stimulate the symptoms of dizziness in order to desensitize the vestibular system to those movements. These are designed to reduce symptoms of dizziness.
- Eye-head coordination exercises: These exercises are designed to improve focus and reduce symptoms of dizziness.
- Balance and gait exercises: These exercises involve challenging the vestibular balance system in order to strengthen it. They are designed to improve balance and confidence when walking.
- Re-positioning techniques: These techniques are used for a specific inner ear (vestibular) condition known as benign paroxysmal positional vertigo (BPPV). This condition results in significant symptoms of vertigo when changing position, such as when lying down or rolling over in bed.
How effective is physiotherapy for dizziness and vertigo?
There has been lots of research over the past 25 years which provides evidence to support the effectiveness of vestibular physiotherapy in successfully treating people with dizziness and vertigo. These studies have demonstrated reductions in dizziness and vertigo, improved function, increased balance and reduced risk of falling following vestibular physiotherapy.
There are a number of factors that affect how long a vestibular physiotherapy program will take and these include: how long you have been dizzy, how regularly you do the vestibular exercises, how significant the symptoms of nausea are, how many other medical problems you have and the presence of any emotional or psychological issues.
BPPV is a specific inner ear (vestibular) condition that occurs when small calcium carbonate particles break loose within the inner ear. This can occur without reason or associated with an isolated incident. The particles can move into the wrong part of the inner ear and cause significant symptoms of positional vertigo when lying flat or rolling over in bed. Techniques such as the Epley manoeuvre can successfully treat BPPV and can be performed by physiotherapists with specific skills in this area. These techniques are highly successful in treating BPPV.
How long until you improve?
Vestibular physiotherapy for the treatment of dizziness and vertigo can be highly successful but time frames can be difficult to determine. Most people need to be doing the vestibular exercises in a safe environment for 3–4 weeks before they feel any significant improvement. Reductions in dizziness and improvements in balance generally occur within 4–6 weeks.
Treatments for conditions such as BPPV are also highly effective, and generally only 1–3 treatments are required if the techniques are performed by physiotherapists with specific skills in vestibular physiotherapy.
Concussion Rehabilitation
Concussion is a mild traumatic brain injury that is caused by an acceleration and deceleration force to the head and neck complex. Concussions can occur when your head is hit by a moving object or your head hits a stationary object. Some concussions don’t require an actual hit to the head and are due to rapid movement of your head and neck through space.
Injury to your brain tissue occurs due to a shear force where the nerve tissue is stretched and the membrane that lines the nerve is altered. This causes a number of chemical responses which leads to an energy crisis in your brain and a variety of symptoms. Most people recover completely, however some people have persistent symptoms (>14 days). There is also a vulnerable period after your concussion injury during which time re-injury could be harmful long term. You should seek advice from a practitioner specifically trained in concussion care before returning to activity or sport.
Symptoms that can occur following a concussion include:
- Dizziness, vertigo & imbalance- Cognitive changes: Brain fogginess, difficulty concentrating or slowed processing
- Sleep disturbances
- Increased sensitivity to light or sound
- Mood changes: Irritability, depression, anxiety
- Neck pain & stiffness
- Headaches & migraines
- Visual changes
Optimal concussion rehabilitation requires a thorough assessment, accurate diagnosis of the contributing factors and collaborative care between health care providers. Early intervention with various treatment strategies can improve recovery and ensure safe return to work, school and sport.
Rehabilitation may include:
- Education on concussion and recovery
- Vestibular and visual retraining
- Graded exercise prescription
- Neck treatment
- Graded return to play, school and work recommendations
At Offshore Physiotherapy Torquay, some of our team have completed extra training in concussion assessment and rehabilitation and are here to help guide you through your concussion recovery journey.