Vestibular Rehabilitation at Total Balance Physiotherapy

Vestibular rehabilitation therapy at Total Balance PhysiotherapyTotal Balance Physiotherapy has been providing Vestibular Rehabiliation for over 10 years. Our certified therapists have received extensive vestibular training through Emory University in Atlanta GA, which is widely considered the highest level of instruction available in North America.

If you suffer from dizziness, vertigo, or imbalance, you may have a vestibular disorder.

This page will help you understand more about what the vestibular system is, how it can be damaged, what symptoms you may present with if you have a vestibular disorder, and how it can be treated.

Kim and Andrew Rajtek, PTs, have been certified in the treatment of vestibular dysfunction. This means they have received advanced training and have been tested and passed various competency exams.

Our clinic is equipped with the most state of the art equipment to help us in formulating a diagnosis of your vestibular disorder.

What is the vestibular system?

The vestibular system is usually referred to as a structure in your “inner ear”. However, the structure in your inner ear is just one component of what makes up the entire vestibular system.

This structure in your inner ear is what we call the peripheral portion of the vestibular system. The peripheral apparatus is really just a complex structure of fluid-filled canals and sensory organs.

The brain and muscles in the body communicate with this peripheral apparatus in your inner ear. These structures in the inner ear detect position and movement of the head and also detect the direction of gravity.

Normally we are unaware that we even have this complex vestibular system, as it functions very efficiently and automatically with no attention from us. But this system is very important, as these signals from the peripheral vestibular system make up a critically important part of the sensory information that the brain needs in order to help control balance, standing and walking. It also helps to control certain eye movements that make it possible to see clearly when we move (i.e. running, walking or turning your head).

What happens with a vestibular disorder?

If your inner ear or brain are damaged by disease or injury, vestibular disorders can result.

The most commonly diagnosed vestibular disorders include:

  • Benign paroxysmal positional vertigo (BPPV)
  • Meniere’s disease
  • Infections of the inner ear due to viruses (called labyrinthitis or vestibular neuritis)
  • Injury caused by head blows
  • Endolymphatic hydrops
  • Perilymph fistula

Other rare disorders include slow-growing tumors on the vestibular nerve (acoustic neuromas) and vestibular disorders associated with allergic or autoimmune disorders.

The most common symptoms of vestibular disorders are dizziness, unsteadiness or imbalance when walking, vertigo (sensation that the room is moving or spinning around you), and nausea. These symptoms can be mild, lasting seconds/minutes or severe, lasting days.

The vestibular system, as mentioned, interacts with many other parts of body, so your symptoms may also be experienced as problems with vision, muscles and thinking/memory.

Vestibular disorders can occur frequently and can affect people of all ages and walks of life. Dizziness and balance problems account for 5-10 % of all physician visits and affect approximately 50 % of all adults at some time. It is common in the older population, due to degeneration of the peripheral vestibular system. In the elderly population, dizziness is also associated with falls, fear of falling and loss of independence.

The causes of dizziness are varied. It may not be the vestibular system that is at fault. However, if you have been to your doctor and if vestibular dysfunction is suspected, vestibular rehabilitation may be of help.

You do not need to see your doctor prior to seeing a physiotherapist for vestibular dysfunction, as we are trained to screen, recognize the dysfunction and treat accordingly, or refer you to your doctor if we feel it is something we cannot address. However, since vestibular disorders are very intense in terms of their symptoms, most people see their physicians first.

What is vestibular rehabilitation?

BPPV rehabilitation

If the disorder you have suffered is as a result of benign paroxysmal positional vertigo, BPPV, this can be treated. BPPV is a mechanical problem with the semi-circular canals in the inner ear, and can be cleared.

Even if you have had previous treatment for this problem, which, for whatever reason, “has not worked”, a therapist who is certified in the treatment of vestibular disorders can help.

The treatment is immediate, and the results are often immediate. You will likely not require multiple follow up visits, as most cases of BPPV can be cleared with one to three treatments. However, there is a small percentage of clients that will require more treatments (for example when the problem is not just BPPV alone, and this may require further treatment to completely correct your vestibular disorders).

Viral neuritis or labyrinthitis rehabilitation

If the problem is a result of a viral neuritis or labyrinthitis, vestibular rehabilitation is an essential treatment that involves exercises to help re-train your brain to compensate for the loss of the peripheral vestibular nerve function.

Vestibular rehabilitation is a form of treatment involving specific exercises designed to:

  1. Decrease dizziness
  2. Increase balance function
  3. Increase general activity levels

Am I a candidate for vestibular therapy?

Unfortunately, vestibular rehab cannot fix all vestibular disorders. For example, Meniere’s disease does not typically respond to vestibular therapy. However, there may be a role for rehabilitation if you are suffering from dizziness or imbalance between episodes or attacks of Meniere’s.

If you have had surgery to correct an inner ear problem, therapy will also be an important part of your treatment.

It is important to note that even if we cannot treat the type of vestibular problem you have, we can certainly help form a diagnosis, and help point you in the right direction. We communicate directly with your family doctor and will assist in any way we can to help you manage the problem.

For individuals who are experiencing balance problems, there are a wide range of exercises that can be given to help improve these areas.

Will therapy help me?

If you perform the exercises correctly and faithfully, you will become steadier on your feet. Muscle tension, headaches, and fatigue will diminish. You will find that your symptoms of dizziness, vertigo, nausea, etc. will decrease dramatically, and may even disappear.