Bournemouth Physiotherapy
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Vestibular Dysfunction

Vestibular dysfunction is a medical term used to describe problems with dizziness and balance that are caused by damage to the vestibular system.

Your vestibular organ is located in your inner ear. In each vestibular organ there are three semi circular canals that can detect when your head moves in different directions. There are additional structures called “otoliths” which detect your orientation with respect to gravity and the movement of your head in a straight line. In addition to the inputs from the vestibular organs, your balance system also relies on information from your vision and hearing, as well as complex inputs from various reflexes and neural pathways throughout your body and brain. If one of these systems fails or is damaged then a mismatch occurs and dizziness symptoms can result.

There are many different conditions that can cause vestibular symptoms; these can be central (relating to the brain) or peripheral (relating to inner ear structures). Symptoms of vestibular impairment can include; dizziness, vertigo (the sensation of the room spinning), unsteadiness, nausea, tinnitus (ringing in your ears), nystagmus (a flicking movement with your eyes), altered balance and falls.

Some common conditions that can cause vestibular dysfunction include; Viral labyrinthitis, Benign Paroxysmal Positional Vertigo (BPPV), Ménière’s disease, vertigo of vascular origin, post traumatic vertigo. 10% of cases are related to central disorders, such as stroke or multiple sclerosis.

Diagnosis can be difficult as many of the symptoms are problematic to assess. The types of investigations needed and specialist you should see depend on your symptoms and history.

Most vestibular problems will resolve on their own with minimal treatment required, however a number will be left with residual imbalance and dizziness issues. These can be highly disabling and distressing and can severely affect day-to-day function.

Physiotherapy for Vestibular Dysfunction

Vestibular rehabilitation is based on the brain’s ability to compensate and adapt after damage. Even where damage is permanent, the body can learn to use other parts of the balance system to take over from the damaged area.

At EastCliff Therapy Centre, one of our specialist Neurophysiotherapists will give you a detailed assessment of your symptoms and triggering factors and formulation of a tailored, exercise programme to retrain your balance system. You will be progressed through the exercises at a speed that is comfortable for you and will be given information to help you deal with relapses or challenging situations.

Treatment may include:

Particle repositioning manoeuvre (Epley) – specialized movements to resolve BPPV

Exercises (eye, head/neck, Cawthorne-Cooksey)- tailored exercises to retain the vestibular system to help it adapt.

Balance retraining – exercises to improve balance reactions and further challenge the vestibular system. Often inputs from your feet and hips can take over some of the role of the vestibular organs.

Relaxation methods – anxiety worsens the symptoms of dizziness. Knowing how to remain calm can greatly reduce attacks.

Fall prevention methods – in severe cases, falling is a risk. Knowing how to avoid situations where you might fall or how to predict an attack can reduce your risk of injury and improve your confidence.

Onward referral to another specialist – if your symptoms and history suggest a cause that needs further investigation, then a referral to the appropriate specialist will be made.

If you would like any further information or have any questions then please do not hesitate to contact us.

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